PT Income: Cash Practice vs Employed Physical Therapist
A physical therapist leaving a salary for a cash practice breaks even when the weekly visits multiplied by what each visit nets cover the salary plus every cost the job used to carry for you. No salary figure is quoted here because public wage data varies by setting and year; use your own pay stub. This page gives the method, and it assumes an hourly private room as the only fixed cost.
Step one: price the job you are leaving
Salary is only the first line. Add what the employer pays on your behalf, since you will buy each of these yourself.
| Item | Where to find it | Notes |
|---|---|---|
| Base pay | Pay stub | Annual figure |
| Health coverage | Benefits statement | Employer share and your share |
| Retirement match | Plan summary | The match you lose |
| Paid time off | Handbook | Days you are paid while away |
| Liability insurance | Employer | You will buy your own |
| Continuing education | Employer | Often partly paid |
| Payroll tax share | Self-employment tax is higher than the employee share | Ask a CPA |
Add the lines. That total is your target, the amount your practice must produce before you are better off. This page is general information, not tax advice.
Step two: find what each visit nets
Net per visit equals your fee minus the room cost per visit and the consumables per visit. If your room costs R per hour and a visit takes one hour with a short gap, the room cost per visit is R. For arithmetic only: at a $22 hour, one hour visit carries $22 of room. Use your own room rate; FlexWerk rooms range $18 to $22 an hour, and cardio rooms from $12.
Step three: the break-even formula
Break-even visits per week equals the weekly target, which is your yearly target divided by the weeks you will work, divided by net per visit.
For example, suppose an invented weekly target of $3,000 and a net of $100 per visit. Then break-even is 30 visits a week. This is a made-up illustration, not a market rate or a statement about what any PT earns. Its point is how fast the visit count climbs when net per visit drops: at a net of $75 the same target needs 40 visits.
Step four: the capacity check
Compare break-even with what you can actually deliver.
- Weekly hours available for patients.
- Minus time for notes, messaging and marketing.
- Minus expected no-shows and gaps.
- Equals sellable visit hours.
If sellable visits fall below break-even, either raise your net per visit, add a service with a different price, or keep an employed day while you build. The moonlighting answer walks through that gradual route.
Why room structure matters
A lease turns break-even into a floor you must clear every month, however few patients arrive. An hourly room is billed only when you book it, so break-even shifts with the visits you schedule. At FlexWerk Carmel there is no lease or membership, and fitness professionals can claim a first free hour through get started. The arithmetic of rent against income is also covered in what is fair to pay for a treatment room, and fee-setting is in the cash PT pricing guide.
What the spreadsheet does not show
Employment brings steady patients and colleagues; cash practice brings control of your schedule and your clinical choices. Neither is free. Each PT sets their own fees and terms, and FlexWerk provides space and no clinical services. Build the sheet, pick a number of visits per week that feels honest, and test it for a quarter before you resign anything.
Related questions
Is a cash practice always more profitable than a salary?
No. It can pay more per hour of care, but you also carry marketing, insurance, notes and empty hours. Compare take-home per week of total work, not the fee per visit.
What costs does a salary hide?
Benefits, paid time off, employer-paid insurance and payroll tax share. Put a price on each before you compare, and include your own health coverage and retirement saving.
What is a realistic number of weekly patients?
Your own calendar tells you. Start with the hours you can sell, then subtract notes, marketing and no-shows, and what is left is your real capacity.