Your schedule
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About 46 weeks, after time off.
What a visit collects
What you receive, not what you bill. This one number already contains your whole insurance mix. Mostly Medicare, you are at the low end. Mostly commercial or workers' comp, higher. For scale: Medicare pays about $27 to $37 for the first unit of a visit and roughly a quarter less for every unit after it, so a Medicare-heavy day averages closer to $22 to $29. Do not know yours? Ask your billing team what a unit actually collects on your caseload, after write-offs.
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Your pay
Advanced finance: if you know your clinic's real numbers
Most clinicians do not know these and you do not need to. Two are set from published figures. One, the share paid to everyone else, has no published figure anywhere and is our estimate. Move either of them only if you know your practice's real numbers.
The published figure for this industry is 47%. Many owners run their business toward 40% as a target. Which one your employer is at changes this whole page, and it is a fair thing to ask.
Front desk, in-house billing, assistants, aides, managers. This is carved out of the payroll budget above, not added on top of it. Their pay and yours come from the same pot, and they get paid first. No one publishes this split. 12% is our estimate and the federal staffing data points higher. If you move it, move the payroll line above it too, because in a real clinic the two rise and fall together.
You cost your employer about 1.2 times your salary. Payroll taxes, health insurance and the retirement match sit on top of what lands in your account, so an $85,000 salary really costs them about $101,000. That figure is computed from federal employer-cost data and is not adjustable here. It does not include malpractice, licensure or CEU, which are real and sit above it.
The comparison
Four structures, three kinds of year
| Structure | Good year | Average | Bad year | Swing |
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Put your own offer's terms into the second row
The second row is modelled on three numbers, and all three are ours, not an industry standard. Your offer letter has its own three. Put them in here and the table above re-prices against your real terms.
This is the haircut, and it is the one that decides the deal. You give it up in every year, good or bad, in exchange for a bonus you are paid only in good ones. At 100% there is no haircut and the bonus is pure upside.
It goes above 100 on purpose. An owner sets the threshold where the practice has already covered what you cost, so a real one often sits at or above what you produce in a normal year. Set it there and watch the bonus column.
Twenty cents on the dollar is a common shape. Read it together with the threshold, never on its own. A generous rate above a threshold you cannot reach is worth nothing.
How to read this table
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Read this before you ask for a percentage
A percentage ties your pay to volume, not to outcomes
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That second number is not advice. Units are governed by medical necessity and by your payer's time rule, not by what a compensation formula rewards. It is here so you can see the incentive before you sign one.
And which time rule applies is not one answer. Medicare uses the eight-minute rule, which totals your timed minutes across the visit and converts the total into units. Many commercial payers use the substantial portion methodology instead, which asks the question service by service. Eight minutes each of manual therapy, therapeutic exercise and neuromuscular re-education is twenty-four timed minutes: two units under Medicare, three under the substantial portion method. Same treatment, same clock, different count.
This matters here because every rate on this page assumes a commercial mix. The ceiling on units is higher than the eight-minute rule alone implies, which means the pressure a percentage model puts on you is worse than the number above, not better. That is a reason to ask which methodology your payers use before you accept a model that pays you by the unit. It is not a reason to bill differently.
And if you are offered a floor, it comes in two kinds and they are not the same deal. A true guarantee is yours. A recoverable draw is a loan against your future production, and if you leave before you earn it back you can owe your employer money. Ask which one it is, in writing, before you sign.
And a percentage exposes you to one thing a salary does not. Work delivered in whole or part by an assistant pays 85%, and near 65 cents on the dollar once the multiple-procedure reduction stacks. A practice can cut a percentage-paid therapist's collections by roughly a third by changing who walks into the treatment room. No notice required, no breach of a normal agreement. Under a salary that is the owner's problem. Under a percentage it is silently yours.
The percentage is the small number. What a visit collects is the big one.
Two practices offer you a percentage of collections. One offers 40%, the other 45%. If the practice offering 45% collects even 11% less per visit, because of the insurance it takes and how well it bills, the 45% deal pays you less. The offer letter will still call it a raise.
Eleven percent is not a big gap. Take Medicare, the one book where the rates are set by law. Line up ordinary practices, not the outliers, and what they are allowed for the very same code already spans about that much. Commercial insurance varies more, not less.
Ask what a visit on your caseload collects before you argue about the percentage.
Take it with you
Two pages, and only one goes in the room
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The evidence under all of this
Open only what you need
What you bill is not what you get paid
Three different numbers, and people call all three "production"
- Charges. What the clinic puts on the claim. The clinic sets this by itself and can change it tomorrow. No one has to agree to it.
- Allowed amount. What the payer's contract says the service is worth. Anything charged above it is written off and was never collectable.
- Net collections. Cash that actually arrived, from the payer and the patient combined. This is the only one of the three used anywhere on this page.
Every dollar on this page is money your clinic actually collected. None of it is what your clinic billed. Those are two very different numbers and confusing them is the fastest way to walk into a conversation with a figure your boss can dismiss in one sentence.
The amount billed is close to meaningless as a measure of anything. Across 71,753 therapists billing the identical code to the identical payer in the identical year, what they charged varied by 2.8 times. What they were actually allowed varied by only 1.2 times. A practice can nearly triple its collection rate by lowering its charges and collecting not one extra dollar.
The size of the gap, from federal data on real physical therapists in private practice: the median charge submitted for a 15-minute unit of therapeutic exercise is $65.00. Medicare allowed about $22 on it. The rest was never collectable. It is written off the moment the claim is processed.
Which is why this matters to your paycheck specifically. If anyone ever offers you a percentage of "production," ask whether production means collections or billed charges. A percentage of charges is a percentage of a number your employer sets by themselves and can change at any time without collecting a cent more. That is not a compensation formula. It is an option they hold against you.
Why a hospital doesn't pay more for the same visit
Medicare pays both settings the same amount, by statute. Outpatient PT in a hospital outpatient department is paid under the Medicare Physician Fee Schedule, not the hospital outpatient system, and CMS pays the hospital the non-facility rate, which is the higher of the two. Same code, same locality, identical allowed amount.
The intuition that hospitals get paid more is not made up. It expired. Hospital outpatient therapy was cost-reimbursed until the Balanced Budget Act moved it onto the fee schedule on January 1, 1999, a year after everyone else. It stopped being true 27 years ago.
Where hospitals do earn more is commercial contracting. Two independent sources find the premium on the identical code and disagree by roughly twofold: Colorado claims data 2017–2022 puts a 15-minute unit of 97110 at 2.6× an independent office, a national 2011 study puts it at 1.4×, and across 18 metro areas that ratio ran from 0.90× to 3.05×. Neither adjusts for case mix. No peer-reviewed study compares the two settings at all.
So this tool applies no multiplier and defaults none. One dominant Michigan insurer contractually equalized hospital and community pricing for physical therapy specifically, and its markets sit at 1.00. It is a negotiated outcome, not a structural constant, which makes it a question for your employer rather than an assumption you carry in.
Two mechanics that do follow you into a hospital: the multiple-procedure reduction and the assistant differential both apply by statute. Two settings this page does not cover: critical access hospitals and Maryland, neither of which is on this fee schedule.
What actually works in a private practice
Argue the residual. The owner keeps what is left, so every argument reduces to one thing: this makes your residual larger, or it protects it. What works is the revenue you generate against your loaded cost, on net collections and never on charges. The payer mix and billing performance you are inheriting move your income more than the percentage does. And an owner can grant non-cash terms instantly because they own the whole P&L: schedule control, caseload composition, mentorship, CEU, profit participation. Their real constraint is that 13% residual, and their real alternative is a vacancy.
If you work for a hospital system, read this before you go in
Argue placement and replacement, not production. The director cannot exceed the band, so an argument to exceed it fails by construction and costs you credibility. What works instead: placement inside the posted range, which is the variable they actually control. Replacement and vacancy cost as the comparison, because their real alternative is a vacant line, a travel contract or a search, and that is a number they own. Non-comp levers that do not breach the band: productivity-standard relief, assistant support, a specialty title, education funds, a defined path to a senior grade. And timing, which a clinician would never guess: a director's ability to say yes is seasonal, gated to the annual budget and merit cycle.
Know what a raise means here before you ask. The 2026 merit budget across healthcare services is about 2.9%. That is the pool your director is dividing, and it was set above them.
Two mechanics inside a graded pay structure decide more than the ask does. Grades overlap heavily, so the move that pays is a grade change, not a step. And step progression typically decelerates with tenure. Certification pay is frequently capped flat no matter how many you hold.
And the ask for help is gated by the same number. Staffing requests commonly run through a position-control committee that weighs how the requesting manager is performing against their own productivity goals. A director missing productivity has less access to headcount, which is why "we need another therapist" and "I need a raise" are the same conversation to them and not to you.
Two different geographic systems price the two sides of their P&L. Revenue moves with the Medicare geographic index on a fee schedule the hospital cannot influence. Cost moves with system-wide wage scales set by an entirely separate index. A director controls neither.
Seven in ten PTs never negotiated their first offer
In a survey of 763 clinicians, 70.5% did not negotiate their first compensation package at all. Men negotiated more often than women, and the strongest single predictor of whether someone negotiated was whether they had ever been taught how.
That is why this page ends in something you can print rather than a number you can admire. The gap is not confidence and it is not nerve. It is that nobody shows clinicians what the other side of the table is solving for.
What this tool does not do
- No national reimbursement figure. Commercial rates by state are not publicly obtainable. You supply your own rate.
- No state comparison. A state-level geographic index does not exist and cannot be honestly built: 109 payment localities, no state field, 16 states split across several.
- No assistant modelling. Work performed under your plan of care by an assistant pays 85%, and near 65% once the multiple-procedure reduction stacks. Modelling it properly means modelling a pay cut, not leverage.
- No published support-staff split. No source breaks clinic payroll into clinician and non-clinician. A staffing-mix estimate can be derived from federal wage data and it points higher than the 12% here, but it moves together with the payroll line above it, so we hold both at their published values rather than move one alone. That slider controls more of the answer than any other input, and it is the softest number here.
- No collection-rate benchmark. None is published for this industry. And gross collection rate should not be used for compensation anyway: across 71,753 therapists billing the same code to the same payer, charges vary 2.8 times while what actually gets allowed varies only 1.2 times.
- No lookup for what an independent practice is paid. Hospitals must publish their negotiated commercial rates; independent practices are outside that rule entirely. One side of the setting comparison is legally obligated to publish and the other is invisible.