$288,000 per PT — and the two reasons your number is lower.

An average in-network outpatient PT, seeing 12 patients a day, 48 weeks a year, collecting $100 a visit, generates about $288,000. How does that number feel to you? High? Low?

If your number is lower, it's one of two things. Not ten. Two.

1. You're not collecting $100+ a visit.

A few reasons why:

• PTs underbilling Are all your clinicians trained on the nuances of coding for their work, or are you losing $5–20 a visit on sloppy billing? Some EMRs clean up large coding messes, but not all of them optimize if the user's documentation doesn't make it obvious. If you have a QA team reviewing your bills you're probably doing OK here — but you're also paying another salary to make it happen.
• Poor contracts Either you didn't negotiate well, or you haven't made the decision to leave the non-negotiable low-paying contracts that are weighing down your average per-visit rate. High admin costs tied to burdensome authorization demands also lower margins. An easy-process $85/visit contract may be a better option than a $95/visit contract that requires an hour of documentation, phone calls and follow-up for each patient every other week.
• A dysfunctional benefits and authorization system Is your staff collecting accurate information from patients and payers? Are they documenting it effectively in your EMR? Are your PTs on top of auth requests and providing defensible documentation?
• Copays and coinsurance going uncollected What does that system look like at your practice? Do you keep a card on file and charge automatically? Is coinsurance payment tied directly to EOB/ERA entry?
• A collection process nobody owns Lots of variables here, and lots can go wrong. If your RCM team is in-house, your system needs to be airtight — if a key person goes on vacation or leaves the company, will that set back your revenue and cash flow? If you're outsourcing your collections, how much are you paying? Every point is a point off your slim margin. Are you paying for all collections, including automatic payers like Medicare? Is your RCM team going after all the money, or do they have a threshold level they pursue versus write off? Have you analyzed which payers, patients and referral sources tend not to pay? Have you factored that into your patient selection process?

2. Your PTs aren't seeing 12 a day.

Which comes down to:

• Unclear expectations I've set 12 patients per 8 hours as a standard. What's your target number? Are you communicating it regularly? Do your PTs know it? Does your front desk and support staff know it? Make that number attainable, and reward the people who keep that promise to you and the practice.
• Schedule imbalance Are some PTs seeing 15–16 a day and others seeing 9–10? Why do you think that is? Is there something you can do about it? Have you considered how you can make that imbalance work for you? This can get complicated — but with an effective system it can be simplified and automated.

Fix your systems and everyone's experience will improve.

PT practice owners want to help their patients, create an environment where their A-team players thrive and excel, and see everyone get fair pay for the effort they put in. Lots of factors go into making that happen, and elite systems make all of it more likely.