Practice and business management is integral to building a successful pain practice for the benefit of our patients. This chapter will review key aspects of business and practice management for pain medicine fellows, including differences in practice settings, e.g., academic or private practice, billing for services including professional and facility fees, and Current Procedural Terminology (CPT®) and Evaluation and Management (E/M)-based billing. Importantly, this chapter will also address topics to prevent or address physician burnout, to ensure a rewarding professional career for our fellows.