Physical therapy KPIs owners should track monthly

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.

KPI 3 rising while KPI 6 falls: the 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 lengthens: demand 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 payer: a 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 be able 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 has to be assembled from an export, the export must contain no patient identifiers that a spreadsheet cannot protect. 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, and 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.