For licensed clinicians
Helping kids get back to being kids.
Cartwheel.
Here's what it's really like to practice at Cartwheel.
Exploring
School-Based Therapist
Cartwheel Health
Primary license state
We'll show accepted licenses for your state
School-Based Mental Health 100% Telehealth K–12 1099 Contractor
89%
Clinical Retention
After reaching full caseload
Placeholder
4.8★
Clinician Satisfaction
Avg platform rating
Based on internal surveys across active clinicians — rated on clinical support, flexibility, and day-to-day experience.
350+
School Districts
Across the US
And growing every semester. Cartwheel expands to new districts as demand for school-based mental health increases.
100%
Telehealth
Work remotely — within your licensed state(s)
No commute, no in-person requirements. Cartwheel is a fully remote practice. Remote work is subject to state licensing requirements. Clinicians must hold an active license in each state where they provide services. Telehealth-specific requirements vary by state — your recruiter can confirm what applies to you.
What sets Cartwheel apart
This is what supported looks like.
Most practices hand you a caseload and wish you luck. Cartwheel does something different. Through district partnerships, you'll have a thoughtfully built caseload, paid supervision for pre-licensed clinicians, optional group supervision, ongoing training, and a dedicated crisis on-call team during sessions. That's not a list of perks—it's how the model was built.
We invest in your clinical growth
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Associate-level clinicians receive individual supervision at no cost, it counts toward licensure hours, and you're compensated for your time. Beyond individual supervision, you have opportunities to participate in group supervision and be part of a collaborative clinical community with ongoing consultation and support throughout your time with us. Details on structure and frequency are in the Clinical Support tab.
Individual supervision available to associate-level licensed clinicians (e.g. ASW, AMFT, APCC) working toward independent licensure. Availability of supervision varies by state.
Clinical support — you're not in this alone
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Cartwheel wraps a full support structure around every clinician. You're backed by dedicated teams for crisis response, provider success, care coordination, and school partnerships, and are part of an active and engaged clinician community.
Impact you can see
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We partner directly with school districts and focus on access to care for all students regardless of insurance status, providing care to underserved students in communities often overlooked. Because of this, the impact of your clinical work shows up beyond symptom relief — it shows up in attendance, engagement, and day-to-day functioning.

We measure outcomes because clinicians deserve to see the difference they're making.

  • 92%of students report feeling better after working with Cartwheel
  • Clinically significant reductions in PHQ-9 and GAD-7 scores
  • 62%fewer absences through our School Avoidance Program

And because we work alongside schools and families, the impact of your work shows up in the outcomes we measure—and in the progress families and school staff get to see every day.

100% telehealth — within the United States
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Every session is remote. You provide your availability within operating hours to the Cartwheel team, and we take it from there, scheduling intake sessions during the times you provided. Clinicians must hold an active license in the state where their students are located. Some states — including New York and Louisiana — also require licensure based on where the clinician is physically located. State licensing requirements vary and are subject to change. Your recruiter will help you understand what applies to your situation and answer any questions along the way.
High retention — and what drives it
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89% of Cartwheel clinicians who reach full caseload stay. We believe that's a reflection of the things that matter most: a supportive community, a manageable caseload, meaningful mission-driven work, and competitive pay. Those aren't separate benefits—they're part of a model intentionally designed to support clinicians over the long term.
You focus on care. We handle the rest.
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From credentialing and billing to scheduling, care coordination, and crisis support, we've built the infrastructure around your practice so you can focus on what matters most: caring for students.
Before you decide
A few things to know.
We want you to have a clear picture of the role—from licensing requirements to the students we serve—so you can decide if Cartwheel is the right fit.
Active clinical state license required. We take telehealth compliance seriously and stay current with state-specific licensing requirements so clinicians can practice with confidence. Your recruiter will walk you through what applies to your situation.
We invest in the next generation of clinicians. As state regulations allow, we welcome associate-level clinicians and provide Day 1 supervision to support your path to independent licensure. Role availability and compensation vary by state.
Meaningful, mission-driven clinical work. You'll care for students with a wide range of mental health needs while helping expand access to care in communities where it's needed most. Our outpatient model is designed to meet students where they are, with clear pathways to higher levels of care when needed.
Flexibility for the career—and life—you're building. There's no non-compete, and many clinicians combine Cartwheel with other professional pursuits or personal commitments. If you also work in a partner district, we'll help coordinate scheduling to avoid conflicts.
Get to know us
Who we are and how we work.
Mental Health Therapist
The role, at a glance
Everything you need to know about compensation, scheduling, caseload, and what to expect as a Cartwheel clinician.
Compensation
Select a state
1099 contractor rate
Schedule
Flexible
You choose the hours that work for you within Cartwheel's service window, with peak demand during weekday afternoons and evenings (3–8 p.m.) and Saturdays (8 a.m.–5 p.m.). We'll build your caseload around the availability you provide.
Caseload
8–14 clinical hours/week
Designed to support consistent, family-centered care while fitting alongside your other commitments.
Hiring Timeline
Rolling
Choose your state above
Language Bonus
+$5/hr for bilingual therapists.
Nearly one in four Cartwheel students receives care in a language other than English. When you can support families in their preferred language, you help make care more accessible, personal, and effective—and we recognize that impact.
Mission Bonus
1–5% of quarterly pay
Our mission bonus reflects our belief that expanding access to care is a shared mission—and one way we recognize that commitment.
Medicaid / Uninsured / Non-English % of sessions Quarterly Bonus
Under 20%+1%
20–40%+2%
40–60%+3% — most clinicians land here
60–80%+4%
Over 80%+5%
Your schedule
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You choose the hours that work for you within Cartwheel's service window (weekdays 8 a.m.–8 p.m., Saturdays 8 a.m.–5 p.m.). We'll build your caseload around the availability you provide, with the greatest demand during weekday afternoons and evenings (3–8 p.m.) and Saturdays. While you can schedule outside those peak hours, caseload growth may take longer.

Most clinicians settle into a consistent rhythm within their first few months. The minimum commitment is 8 clinical hours per week, and you can request additional hours once your schedule is established.

Because students and families rely on consistency, schedule changes require four weeks' notice. The same notice applies if you need to change hours that affect your assigned students.

During the summer, schools make very few new referrals, but Cartwheel continues operating and clinicians can maintain care for their existing caseloads.
How you get paid
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Cartwheel pays biweekly based on Care Contribution Hours (CCH), a workload-based compensation model designed to recognize the different types of clinical care you provide—not just time spent in session. Every session type has a set CCH value that's multiplied by your base hourly rate:
Session typeCCH value
Intake1.2 hrs
53+ min session1.0 hr
38–52 min session0.75 hrs
16–37 min session0.5 hrs
Parent guidance (26+ min)0.5 hrs
Family therapy with patient (26+ min)0.75 hrs
No-show / late cancel0.5× original
Timely documentation helps ensure continuity of care and accurate billing. Notes signed within 72 hours are compensated at your standard rate; after 72 hours, they're compensated at a flat $25 per note.
What a typical week looks like
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Once Care Coordination schedules your first intake, you manage your ongoing schedule in Healthie while Cartwheel continues supporting coordination behind the scenes. A typical week includes:
  • Individual therapy sessions (typically 53 min each)
  • Intakes for new students (typically 53 min each)
  • Parent guidance sessions
  • Collaboration with families and school staff to support student progress
  • Timely documentation (notes within 72 hours) and treatment plan updates every 90 days to support high-quality, coordinated care
  • Coordinating care with Cartwheel psychiatric providers when appropriate
  • Navigating higher-acuity clinical moments with support from our crisis on-call team (available weekdays and Saturdays, with urgent responses in under 10 minutes)
Clinical supervision
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Associate-level clinicians receive individual supervision at $25/hour, fully paid by Cartwheel, with frequency based on weekly clinical hours:
Weekly hoursSupervision
0–15 hrs/week1 hr/month
16–20 hrs/week2 hrs/month
21+ hrs/week4 hrs/month

Clinical growth doesn't stop at licensure. While associate-level clinicians receive individual supervision, all clinicians have access to optional group supervision and opportunities for consultation with peers and clinical leaders.

Your clinical population
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You'll support Pre-K–12 students and their families across a wide range of mental health needs in diverse school communities, helping expand access to care for students who have historically faced barriers to mental health services.

For Pre-K–2 students, clinicians typically provide parent guidance to caregivers, with psychiatry consultation available when appropriate. Individual therapy begins in 3rd grade. Most students work with Cartwheel for 12–24 sessions on average, with extensions available when clinically appropriate.

While you'll encounter crisis situations and complex clinical presentations, Cartwheel's model is designed to provide high-quality outpatient care, with clear pathways to higher levels of care when students need services such as PHP or IOP.
What we expect clinically
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Therapeutic relationships first
Students and families rely on you to be a steady presence. Consistency is central to effective care.
Collaboration beyond the session
Partnering with caregivers and school staff is essential to supporting each student's progress.
Same-day safety planning
When indicated, safety planning happens the same day so students and families leave with a clear plan.
95% on-time session starts
Families coordinate around school and work schedules. Showing up on time builds trust.
Documentation within 72 hours
Notes completed and signed within 72 hours keep records current, billing accurate, and care coordinated for everyone on the student's team.
How quality works here
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We use our Quality Snapshot to support consistent, high-quality care across five areas: safety planning, therapeutic alliance, on-time session starts, parent and caregiver engagement, and school collaboration. Clinicians receive a score from 1–5, with 3.0 representing our baseline and 3.5+ reflecting strong performance.

If scores fall below 3.0, we start with a conversation about what's getting in the way and what support would be helpful. Quality monitoring is part of how we practice at Cartwheel because students and families deserve consistent, high-quality care, and clinicians deserve the support and feedback to deliver it.

Most clinicians find that, after working with the Quality Snapshot, it becomes a valuable tool for reflection, coaching, and professional growth.

Compensation figures and hiring timelines are current as of April 2026 and subject to change. Your recruiter will confirm the latest details before any offer is extended.

Up next
See how the process works
From recruiter screen to first session — what to expect at each step →
Who's in your corner
You won't be doing this alone.
From your first day to your hundredth session, Cartwheel builds a support system around you—clinical guidance, administrative support, and a collaborative community—so you can focus on caring for students.
For supervised clinicians
Supervision is included — and paid.
If you're working toward independent licensure, Cartwheel invests in your growth with structured individual supervision at no cost to you—and pays you for your time. Beyond individual supervision, all clinicians are invited to participate in optional group supervision and ongoing clinical consultation.
Rate
$25/hour
Paid by Cartwheel for your time
Frequency
Scales with hours
0–15 hrs/week → 1 hr/month
16–20 hrs/week → 2 hrs/month
21+ hrs/week → 4 hrs/month
What it includes
  • Supervisor review and co-signature of clinical documentation
  • 1:1 supervision focused on your clinical work and development
  • Optional group supervision and case consultation
  • Counts toward base pay and licensure requirements
1:1 supervision is available to associate-level clinicians working toward independent licensure. Optional group supervision is available to all clinicians and does not count toward Care Contribution Hours.
Your support team
The people in your corner.
Clinical Community
Clinical support looks different depending on where you are in your career. Associate-level clinicians receive structured individual supervision, while independently licensed clinicians can schedule consultations with clinical leaders whenever they need guidance. All clinicians have opportunities to connect with peers, participate in optional group supervision, join employee resource groups, and be part of a collaborative clinical community. Together, it's a support system designed to help you keep growing—because wherever you are in your career, you'll have a team around you.
Day-to-day support
  • Onboarding specialists to help you get started with confidence
  • Provider Success for payroll, scheduling, and day-to-day questions
  • Cartwheel Helpdesk for technology and system support
Clinical guidance
  • Clinical Quality experts who provide coaching on documentation, care workflows, and best practices
  • Drop-in consultation hours with experienced clinical leaders
  • Wheelie AI, your 24/7 clinical resource
Crisis support
  • Dedicated crisis support available during clinical sessions
  • Urgent response within 5–10 minutes
  • An experienced on-call clinician stays with you throughout the situation
The work can be challenging. Feeling alone shouldn't be part of it. That's why we've built a support system you can rely on when it matters most.
Community
You're connected from day one.
You'll have questions—and you won't have to figure them out alone. Whether it's a clinical question, navigating the platform, understanding a billing process, or simply wanting a second opinion, there's always someone to turn to. Our goal is simple: connect you with the right person so you can stay focused on caring for students.
Clear boundaries support great care.
Because we partner closely with schools and communities, we've built clear policies around conflicts of interest to protect therapeutic relationships while making these situations straightforward to navigate.
Current district employment: If you currently work for a district Cartwheel serves, you'll automatically be prevented from being assigned students from that district.
Previous district employment: If you previously worked in one of our partner districts, it's generally not considered a conflict, though some districts may request additional restrictions. We review those situations case by case.
Existing relationships: If you're assigned a student you already know personally—or have another potential dual relationship—you can request reassignment to ensure appropriate clinical boundaries.
Up next
See how the process works
From recruiter screen to first session — what to expect at each step →
The interview process
Know exactly what to expect at every step.
Three conversations designed to help both of us determine whether Cartwheel is the right fit. We'll be getting to know you, and we hope you'll use each step to get to know us, too. Click any stage to see prep tips and questions to ask.
30m Stage 1
Recruiter Screen
Recruiter
What we'll cover
  • Your clinical background and what you're looking for in your next role
  • Licensure, supervision needs (if applicable), and state-specific logistics
  • Compensation, scheduling preferences, and availability
  • An overview of Cartwheel and time for your questions
How to prepare
  • Know your license type, state(s) of licensure, and whether you'll need supervision on your path to independent licensure.
  • Come with a sense of your ideal weekly clinical hours, comp expectations, and general availability.
  • Bring any questions you have about the role, team, or interview process—we want this to be as informative for you as it is for us.
Questions to ask
  • "What do clinicians find most rewarding about working at Cartwheel?"
  • "What support do new clinicians tend to lean on most during their first few months?"
  • "How can I optimize my schedule to build a caseload quickly?"
  • "What should I prepare for in the clinical interview?"
30m Stage 2
Clinical Leader Interview
Clinical Leader
Expand →
What we'll cover
  • Your clinical background and experience
  • How you approach assessment, treatment, and clinical decision-making
  • A clinical scenario to understand your reasoning
  • How you collaborate with families, schools, and other providers
  • Time for your questions about the role and clinical support
How to prepare
  • Come ready to discuss a few specific clinical experiences—concrete examples help us understand how you think and practice.
  • Be prepared to talk through a clinical or crisis scenario. We're more interested in your clinical reasoning than finding the "right" answer.
  • Familiarize yourself with Cartwheel's school-based care model and think about how you approach collaboration with families, schools, and other providers.
Questions to ask
  • "How is clinical supervision and consultation structured at my license level?"
  • "What does day-to-day collaboration with school counselors and caregivers look like?"
  • "How do you handle escalations when a clinician is mid-session?"
15m Stage 3
Offer Call
Recruiter
Tap to see what the offer covers →
What we'll cover
  • Your compensation and state-specific rate
  • What to expect from onboarding and your first few weeks
  • The Independent Contractor Agreement (ICA) and time for your questions
  • Next steps and anticipated start timeline
Compensation
Rate is based on your license type and state.
Independent Contractor Agreement (ICA) review
You'll have time to review everything before signing. The ICA is the agreement that formalizes your engagement with Cartwheel.
What to know
  • After you sign, we'll guide you through every step of onboarding. Most clinicians begin within 6–8 weeks, depending on their state, license type, and anticipated referral timing.
How long does the whole process take?

Most candidates move from initial recruiter conversation to an offer within 1–2 weeks. Once you accept your offer, onboarding and your start date typically take 6–8 weeks, depending on your state, license type, referral timing, and any specialized skills (such as bilingual language proficiency). In some states, anticipated referral demand may result in a later start date. Your recruiter will keep you informed throughout the process.

Do I need school-based experience?

No. While school-based experience is a plus, it's not required. What matters most is strong clinical judgment, experience working with children and adolescents, and an interest in collaborative, school-based care. We'll provide the training and onboarding you need to be successful in our model.

What does the clinical scenario question look like?

Expect a crisis or complex clinical vignette — often involving suicide risk, family dynamics, or collaboration with a school team. They're not looking for a perfect answer; they're interested in understanding your clinical reasoning, how you think through risk, and how you approach collaboration. Think out loud.

Can I negotiate the offer?

Compensation is standardized based on licensure, state, and other role-specific factors. Your recruiter will be transparent about how rates are determined and what flexibility, if any, is available.

What happens if I don't pass the clinical interview?

If we don't think the role is the right fit, we'll let you know promptly. When appropriate, we may encourage you to reapply after gaining additional experience. Our goal is to provide clear, constructive feedback whenever possible.

What's in the ICA I should watch for?

The Independent Contractor Agreement (ICA) formalizes your engagement with Cartwheel. It covers topics like your compensation, expected weekly session range, termination notice (typically 30 days), confidentiality, and credentialing. You'll receive the agreement in advance, have time to review it carefully, and your recruiter will walk through any questions before you sign.

Practice with Copilot
Run a mock clinical interview
The Copilot can give you a scenario question and honest feedback on your answer →
AI Assistant
Not sure if Cartwheel is right for you?
Ask anything — about the role, compensation, day-to-day work, the interview process, or whether your license may qualify.
M
Hi — I'm your Copilot. I'll give you straight, honest answers about Cartwheel, the clinical interview process, and what to expect. No hype.

Please don't share personal health information in this chat. Copilot isn't designed to receive or store health-related information — your recruiter is the right contact for sensitive or personal questions.

Copilot can answer general questions about Cartwheel's clinical roles and credentialing process. It can't access your application status or provide feedback on your candidacy — those updates will come directly from your recruiter.

After you sign
From signature to your first student.
Offer signed → first day and onboarding
6–8 weeks
Depends on state, license type, and niche skills (like language)
Full in-network status
3–6 months
Caseload grows as insurance payers clear you
We've designed onboarding to set you up for long-term success—not just get you started quickly. Credentialing, training, and payer enrollment take time, so onboarding may be longer than at some other practices. We want you to know exactly what to expect every step of the way, so there are no surprises.
Why it takes longer at Cartwheel
Most organizations credential with a handful of large national insurance plans or use delegated credentialing to get clinicians seeing patients more quickly. Cartwheel takes a different approach. We credential with Medicaid and state-specific payers because our mission is to expand access to mental health care for students who have historically faced the greatest barriers to care.

That means onboarding can take longer—but it also means clinicians can care for more students and families, regardless of how they're insured.
Before you start
Within 24–48 hours
You'll receive a welcome email and your Cartwheel account setup will begin. Your recruiter and our People Ops team take it from here. They'll guide you through each step, so you'll always know what's coming next.
Within 72 hours
You'll receive your credentialing survey along with a clear checklist of everything you'll need to complete it. We ask that you submit it at least 45 days before your start date to help keep your onboarding on track.

The sooner you submit it, the better. Early submission helps protect your start date and may allow you to begin receiving referrals sooner as you're credentialed with additional insurance plans.
Two weeks before start
You'll complete your clinical schedule form and your background check will begin automatically. One thing to note: your background check link expires after 7 days, so we recommend completing it as soon as it arrives.
Weekend before start
Your work account activates, and your Cartwheel email goes live about 5 days before your start date so you have time to log in and get oriented before Day 1.
Your first three weeks
Day 1 — Start date
Welcome to Cartwheel! You'll meet your clinical leader, have the option to attend new clinician orientation, and gain access to your scheduling, video, and communication tools. Your asynchronous onboarding begins, and if your state has additional onboarding requirements, we'll guide you through them.
Within 3 weeks of start
Once your training, state-specific requirements, and credentialing milestones are complete, you'll begin seeing students.

Most clinicians start with 8–14 Care Contribution Hours per week, gradually increasing as additional insurance payers complete credentialing.

In some situations, when there's an urgent clinical need, you may begin seeing students before full credentialing is complete. Your compensation is not affected.
Pay — you're covered from day one
Once you're cleared to begin seeing students (typically within your first three weeks), you'll be paid at your full rate regardless of which insurance plans have completed credentialing. Cartwheel absorbs that timing difference, so your compensation is never tied to when a specific payer processes reimbursement.

You'll be paid biweekly (every other Friday), and you'll receive a $500 onboarding stipend in your first paycheck after completing onboarding within three weeks of your start date.
State-specific requirements
Some states have additional onboarding or credentialing requirements before you can begin seeing students. If any apply to you, we'll guide you through each step, let you know exactly when it needs to happen, and make sure you have what you need to stay on track.

Select your state above to see any requirements that apply to you.
Select your state above to see state-specific requirements.
Credentialing survey — gather these items in advance
You'll receive your Credentialing Survey within 72 hours of signing. To help keep your onboarding on track, we recommend gathering these items ahead of time. The survey should be completed at least 45 days before your start date.

You'll be asked for:
Active state license
Government-issued photo ID (driver's license or equivalent)
Social Security card
Resume / work history
Professional headshot
Education credentials
Therapy specialties / areas of focus
Disclosure information (completed in the survey)
Having these items ready ahead of time makes completing the survey much faster and helps keep your onboarding timeline on track.
How long does credentialing take?

From signing your offer to your first day typically takes 6–8 weeks, though timing varies by state, license type, and specialized skills (such as bilingual language proficiency). Your insurance credentialing continues over your first 3–6 months, allowing your caseload to grow as additional payers are added.

Cartwheel's timeline is longer than many practices because we credential with Medicaid and state-specific plans—not just a handful of national insurance carriers. Your recruiter will walk you through the timeline that applies to your state.

What does the credentialing process involve?

You'll complete the Credentialing Survey via Verifiable, provide proof of licensure, and submit any state-specific compliance documents that apply to you. Both NPI and CAQH are required — if you don't have them, Cartwheel helps you get set up, though this could impact your start date. Our recommendation is to ensure you have an NPI and CAQH profile during the interview process ahead of a potential offer call. Cartwheel walks alongside you through every step.

Can I see students before credentialing is complete?

In most cases, you'll begin seeing students once your primary payer credentialing and any required state-specific onboarding steps are complete—often within your first 2–3 weeks. In cases where there's an urgent clinical need, Cartwheel may assign you to a student out of network before full credentialing is complete. When that happens, your pay is not affected. Full in-network status across every payer continues to build over your first 3–6 months, expanding your caseload over time.

What happens during onboarding before my first session?

You'll complete training on the technology you'll use every day, documentation workflows, telehealth best practices, and any required state-specific modules. You'll also meet your clinical leader, get to know the Cartwheel support teams, and become familiar with the resources available throughout your time here.

Do I need to be credentialed in multiple states?

No — you'll be matched to districts within your primary license state. If you hold licenses in more than one state and are interested in serving students across state lines, your recruiter can walk you through the available opportunities.

Will Cartwheel help me with credentialing paperwork?

Yes. Your recruiter, onboarding team, and dedicated credentialing specialists will guide you through every step of the process and let you know exactly what's needed along the way.

What's my role in credentialing vs. Cartwheel's?

Your role: Complete the Credentialing Survey, provide requested documentation, complete any required state-specific training, and respond promptly to requests from our credentialing team.

Our role: We handle insurance credentialing, payer enrollment, background check coordination, licensing support, and everything else required to get you ready to see students.

What tools will I be using?

You'll receive access to the tools you need for clinical care, documentation, communication, onboarding, payroll, and continuing education before your start date—including Healthie, Slack, Zoom, and other role-specific systems. We'll introduce each platform during onboarding, so you don't need to learn everything ahead of time.

When will I start getting paid?

You'll be paid biweekly (every other Friday), beginning with the first full pay period after you're cleared to see students. If you complete onboarding within three weeks of your start date, you'll also receive your $500 onboarding stipend in your first paycheck. Your compensation is never dependent on insurance reimbursement.

Does my pay change as insurance payers clear me?

No. Your hourly rate is established from your first session and doesn't change as additional insurance payers complete credentialing. Cartwheel matches you with students whose insurance you're already approved to serve.

What if I have questions during onboarding?

You'll never be expected to figure things out on your own. Your recruiter, onboarding team, credentialing specialists, clinical leader, and Provider Success team will guide you through each step and let you know what's coming next.

One phrase you'll hear often at Cartwheel is, "Never worry alone." That starts well before your first session.