Guides
What to measure every month in a physical therapy business for owner-operators
Physical therapy KPIs owners should track monthly: ten measures with formula, source and owner, thresholds set from your own data, and what each fails to show.
What to take away
- Ten measures cover a practice's month. Each is defined below with its formula, its source and the role that acts on it.
- No threshold is given. Set each one from your own first three months of data and the practice's own targets, then move it only with a reason written down.
- Every measure has a blind spot, stated beside it. A KPI read without its blind spot is a way of being confidently wrong.
- The sheet is read once a month in one sitting, with the audit and the complaint log beside it.
The sheet
| KPI | Formula | Source | Owner | What it fails to show |
|---|---|---|---|---|
| 1. New evaluations by source | Count of evaluations delivered in the month, grouped by referral source | Referral log and schedule | Owner | Inquiries that never became evaluations |
| 2. Referral-to-evaluation days | Days from referral arrival to evaluation date, per referral, reported as a distribution by source | Referral log | Front desk lead | Patients who gave up before booking |
| 3. Delivered visits per therapist per week | Visits delivered divided by weeks worked, per therapist | Schedule outcomes | Owner | Whether the slots were the right type |
| 4. Cancellation and no-show rate by reason | Visits not delivered divided by visits scheduled, grouped by recorded reason | Schedule outcomes | Front desk lead | Cancellations the front desk rebooked without recording |
| 5. Planned visits delivered | Visits delivered divided by visits in the plan of care, per plan closed in the month | Schedule and record | Clinicians | Why the patient stopped |
| 6. Notes signed same day | Notes with signature date equal to visit date divided by all notes, per therapist | Record timestamps | Each clinician | Whether the note met the payer's standard |
| 7. First-pass claim payment rate | Claims paid without rework divided by claims submitted, by payer | Billing | Biller | Underpayment on claims that were paid |
| 8. Patient share collected at visit | Patient share collected at check-in divided by patient share due, by visit | Billing and payments | Front desk lead | Balances that were later written off as uncollectable |
| 9. Collected per delivered visit by payer | Total collected for the month's visits divided by visits delivered, by payer, once remittances are in | Billing and accounting | Owner | The collections lag; the month closes before the money arrives |
| 10. Loaded cost per sellable hour | Labor cost per clinician divided by sellable hours after documentation and supervision time | Payroll and template | Owner | Whether the sellable hours were sold |
Setting the thresholds
- Run the sheet for three months without acting on it, so that the numbers reflect the practice as it is.
- For each KPI, write the level the practice wants and the level that triggers action, from those three months and from the practice's own standards. This site states no figure, because a threshold copied from a page is a threshold for someone else's practice.
- Write beside each threshold what the owner does when it is crossed, and who else is told.
- Move a threshold only with a written reason and a date. A threshold that drifts to meet the number is not a threshold.
Reading the sheet
Once a month, in one sitting, with the monthly audit and the complaint log open. Read each KPI against its threshold and its trend, then read its blind spot and ask what the audit says about it. Three patterns are worth knowing in advance.
Reading the Sheet
KPI 3 rising while KPI 6 falls?
template problem and employment question
check next pattern
- KPI 3 rising while KPI 6 fallsthe therapist is delivering more visits by pushing notes out of the day. That is a template problem and, if the notes are done after hours, an employment question.
- KPI 1 rising while KPI 2 lengthensdemand is arriving faster than the template can absorb it, and the referrers will notice before the sheet does. The marketing and growth guide explains why growth has to follow capacity.
- KPI 7 falling for one payera rule changed. Read the payer's notice, check the billing settings, and confirm that whoever reads payer notices is doing so, which the licensing and compliance guide puts on the compliance calendar.
Where the numbers come from
Each KPI names a source system, and the practice's systems have to produce it without retyping. The software and KPI guide covers the six systems and the data flow that makes the sheet possible. Where a number is assembled from an export, the export must contain no patient identifiers that a spreadsheet cannot protect.
Where the Numbers Come From
- Source system produces KPI without retyping
- Export contains no patient identifiers
- Security baseline: NIST and CISA guidance
- KPIs 8-10 reconcile to the ledger
- IRS records show income and what produced it
The security baseline for handling that data in a small organization is set out in the NIST small business quick-start guides and the CISA guidance for small and medium businesses. The compliance adviser says what the privacy rules require of the practice on top.
KPIs 8, 9 and 10 are also accounting numbers, and they should reconcile to the ledger. The IRS guidance on which records to keep expects a business to be able to show its income and what produced it; a KPI sheet whose collections do not match the deposits is telling the owner something about the books.
Who acts
The owner column above is deliberate: most of the KPIs are acted on by the front desk lead or the clinicians, not the owner. The hiring and training guide puts each role's KPIs into its written role, so that the monthly sitting is a conversation about numbers people already own rather than a report the owner delivers to them.
Common questions
What is a good no-show rate for a physical therapy practice?
Nobody can tell you from a page, and any figure offered would be for a different patient population and a different front desk. Measure yours for three months, set the threshold from that and from what the calendar can absorb, and act when it is crossed.
Should we track revenue?
Track collected per delivered visit by payer, which is KPI 9, and the deposits in the ledger. Revenue billed is a promise; collected is the number, and the lag between them is the cash-flow article's subject.
The sheet has ten measures and the team has three people. Is that too many?
Each person owns two or three. The owner reads all ten once a month. That is an hour, and it is the hour that decides the next month.
