The physical therapy clinic launch plan
Every step from deciding to opening, in the order it happens, shaped to your situation, with your own numbers beside it. About 50 steps in 8 phases, 21 of them specific to a physical therapy clinic. Free to read; ticking steps off and putting in your own numbers come with membership.
The plan50 steps
- 01Not started0/6Fold
Decide with the numbersa week or two
Before a dollar is spent. Most expensive mistakes happen here, and this phase costs nothing.
A PT clinic makes money one visit at a time, and the order you grow the mix decides your .
Typical for one unit is $400,000 to $2,000,000 a year; the owner keeps 12 to 22% of it before paying themselves. If that band does not cover what you need, that is the signal to pause and look again.
~50-60% survive 5 years. Roughly half of new U.S. businesses reach five years.
Twelve questions about your money, time, experience and temperament, scored. Then the 5 questions this business asks of its owner, about the hours and the work. Answer both before you spend a dollar.
Rule of thumb: if you can buy a clinic with diversified referrals, a healthy payer mix, and therapists likely to stay, buying buys you the credentialing and the referral network, the slowest parts... Answer it in your situation above and the plan reshapes.
Customers, prices, rent, staff pay, what it costs to open. We filled in typical numbers; change what you know and everything on this page follows.
- 02Not started0/5Open
Plan the moneya week
What it costs to open, where the money comes from, and the cushion that keeps you alive until the business pays for itself.
A PT clinic is moderately capital-intensive: most of the money goes into the treatment-space , therapy equipment, and a cash reserve to float support-staff through the...
The itemized cost to open9 lines
- Build-out, drawings & permits: $63,000 to $261,000Open gym, private treatment rooms, ADA restroom; about $30 to $80 a sq ft
- Treatment tables, mat table & modalities: $11,000 to $61,000Electric hi-lo tables, e-stim and ultrasound, hot packs
- Gym & exercise equipment: $11,000 to $39,000Recumbent stepper, treadmill, parallel bars, weights and balance gear
- Evaluation tools & opening supplies: $3,000 to $10,000Goniometers, dynamometers, bands, tape, electrodes, linens
- Laptops, front desk & security: $5,000 to $23,000A laptop for each therapist to document at the table, check-in desk, network
- Signage & referral launch: $7,000 to $33,000How referring doctors and patients find you
- Credentialing, insurance & legal: $11,000 to $29,000Payer credentialing for each therapist, first-year insurance, entity and lease review
- Lease & utility deposits: $8,000 to $18,000Security deposit and utility hookups
- Initial working capital: $100,000 to $250,000Payroll and float on receivables while credentialing and referrals build; the default plan sets aside about $244k
Costs start on day one; customers take months. Map the first twelve months of cash so the business does not run out of money while it is getting going.
The business has to earn your pay like any other bill. Set it in your numbers and watch the month it move.
How deals in this business are financed4 lines
- SBA 7(a) loan (Up to 10 yr (25 with real estate) · partly government-guaranteed)The workhorse for buying an existing PT clinic or funding a startup’s buildout and working capital.
- Seller financing (Often 5-25% of price · 3-7 yr)Common when buying a clinic.
- Equipment financing (Secured by equipment)Finance therapy tables, modalities, and exercise equipment, secured by the assets themselves.
- Working-capital line of credit (Revolving · bridges A/R)A revolving line to float support-staff payroll and bridge the gap between delivering visits and collecting on claims, useful given the lag in a reimbursement business.
Most new shops pair an with 10 to 20% of your own cash. Know the monthly payment before you look at a single space.
Before you shop. A lender tells you what they would fund, what they need from you (credit, your cash in, a plan with numbers), and a pre-qualification letter makes a landlord or a seller take you seriously.
- 03Not started0/4Open
Set up the companya day or two
A day of paperwork, and it has to come before the space: a lease, a loan application and every permit are in the company’s name.
Your state’s business name search, the trademark register, and the domain, before the name is on a sign, a van, or a lease.
A , an , and the S-corporation election each change what you keep and what you are exposed to. Compare them with the numbers, confirm with a CPA and an attorney, then file with your state.
After:The is free from the IRS in minutes once the company exists. The bank account needs both. Keep business money separate from day one.
After:Pick the accounting software and connect the bank account now, so every cost of opening is captured and the numbers you later are real.
- 04Not started0/5Open
Find and secure the spaceone to three months
A PT clinic draws from a local catchment fed by physicians and surgeons.
What decides it for this business: dense physician & surgical referrers nearby, adequate population & catchment, favorable payer mix, aging or active demographics, not oversaturated with clinics.
One call to the planning desk with the address: is this use allowed there, and what will it take (, permits, fire sign-off)? A space that needs a change of use can add months.
Rent, free months for the , who pays for what, the and the renewals, subject to financing and permits. The lender needs this letter or a draft lease to take your application.
After: ,, renewal options, increase caps, what the landlord adds on top of rent, and what happens if you have to leave. For a location business the lease is part of the purchase price.
After:at minimum; property, workers’ compensation and the rest as the business needs. The landlord asks for a certificate at signing and the lender at closing.
- 05Not started0/2Open
Get the loanfour to eight weeks
Four to eight weeks with an SBA lender, longer if the file is incomplete. Everything else waits on this, so send a complete file.
Your plan with numbers (download it as a PDF from this page), the company’s papers, the or draft lease, the and equipment quotes, your personal financial statement, and proof of the cash you put in.
After:The lender approves against the ; you sign the lease once approved; the loan closes against the signed lease and the insurance certificate. Ask for the to match the or longer.
After:
- 06Not started0/13Open
Permits and the build-outone to three months
A PT clinic is a licensed clinical business: a licensed physical therapist must deliver the care, and you bill insurers, so licensing, credentialing, and compliance are real barriers, and a moat.
Bind the policies you had quoted before a contractor, a vehicle or a customer is in play. Keep the certificates; the landlord, the lender and the city will ask.
After:Your contractors pull the building, plumbing, electrical and mechanical permits and close them out by inspection. Hold the free rent months for this.
After:Most cities approve exterior signs separately; signs take weeks to make. Order early.
Register your or professional corporation and obtain a city or county operating license.
With your state, before the first taxable sale. Usually free and online; check your state.
The treating therapist (and the clinic where ) must be licensed by the state PT board to deliver care.
Enroll and credential with commercial payers and Medicare to bill for visits.
A National Provider Identifier and Medicare enrollment are to bill federal payers.
Professional liability and coverage are to treat patients and often to credential.
Patient-data privacy and security policies, training, and safeguards are mandatory for a clinical practice.
The treatment space must meet building, fire, and accessibility codes for a clinical setting.
Fire-marshal review of exits, extinguishers and load, after the build and before the .
After:The city’s sign-off that the space is approved for this use. You cannot open the doors without it.
After:
- 07Not started0/10Open
Set up to runduring the build
During the build, so the business runs from day one: the systems, the prices, the people and the routine.
The backbone: scheduling, plan-of-care documentation, and clean claim capture in one place.
Submits clean claims, works denials, and keeps days in A/R low.
Getting credentialed with commercial payers and Medicare is what lets you bill at all.
You deliver hands-on clinical care.
See the price the the business needs implies, then check it against what the market pays.
Federal plus state employer, withholding, and workers’ comp once you hire therapists and support staff.
After:Wages are the start: , insurance, training time and the hours you stop billing. Owners usually post the jobs a month out and hire two to four weeks before opening so training happens before the doors open.
Early morning: Front desk confirms the day: verify benefits and authorizations,... Daytime: Therapists run back-to-back visits: evaluations, treatment sessions,... Plan-of-care checkpoints: Therapists reassess against the plan of care: is the patient...
Opening, closing, the sale, the complaint, the cash. One page each. This is the manual a franchise would have sold you.
Free, and it is how most people will find you. Address, hours, photos and the menu or price list, live before opening day; then the sign, the soft opening and the first regulars.
- 08Not started0/5Open
Open and measurethe first ninety days
You own it. Now run it on the numbers.
Friends, neighbors and a short menu or list. Find the problems while the room is forgiving.
Enter the real numbers and see every cost line against the for this business.
Therapist compensation & utilization; Support-staff burden; Reimbursement compression.
Growth consumes cash before it produces it. Find the rate your own cash funds before you push.
PT clinics are sellable assets, and well-run multi-location groups draw private-equity-backed consolidators.