How to Start a Physical Therapy Clinic

As Baby Boomers move into their golden years, the need for physical therapy has spiked, which is why the market has expanded by a third in the last decade. If you’re a physical therapist, you could start your own clinic to boost patients’ quality of life, grab a share of a $40 billion market and make a great living, all while following your passion. 

But they don’t teach many business skills in physical therapy school, so you’ll need to learn how to cut through the red tape and become an entrepreneur. Luckily, this step-by-step guide contains all you need to know to launch and run a successful physical therapy clinic.

Step 1: Decide if the Business Is Right for You

Pros and cons

Starting a physical therapy business has pros and cons to consider before deciding if it’s right for you. 

Physical therapy industry trends

Industry size and growth

• Industry size and past growth – The US physical therapy industry is worth $40.1 billion in 2022 after expanding 33% in the last decade.((https://www.ibisworld.com/industry-statistics/market-size/physical-therapists-united-states/)) 
• Growth forecast – The US physical therapy industry is projected to grow 4.7% in 2022.((https://www.ibisworld.com/industry-statistics/number-of-businesses/physical-therapists-united-states/)) 
• Number of businesses –  In 2022, 122,254 physical therapy businesses are operating in the US. 
• Number of people employed – In 2022, the US physical therapy industry employs 503,918 people.((https://www.ibisworld.com/industry-statistics/employment/physical-therapists-united-states/))

Trends and challenges

Trends in the physical therapy industry include:

• Telehealth options have made their way into the physical therapy business, with more and more patients seeking virtual physical therapy consultations.
• Alternative treatment options such as holistic physical therapy, which means treating the mind, body, and spirit, are seeing increased demand. This means integrating meditation and yoga into treatment plans, boosting revenue potential. 

Challenges in the physical therapy industry include:

• Advancements in physical therapy techniques and practices make continuing education necessary for physical therapists.
• Regulations in the physical therapy industry, particularly in terms of electronic medical records keeping, are constantly changing, creating the need for physical therapists to keep up in order to stay compliant. 

Demand hotspots

• Most popular states – The most popular states for physical therapists are Washington, Wyoming, and California.((https://www.zippia.com/physical-therapist-jobs/best-states/))
• Least popular states – The least popular states for physical therapists are Florida, Arkansas, and Utah.

What kind of people work in physical therapy?

• Gender – 63.7% of physical therapists are female, while 36.3% are male.((https://www.zippia.com/physical-therapist-jobs/demographics/))
• Average level of education – The average physical therapist has a bachelor’s degree.
• Average age – The average physical therapist in the US is 41.1 years old.

How much does it cost to start a physical therapy clinic?

Startup costs for a physical therapy clinic range from $12,000 to $30,000. The main cost is renting and outfitting the clinic space. If you have more limited financing, you could cut costs by starting out as a mobile and virtual physical therapist, going to your clients and providing therapy online to build a reputation. This would save you $5,000 to $10,000 in startup costs, but you would only be able to take a limited amount of equipment to your patients’ homes.

Either way, you’ll need to obtain malpractice insurance. If you’re not a physical therapist, you can find information on becoming one through the American Physical Therapy Association. 

To practice as a physical therapist in the US, you must earn a doctor of physical therapy degree from a Commission on Accreditation in Physical Therapy Education-accredited physical therapist education program and pass a state licensure exam. Programs typically take three years, and most require a bachelor’s degree. 

You’ll need a handful of items to successfully launch your physical therapy business, including: 

• Treatment tables – wooden plinths
• Treatment tables – adjustable
• Mat table
• Adjustable height exercise steps  
• Step stools
• Therapist stools on wheels 
• Variety of bolsters, wedges, supports
• Mobilization belts and devices
• Gait belt
• Various assistive devices
• Taping supplies
• Orthotics
• Splinting materials
• Goniometers
• Tape measures
• Grip dynamometer
• Manual muscle testing dynamometer
• Reflex hammer
• Neurological testing instruments
• Blood pressure cuff
• Stethoscope
• Thermometer 
• Video analysis hardware & software
• FCE testing equipment or system

How much can you earn from a physical therapy business?

The average cost of a one-hour physical therapy session is $100. If you start with a small clinic working alone, your profit margin after rent and overhead should be about 50%.

In your first year or two, you might have 25 sessions per week, bringing in $130,000 in annual revenue. This would mean $65,000 in profit, assuming that 50% margin. As your business gains traction, your clinic might provide 80 sessions per week. At this stage, you’d hire staff, including other physical therapists, reducing your profit margin to around 20%. With annual revenue of $416,000, you’d make a healthy profit of nearly $84,000.

What barriers to entry are there?

There are a few barriers to entry for a physical therapy clinic. Your biggest challenges will be:

• Education and licensing
• Standing out into a competitive industry
• Getting credentialed with insurance companies

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Step 2: Hone Your Idea

Now that you know what’s involved in starting a physical therapy clinic, it’s a good idea to hone your concept in preparation to enter a competitive market. 

Why? Identify an opportunity

Research physical therapy clinics in your area to examine their services, price points, and customer reviews. You’re looking for a market gap to fill. For instance, maybe the local market is missing a sports medicine clinic, a clinic that also offers athletic training, or a clinic that provides electrical stimulation therapy. 

You might consider targeting a niche market by specializing in a certain aspect of your industry, such as treating shoulder pain or knee pain, or adding yoga and meditation therapy.

This could jumpstart your word-of-mouth marketing and attract clients right away. 

What? Determine your products or services

Your services will depend on what you decide to specialize in. They might include:

• Physical Therapy
• Manual Therapy and Modalities
• Pre and Post-operative Care
• Sports Rehabilitation
• Injury Screenings
• Dance Medicine Services
• Work Conditioning/Hardening
• Gait Analysis
• Balance Problem Treatments

How much should you charge for physical therapy services?

The average price of a one-hour physical therapy session is $100. After your costs of rent and overhead, you should aim for a profit margin of about 50% when you’re working by yourself. 

Once you know your costs, you can use this Step By Step profit margin calculator to determine your mark-up and final price points. Remember, the prices you use at launch should be subject to change if warranted by the market.

Who? Identify your target market

Your target market will be broad. You should spread out your marketing to include sites like TikTok, Instagram, and Facebook. You should also try to partner with private practice physicians to get referrals. You can connect with them on LinkedIn or find them on Google or Yelp and call them directly. 

Where? Choose your business premises

Unless you start out working from home, you’ll need to rent out a space for your clinic. You can find commercial space to rent in your area on sites such as Craigslist, Crexi, and Instant Offices.

When choosing a commercial space, you may want to follow these rules of thumb:

• Central location accessible via public transport
• Ventilated and spacious, with good natural light
• Flexible lease that can be extended as your business grows
• Ready-to-use space with no major renovations or repairs needed

Step 3: Brainstorm a Business Name

Your business name is your business identity, so choose one that encapsulates your objectives, services, and mission in just a few words. You probably want a name that’s short and easy to remember, since much of your business, and your initial business in particular, will come from word-of-mouth referrals.

Here are some ideas for brainstorming your business name:

• Short, unique, and catchy names tend to stand out
• Names that are easy to say and spell tend to do better 
• Name should be relevant to your product or service offerings
• Ask around — family, friends, colleagues, social media — for suggestions
• Including keywords, such as “physical therapy”, boosts SEO
• Name should allow for expansion, for ex: “Jim’s Bakery” over “Jim’s Cookies”
• Avoid location-based names that might hinder future expansion
• Use online tools like the Step by Step Business Name Generator. Just type in a few keywords and hit “generate” and you’ll have dozens of suggestions at your fingertips.

Once you’ve got a list of potential names, visit the website of the US Patent and Trademark Office to make sure they are available for registration and check the availability of related domain names using our Domain Name Search tool. Using “.com” or “.org” sharply increases credibility, so it’s best to focus on these. 

Finally, make your choice among the names that pass this screening and go ahead with domain registration and social media account creation. Your business name is one of the key differentiators that sets your business apart. Once you pick your company name, and start with the branding, it is hard to change the business name. Therefore, it’s important to carefully consider your choice before you start a business entity.

Step 4: Create a Business Plan

Every business needs a plan. This will function as a guidebook to take your startup through the launch process and maintain focus on your key goals. A business plan also enables potential partners and investors to better understand your company and its vision:

• Executive Summary: Brief overview of the entire business plan; should be written after the plan is complete.
• Business Overview: Overview of the company, vision, mission, ownership, and corporate goals.
• Product and Services: Describe your offerings in detail.
• Market Analysis: Assess market trends such as variations in demand and prospects for growth, and do a SWOT analysis.
• Competitive Analysis: Analyze main competitors, assessing their strengths and weaknesses, and create a list of the advantages of your services.
• Sales and Marketing: Examine your companies’ unique selling propositions (USPs) and develop sales, marketing, and promotional strategies.
• Management Team: Overview of management team, detailing their roles and professional background, along with a corporate hierarchy.
• Operations Plan: Your company’s operational plan includes procurement, office location, key assets and equipment, and other logistical details.
• Financial Plan: Three years of financial planning, including startup costs, break-even analysis, profit and loss estimates, cash flow, and balance sheet.
• Appendix: Include any additional financial or business-related documents.

If you’ve never created a business plan, it can be an intimidating task. You might consider hiring a business plan specialist at Fiverr to create a top-notch business plan for you.

Step 5: Register Your Business

Plus, registration is exciting because it makes the entire process official. Once it’s complete, you’ll have your own business! 

Choose where to register your company

Your business location is important because it can affect taxes, legal requirements, and revenue. Most people will register their business in the state where they live, but if you’re planning to expand, you might consider looking elsewhere, as some states could offer real advantages when it comes to physical therapy clinics. 

If you’re willing to move, you could really maximize your business! Keep in mind, it’s relatively easy to transfer your business to another state. 

Choose your business structure

Business entities come in several varieties, each with its pros and cons. The legal structure you choose for your physical therapy clinic will shape your taxes, personal liability, and business registration requirements, so choose wisely. 

Here are the main options:

• Sole Proprietorship – The most common structure for small businesses makes no legal distinction between company and owner. All income goes to the owner, who’s also liable for any debts, losses, or liabilities incurred by the business. The owner pays taxes on business income on his or her personal tax return.
• General Partnership – Similar to a sole proprietorship, but for two or more people. Again, owners keep the profits and are liable for losses. The partners pay taxes on their share of business income on their personal tax returns.
• Limited Liability Company (LLC) – Combines the characteristics of corporations with those of sole proprietorships or partnerships. Again, the owners are not personally liable for debts.
• C Corp – Under this structure, the business is a distinct legal entity and the owner or owners are not personally liable for its debts. Owners take profits through shareholder dividends, rather than directly. The corporation pays taxes, and owners pay taxes on their dividends, which is sometimes referred to as double taxation.
• S Corp – An S-Corporation refers to the tax classification of the business but is not a business entity. An S-Corp can be either a corporation or an LLC, which just need to elect to be an S-Corp for tax status. In an S-Corp, income is passed through directly to shareholders, who pay taxes on their share of business income on their personal tax returns.

We recommend that new business owners choose LLC as it offers liability protection and pass-through taxation while being simpler to form than a corporation. You can form an LLC in as little as five minutes using ZenBusiness’s online LLC formation service. They will check that your business name is available before filing, submit your articles of organization, and answer any questions you might have. 

Step 6: Register for Taxes

The final step before you’re able to pay taxes is getting an Employer Identification Number, or EIN. You can file for your EIN online or by mail or fax: visit the IRS website to learn more. Keep in mind, if you’ve chosen to be a sole proprietorship you can simply use your social security number as your EIN. 

Once you have your EIN, you’ll need to choose your tax year. Financially speaking, your business will operate in a calendar year (January–December) or a fiscal year, a 12-month period that can start in any month. This will determine your tax cycle, while your business structure will determine which taxes you’ll pay.

The IRS website also offers a tax-payers checklist, and taxes can be filed online.

It is important to consult an accountant or other professional to help you with your taxes to ensure you’re completing them correctly.

Step 7: Fund your Business

Securing financing is your next step and there are plenty of ways to raise capital:

• Bank loans: This is the most common method but getting approved requires a rock-solid business plan and strong credit history.
• SBA-guaranteed loans: The Small Business Administration can act as guarantor, helping gain that elusive bank approval via an SBA-guaranteed loan.
• Government grants: A handful of financial assistance programs help fund entrepreneurs. Visit Grants.gov to learn which might work for you.
• Friends and Family: Reach out to friends and family to provide a business loan or investment in your concept. It’s a good idea to have legal advice when doing so because SEC regulations apply.
• Crowdfunding: Websites like Kickstarter and Indiegogo offer an increasingly popular low-risk option, in which donors fund your vision. Entrepreneurial crowdfunding sites like Fundable and WeFunder enable multiple investors to fund your business.
• Personal: Self-fund your business via your savings or the sale of property or other assets.

Bank and SBA loans are probably the best option, other than friends and family, for funding a physical therapy business. You might also try crowdfunding if you have an innovative concept. 

Step 8: Apply for Licenses/Permits

Starting a physical therapy business requires obtaining a number of licenses and permits from local, state, and federal governments.

You will need to be a licensed physical therapist in your state. Check with your state for requirements. To get credentialed by insurance companies you will need:

• Malpractice insurance
• A National Provider Identifier (NPI)

Federal regulations, licenses, and permits associated with starting your business include doing business as (DBA), health licenses and permits from the Occupational Safety and Health Administration (OSHA), trademarks, copyrights, patents, and other intellectual properties, as well as industry-specific licenses and permits. 

You may also need state-level and local county or city-based licenses and permits. The license requirements and how to obtain them vary, so check the websites of your state, city, and county governments or contact the appropriate person to learn more. 

You could also check this SBA guide for your state’s requirements, but we recommend using MyCorporation’s Business License Compliance Package. They will research the exact forms you need for your business and state and provide them to ensure you’re fully compliant.

If you feel overwhelmed by this step or don’t know how to begin, it might be a good idea to hire a professional to help you check all the legal boxes.

Step 9: Open a Business Bank Account

Before you start making money, you’ll need a place to keep it, and that requires opening a bank account.

Keeping your business finances separate from your personal account makes it easy to file taxes and track your company’s income, so it’s worth doing even if you’re running your physical therapy business as a sole proprietorship. Opening a business bank account is quite simple, and similar to opening a personal one. Most major banks offer accounts tailored for businesses — just inquire at your preferred bank to learn about their rates and features.

Banks vary in terms of offerings, so it’s a good idea to examine your options and select the best plan for you. Once you choose your bank, bring in your EIN (or Social Security Number if you decide on a sole proprietorship), articles of incorporation, and other legal documents and open your new account. 

Step 10: Get Business Insurance

Business insurance is an area that often gets overlooked yet it can be vital to your success as an entrepreneur. Insurance protects you from unexpected events that can have a devastating impact on your business.

Here are some types of insurance to consider:

• General liability: The most comprehensive type of insurance, acting as a catch-all for many business elements that require coverage. If you get just one kind of insurance, this is it. It even protects against bodily injury and property damage.
• Business Property: Provides coverage for your equipment and supplies.
• Equipment Breakdown Insurance: Covers the cost of replacing or repairing equipment that has broken due to mechanical issues.
• Worker’s compensation: Provides compensation to employees injured on the job.
• Property: Covers your physical space, whether it is a cart, storefront, or office.
• Commercial auto: Protection for your company-owned vehicle.
• Professional liability: Protects against claims from a client who says they suffered a loss due to an error or omission in your work.
• Business owner’s policy (BOP): This is an insurance plan that acts as an all-in-one insurance policy, a combination of the above insurance types.

For a physical therapy business, you’ll also need to obtain malpractice insurance. 

Step 11: Prepare to Launch

As opening day nears, prepare for launch by reviewing and improving some key elements of your business. 

Essential software and tools

Being an entrepreneur often means wearing many hats, from marketing to sales to accounting, which can be overwhelming. Fortunately, many websites and digital tools are available to help simplify many business tasks. 

You may want to use industry-specific software, such as Kareo, WebPT, or MWTherapy, to manage your scheduling, record keeping, billing, and payments. 

Accounting

• Popular web-based accounting programs for smaller businesses include Quickbooks, Freshbooks, and Xero. 
• If you’re unfamiliar with basic accounting, you may want to hire a professional, especially as you begin. The consequences for filing incorrect tax documents can be harsh, so accuracy is crucial. 

Marketing

Some of your business will come from the casual passerby or online visitors, but you should still invest in digital marketing! Getting the word out is especially important for new businesses, as it’ll boost customer and brand awareness. 

Once your website is up and running, link it to your social media accounts and vice versa. Social media is a great tool for promoting your business because you can create engaging posts that advertise your products: 

• Facebook: Great platform for paid advertising, allows you to target specific demographics, like men under age 50 in the Cleveland area. 
• Instagram: Same benefits as Facebook but with different target audiences.
• Website: SEO will help your website appear closer to the top in relevant search results, a crucial element for increasing sales. Make sure that you optimize calls to action on your website. Experiment with text, color, size, and position of calls to action such as “Schedule Now.” This can sharply increase purchases.
• Google and Yelp: For businesses that rely on local clientele, getting listed on Yelp and Google My Business can be crucial to generating awareness and customers.

Kickstart Marketing

Take advantage of your website, social media presence, and real-life activities to increase awareness of your offerings and build your brand. Some suggestions include:

• Signage – Put up eye-catching signage at your clinic and website. 
• In-Person Sales – Offer your physical therapy services to local physicians.
• Email marketing/newsletter – Send regular emails to customers and prospects. Make them personal. 
• Start a blog – Start a blog and post regularly. Change up your content and share it on multiple sites.
• Paid ads on social media – Choose sites that will reach your target market and do targeted ads.
• Pay–per-click marketing – Use Google AdWords to perform better in searches. Research your keywords first.
• Testimonials – Share customer testimonials about how your physical therapy helped them.

Develop your website

Website development is crucial because your site is your online presence and needs to convince prospective clients of your expertise and professionalism. They are unlikely to find your website, however, unless you follow Search Engine Optimization (SEO) practices. These are steps that help pages rank higher in the results of top search engines like Google. 

You can create your own website using services like WordPress, Wix, or Squarespace. This route is very affordable, but figuring out how to build a website can be time-consuming. If you lack tech-savvy, you can hire a web designer or developer to create a custom website for your business.

Focus on USPs

Unique selling propositions, or USPs, are the characteristics of a product or service that set it apart from the competition. Customers today are inundated with buying options, so you’ll have a real advantage if they are able to quickly grasp how your physical therapy clinic meets their needs or wishes. It’s wise to do all you can to ensure your USPs stand out on your website and in your marketing and promotional materials, stimulating buyer desire. 

Global pizza chain Domino’s is renowned for its USP: “Hot pizza in 30 minutes or less, guaranteed.” Signature USPs for your physical therapy business could be: 

• Smart sports therapy to get you back in the game
• Our holistic therapy heals mind, body, and soul 
• Soothe your pain with advanced physical therapy techniques

Networking

You may not like to network or use personal connections for business gain. But your personal and professional networks likely offer considerable untapped business potential. Maybe that Facebook friend you met in college is now running a physical therapy business, or a LinkedIn contact of yours is connected to dozens of potential clients. Maybe your cousin or neighbor has been working in physical therapy for years and can offer invaluable insight and industry connections. 

The possibilities are endless, so it’s a good idea to review your personal and professional networks and reach out to those with possible links to or interest in physical therapy. You’ll probably generate new customers or find companies with which you could establish a partnership. 

Step 12: Build Your Team

If you’re starting out small from a home office, you may not need any employees. But as your business grows, you will likely need workers to fill various roles. Potential positions for a physical therapy business include:

• Receptionist – patient check-ins, book appointments, customer service
• Physical Therapists – provide physical therapy services
• General Manager – staff management, accounting
• Marketing Lead – SEO strategies, social media

At some point, you may need to hire all of these positions or simply a few, depending on the size and needs of your business. You might also hire multiple workers for a single role or a single worker for multiple roles, again depending on need. 

Free-of-charge methods to recruit employees include posting ads on popular platforms such as LinkedIn, Facebook, or Jobs.com. You might also consider a premium recruitment option, such as advertising on Indeed, Glassdoor, or ZipRecruiter. Further, if you have the resources, you could consider hiring a recruitment agency to help you find talent. 

Step 13: Start Making Money!

Physical therapy is experiencing strong growth as the population ages, which means this is a great opportunity to help people every day and make a good living at the same time. If you have yet to complete your physical therapy education, doing so will be well worth your time and money, as it will enable you to follow your passion and provide an invaluable service. 

You’ve gained the required business knowledge, now it’s time to get your successful physical therapy clinic up and running!