Guides
Physical therapy rates that pay the bills and then some for owner-operators
How to price physical therapy services for a fair margin: a floor-then-ceiling sequence for the cash fee schedule, the contract checks, and the discount rules.
What to take away
- Physical therapy rates that pay the bills in a typical mid-size US metro in 2026: evaluations $175 to $225, standard treatment visits $125 to $160, extended visits $175 to $220, assistant-delivered visits $100 to $125, and remote check-ins $60 to $90.
- A fair margin is one you can explainthe fee covers what the slot costs to deliver, including the documentation nobody sees, and leaves a stated amount over.
- Set the cash fee in a fixed orderthe cost floor per slot, then the market ceiling, then the contract check, then the discount rules. Most fees are set in the reverse order.
- A worked example puts the floor near $107 for a 60-minute slot and near $132 for a 75-minute evaluation slot, so the posted fee carries the margin on top.
- The evaluation is the fee most often set too low, because it is priced as one visit rather than as the start of a plan.
- Discounts are a policy with criteria and an owner, or they are a leak.
Step one: the cost floor per slot
Take one therapist's week. Count the hours they are paid for. Subtract the hours that cannot be sold: documentation, meetings, breaks, and the supervision minutes an assistant needs. What remains is sellable slot-hours.
Cost floor per slot
- Count paid therapist hours
- Subtract unsellable hours
- Divide fixed costs by sellable slot-hours
- Add variable cost and therapist cost
- Divide by expected delivered slots
Now price them. A salaried therapist earning $80,000 to $105,000 in most metros, with benefits near 20%, costs roughly $96,000 to $126,000 loaded. At 30 sellable slot-hours a week over 48 working weeks, that is 1,440 slot-hours. Therapist cost per slot-hour: about $67, or up to $88 at the top of the range.
Add the month's fixed costs and divide by the sellable slot-hours across all therapists. Rent, front desk, billing and software in a small clinic often run $10,000 to $14,000 a month. Three therapists at 1,440 hours each give 4,320 hours to carry that. At $12,000 a month, fixed cost per slot-hour is about $33.
Add the variable cost of a visit: $5 to $10 for supplies, laundry and billing fees. The floor for a 60-minute treatment slot lands near $105 to $110. A 75-minute evaluation slot carries fifteen minutes more, so its floor sits near $130 to $140.
Medicare's published rates follow the same math. Under the 2025 Physician Fee Schedule, one 15-minute unit of therapeutic exercise (97110) pays roughly $30 to $40 depending on locality, so four units land near $120 to $160. Evaluations (97161 through 97163) pay roughly $75 to $130 by complexity and location.
Two corrections most owners skip:
- Divide by the slots you expect to deliver, not the slots you have. If one in ten scheduled visits is not delivered, the fixed cost is carried by fewer visits and the floor rises about 11%.
- Time the documentation. The occupational outlook page from the Bureau of Labor Statistics on physical therapists lists record keeping as part of the job for a reason. If it happens after hours it is still a cost.
Step two: the market ceiling
Look at what other practices in your area post publicly for the same visit types. That is information a patient has, so you should have it too. Cash-pay clinics in most US metros post initial evaluations between $150 and $300 and follow-up visits between $95 and $200.
Market ceiling check
Is the market ceiling below your floor?
Cost per slot too high or too few slots delivered
Set fee between floor and ceiling
Do not discuss fees with competitors. Posted prices are fair to read; agreements are not. A posted price tells you what a practice asks. It does not tell you what the practice collects or what its slots cost. The ceiling limits what patients will accept. It does not set your target.
Three national models show where buyers already shop. Luna Physical Therapy sends therapists into homes and bills per visit. Hinge Health and Sword Health sell virtual musculoskeletal care to employers and health plans, usually on a per-member-per-month fee rather than a per-visit fee.
If the ceiling is below your floor, the fee is not the problem. Either the cost per slot is too high, or the slots delivered are too few, and the supporting article on most profitable physical therapy services shows which line is carrying the cost.
Step three: the contract check
Before a cash fee is posted, read each payer contract for what it says about charging their members. A cash fee for a covered service that is lower than the member's share under the plan can raise contract and compliance questions. Some programs have their own rules on what may be charged to their beneficiaries.
Contract check before posting
- Read each payer contract for charging rules
- Check if cash fee is below member share
- Review program-specific beneficiary rules
- Consult a compliance adviser with contracts
Medicare is the clearest case. A provider who has not opted out must bill Medicare for covered services, so cash collection on those services is not an option. Opting out runs two years and requires private contracts with patients.
This is a question for a compliance adviser with the contracts in hand, not for a colleague. The licensing and compliance guide lists where each rule lives. The pricing and profit guide explains why the allowed amount is a price you accept rather than set.
Step four: the fee schedule
Write it by visit type, and put a number on every line. The schedule the front desk quotes should be short enough to read aloud.
Fee schedule by visit type
Visit type
- Evaluation
- Assessment, plan, first treatment, written plan
- Treatment visit
- Standard-length session with therapist
- Extended visit
- Longer session where clinically indicated
- Assistant-delivered visit
- Session under supervision
- Remote check-in
- Short remote session inside a plan
- Program or package session
- Session inside a self-pay program
What it includes
- Evaluation
- Floor for longer slot plus plan share
- Treatment visit
- Floor for standard slot
- Extended visit
- Floor for longer slot, not multiple
- Assistant-delivered visit
- Floor including supervising therapist's minutes
- Remote check-in
- Floor for short slot; check telehealth rules
- Program or package session
- Program's own build
Set from
- Evaluation
- Treatment visit
- Extended visit
- Assistant-delivered visit
- Remote check-in
- Program or package session
| Visit type | What it includes | Floor the fee must clear | Typical posted cash fee, mid-size US metro, 2026 |
|---|---|---|---|
| Evaluation | The assessment, the plan, the first session's treatment if given, and the written plan | About $130 for a 75-minute slot, plus plan-writing time | $175 to $225 |
| Treatment visit | A 60-minute session with a therapist | About $107 | $125 to $160 |
| Extended visit | A 75 to 90-minute session where clinically indicated, not a multiple of the standard fee | About $130 to $155 | $175 to $220 |
| Assistant-delivered visit, where the board allows | A 45-minute session delivered under supervision | About $80 plus the supervising therapist's minutes | $100 to $125 |
| Remote check-in | A 20 to 30-minute remote session inside a plan; check the board's telehealth rules first | About $55 | $60 to $90 |
| Program or package session | A session inside a self-pay program, in the packaging article on this site | The program's own build | $40 to $60 per session, or $200 to $400 for a six-week program |
Every line carries a margin above the floor that you chose and wrote down. A $150 treatment visit against a $107 floor leaves $43, about 29% of the fee, toward the owner's pay and reserve. That is what makes the fee fair: you can say what it covers and what is left.
Step five: the discount rules
Discounts destroy a fee schedule faster than any competitor. Two are common: a prompt-pay discount of 5% to 10%, and a hardship rate of 20% to 30% off the posted fee. Write both down before the schedule goes live.
- Which discounts exista reduced fee by financial circumstance, a prompt-pay rate, a program rate. Nothing else.
- The criteria for each, in words the front desk can apply without judgment.
- Who may grant each one, and who may not.
- How each is recorded, so that collections by visit type stay readable.
- Whether each is consistent with the payer contracts, checked by the compliance adviser in step three.
- What is said to a patient who asks for a discount that does not exist.
A hardship discount is expensive at the rates on this page. Twenty percent off a $150 visit cuts the fee to $120 and leaves $13 over a $107 floor.
The FTC advertising guidance for small business applies to how discounts and fees are presented: a "regular" price that nobody pays, or a discount that is always available, is a claim that has to be true.
Keeping the schedule honest
Review the fee once a year against a fresh floor calculation. Review it earlier if a payer contract changes or a therapist's documentation time changes. Keep the calculation with the schedule. A 5% increase on a $150 visit is $7.50, which is easier to defend than a $25 jump.
The IRS guidance on which records to keep expects the business to show its income and what produced it. The fee calculation connects the two.
Two people make or break the schedule. The front desk, who quotes it and applies the discount rules; the hiring and training guide puts the fee script in their first week. And whoever writes the listing and the website; the marketing and growth guide covers how a fee may be shown there.
Common questions
What margin is fair?
A common target is 25% to 40% above the floor on each visit type, about $30 to $60 on a $140 visit. That range funds a reserve, a second therapist or the owner's own pay. It is still a choice: write your number down with the reason.
Should the evaluation cost more than a treatment visit?
It takes longer and it starts the plan that fills the calendar, so pricing it below a treatment visit subsidizes the patients who never return. Posted schedules in most markets run evaluations at $175 to $225 against $125 to $160 for a treatment visit. Set it from its own floor.
Can I charge cash patients less than insured patients pay?
That is the contract question in step three, and the answer depends on what your payer agreements say. Insured allowed amounts for a treatment visit often land between $90 and $140, so a $150 cash fee can sit above the insured rate. Ask a compliance adviser with the contracts in front of them before posting anything.
How do I raise fees without losing patients?
Announce the date in advance, keep existing plans of care at the fee they started on, and explain what the fee covers. Annual increases of 5% to 8% are easier to defend than a one-time leap. Patients leave over surprises more than over amounts.
What does Medicare pay for a physical therapy visit?
Roughly $30 to $40 per 15-minute unit of therapeutic exercise in 2025, so a four-unit treatment visit pays about $120 to $160. Evaluations run about $75 to $130. Rates vary by locality and by the annual conversion factor. Medicare pays 80% of the allowed amount after the deductible, and the patient owes the rest.
