Model your physical therapy practice revenue down to collected dollars — factoring in your collections rate, insurance mix, no-shows, and overhead in one calculation.
You billed $162,000 last month and your bank account knows nothing about it. Every PT owner learns this the hard way: billed is a wish, collected is the truth, and the distance between them is whatever your payers feel like paying. This calculator starts where your billing software does — Patients Per Day and Average Billed Per Visit — then drags that number down through your Collections Rate, Insurance vs Cash Split, and No-Show Rate to land on what actually clears. From there it subtracts overhead and acquisition cost to show you net.
The model is designed for owners who want to pressure-test a staffing decision, evaluate a new payer contract, or figure out whether adding evening hours actually pencils out. Real PT practice numbers — not billing benchmarks — drive every output.
Why billed revenue is the wrong number to plan around
A physical therapy practice billing $180 per visit for 30 visits a day shows a gross billing run-rate of roughly $162,000 a month. But that number almost never hits the bank account. Collections rates for PT practices typically run between 55% and 80% depending on payer mix, with pure-insurance practices often landing in the lower half of that range and cash-pay practices capturing significantly more per dollar billed.
The calculator adjusts billed revenue downward by your collections rate before any other cost comes out. If you bill $162,000 and collect at 68%, your starting point is $110,160 — not the gross billing number. Planning around billed revenue instead of collected revenue is one of the fastest ways to find yourself short on payroll.
The Insurance vs. Cash Split input lets you describe your payer mix. Cash-pay patients typically generate higher net revenue per visit because there is no billing lag and no contractual adjustment. If you are actively shifting your practice toward direct-pay, this field lets you model what a 10-point shift in the cash percentage does to collected monthly revenue.
The no-show problem and its dollar cost
No-show rate is the input that tends to get underestimated. A 10% no-show rate on a 30-patient day means 3 empty slots. At $180 billed and a 68% collection rate, each of those slots represents about $122 in collected revenue that never arrives. Over 22 working days, a 10% no-show rate costs a solo practitioner roughly $8,000 a month in collected revenue — money that does not appear on any invoice because no invoice is ever sent.
The calculator accounts for no-shows by reducing effective patient volume before calculating collected revenue. This gives you a cleaner picture of what your practice actually earns versus what it would earn at full utilization, and it makes the case for investing in reminder systems or same-day scheduling policies that fill cancellations.
Overhead in a PT practice: what the number should include
Monthly Overhead in this model should include rent, utilities, billing software, electronic health records subscription, malpractice insurance, and any standing equipment lease payments. For a solo practice in a mid-sized city, this number typically runs $8,000–$18,000 a month before staff salaries.
New Patient Acquisition Cost captures what you spend, on average, to bring one new patient through the door. For practices relying on physician referrals, this is difficult to isolate — but for those running digital ads or paying for marketing services, it is a real, measurable cost. Multiply acquisition cost by new patients per month and you have a monthly marketing spend figure that belongs in the model.
Once you load all overhead categories, the net revenue number reflects what is left after collections adjustments, no-shows, overhead, and patient acquisition. That is the number to benchmark against your target salary and business investment goals.
Modeling a staffing or hours expansion
Adding an associate PT or extending to evening hours changes two inputs: Patients Per Day and Monthly Overhead. The calculator lets you test whether the added patient volume at your collections rate and no-show profile covers the added staff cost. An associate billing 15 additional visits a day at a 65% collections rate on $160 average billed generates roughly $34,000 in collected monthly revenue — against a fully-loaded employment cost that typically runs $12,000–$18,000 a month for a licensed PT in most markets.
The gap between those two numbers is your margin on the hire. Run it before you commit to a lease expansion or a new employee. The model does not account for ramp time — a new associate will not hit 15 visits a day in their first month — so you may want to model a conservative 10-visit first quarter alongside the full 15-visit steady state.
Using new patient acquisition cost as a growth lever
The New Patients Per Month and New Patient Acquisition Cost fields together expose your patient acquisition economics. If you are bringing in 12 new patients a month at $85 acquisition cost, you are spending $1,020 per month on growth. If those patients complete a full plan of care averaging 9 visits at your net per-visit rate, that is the lifetime revenue per acquisition — and the ratio of acquisition cost to lifetime value tells you whether you should be spending more, less, or holding.
Most PT practices do not think in these terms because the acquisition is often indirect — a physician referral has no explicit cost. But even in that model, the question is worth asking: how much time and effort goes into referral development, and what is its dollar equivalent? Treating patient acquisition as a real cost makes growth decisions cleaner. Run the model with your real acquisition numbers and start a free trial to save it — the next time you evaluate a new payer contract, you will want the comparison at hand.
How to use it
- Enter Patients Per Day and Working Days Per Month — your real schedule, not a full-capacity projection.
- Set Average Billed Per Visit to your blended per-visit billing rate across all visit types and CPT codes.
- Adjust Collections Rate to match your actual collections percentage from your billing reports.
- Set the Insurance vs Cash Split — Cash % to reflect how much of your revenue bypasses insurance billing.
- Enter No-Show Rate, Monthly Overhead, New Patient Acquisition Cost, and New Patients Per Month to complete the model.
Who it's for
- Solo PT evaluating a direct-pay pivot — Models shifting cash percentage from 20% to 50% to see how the collections rate improvement affects monthly net, even with fewer total visits.
- Group practice owner adding an associate — Adds 15 patients per day to the model, increases overhead by $14,000 for the new hire, and checks whether the net gain is worth the hire.
- Practice owner renegotiating a payer contract — Increases average billed per visit by $15 and watches how the collections-adjusted monthly revenue changes across a full patient panel.
- PT practice planning a second location — Models a new location's patient ramp over the first 6 months by running the calculator at 40%, 60%, and 80% of target daily patient volume.
- Owner assessing the cost of a high no-show rate — Raises no-show rate from 8% to 14% to see the exact dollar impact before investing in a reminder and re-scheduling system.
Key terms
- Collections rate
- The percentage of billed charges that are actually collected after insurance adjustments, copays, and write-offs. Your real revenue denominator.
- Billed per visit
- The gross charge submitted to the payer or patient for a single visit, before any adjustments or contractual write-offs.
- No-show rate
- The percentage of scheduled appointments where the patient does not arrive and the slot cannot be filled. Directly reduces collected revenue.
- Payer mix
- The distribution of revenue across insurance types, Medicare/Medicaid, and cash-pay — a primary driver of effective collections rate.
Frequently asked questions
What is a typical collections rate for a physical therapy practice?
Collections rates vary significantly by payer mix. Practices with a heavy commercial insurance panel often collect 60–75% of billed charges after contractual adjustments. Cash-pay practices collect close to 100% of billed amounts but set fees lower than insurance-billed rates. Your actual rate is in your billing software — use that number, not an industry average.
Should I include staff salaries in Monthly Overhead?
Yes, if you have front-desk staff, billing staff, or support aides, their wages belong in overhead. If you are a solo practitioner with no support staff, your only overhead is facility costs, insurance, and software. Including or excluding payroll consistently is what matters — just do not double-count.
How does the insurance vs. cash split affect my net revenue?
Cash-pay visits do not go through the collections adjustment the same way insurance claims do. A cash visit at $160 generates $160. An insurance visit billed at $180 with a 65% collection rate generates $117. The split input lets the model apply different effective rates to your revenue mix.
Does a lower no-show rate actually move the net number significantly?
More than most owners expect. A 5-point improvement in no-show rate on a 25-patient day over 22 working days recovers roughly 27 visits a month. At a typical net per-visit rate of $110–$130, that is $3,000–$3,500 a month in recovered revenue — often more than a price increase would generate.
What is New Patient Acquisition Cost for a referral-based practice?
For practices relying entirely on physician referrals, acquisition cost is low in cash terms but real in time. If you spend 3 hours a week on referral development and value your time at $150/hour, that is $1,800 a month in acquisition investment. Entering a realistic number — even if estimated — makes the model honest.