How Much Does it Cost to Start a Cash PT Clinic?

If you’re thinking about starting a cash pay physical therapy, occupational therapy, or other healthcare practice, one of the first questions you’re probably asking is:

How much is this actually going to cost me?

It’s a fair concern—and one I see come up all the time. A few weeks ago, I saw an Instagram post claiming it costs around $50,000 to start a cash-based practice. As someone who’s built her own cash based physical therapy practice and coaches hundreds of others through this process, I can confidently say: that number is not even close to typical. If you’re interested, you can learn more about how I got started with my practice at the blog post here.

During this post, we’re going to dive into the real physical therapy business startup costs and why you absolutely do not need to spend anywhere near that amount to start working with clients and making money in your business.

The Truth About Startup Costs

When I ventured into physical therapy entrepreneurship and started my own cash-based PT practice, my total upfront investment was around $2,600 to $3,000. That included:

• About $800–$1,000 on basic business setup expenses (like forming an LLC, liability insurance, documentation software, etc.)

• $1,800 on a business coaching program that helped me learn how to launch, market, and grow

Now, keep in mind, that number can vary depending on your state and your setup. For example, forming an LLC in Nevada costs more than it might in other states. But even so, most indivuals wondering how to start a PT practice can probably get started for under $5,000.

According to the U.S. Small Business Administration from some research I did, most microbusinesses cost between $2,000 and $5,000 to start. That’s right in line with what we’ve seen in our community and what I’ve experienced myself.

“Expensive Compared to What?”

One of my favorite exercises (and one I borrowed from my own business coach) is asking the question: Expensive compared to what?

We’re so quick to label things as “expensive” without context. So let’s look at it this way: If you're currently working in a staff PT job making $70K–$100K a year, and you could potentially start a physical therapy business that pays you that same amount (or more), is a $3K–$5K investment really “expensive”? Or is it a low-cost entry to building a six-figure income?

Even when you add a coaching program to help speed up the process—let’s say you invest $7,000–$10,000 total—you’re still looking at an opportunity to turn that into a business that pays you six figures, gives you flexibility, and helps you reclaim your time.

What Are You Actually Paying For?

Let’s break down the real numbers based on four of the most common cash-based practice models: home-based, telehealth, mobile, and gym-based/renting space. Below is an approximate breakdown of startup and operational costs it could take to build a business over one year of time. I’ve included the total cost with and without business coaching.

A few takeaways from this breakdown:

• Home-Based and Telehealth Physical Therapy practices cost about $3,061/year to run, or around $255/month. When you add in business coaching (averaging $7,500 for 6–9 months), total first-year costs are just over $10,500.

• Mobile practices come in higher at $6,661/year ($555/month) due to gasoline and transportation.

• Gym-Based or Renting Space (Brick & Mortar) setups average around $9,061/year ($755/month), largely due to rent.

• With coaching added, the total for mobile practice setup is around $14,161, and gym-based is about $16,561.

Even at the highest end of that range, you’re still launching your business for less than many people pay for a used car. So referring back to our previous conversation, starting a cash practice is really “expensive compared to what?”

To break it down further, let’s say your session rate is $150. That means it would only take 1–2 clients per month to cover the cost of a home-based setup, and around 6–9 sessions to cover a mobile or gym-based model. And that’s by providing physical therapy services 6-9 times over the course of a month, not 6-9 sessions a week.

The Real Cost of Waiting

Because of my experience starting a practice, as well as helping many practice owners build a successful business, I think it would be a disservice to not touch on the cost of waiting.

Many aspiring practice owners fall into a cycle that sounds like this:

“Once I get a few clients, then I’ll invest in coaching… then I’ll grow.”

But what often happens is the growth never really takes off. I’ve spoken with dozens of clinicians who spent 6–12 months trying to piece everything together themselves—posting on Instagram, getting one or two clients, then getting stuck. They end up feeling frustrated, overwhelmed, and unsure why nothing is working.

Here’s the hard truth: doing it alone will cost you time. And time is money.

If you feel like you have the time, energy, and knowledge to figure everything out yourself, go for it! That’s why we offer free content, YouTube videos, and even a low-cost business setup mini course. It might even be worth checking out this blog post on time and task management as a business owner.

But if you’ve already tried doing it alone and it’s not working, or you’re ready to create a business plan that propels you into success, it might be time to stop waiting and start building—with support.

Is Business Coaching Worth It?

Business coaching programs—like our DPT to CEO program—do come with a higher price tag. Most beginner programs fall in the $5,000 to $10,000 range for 6 to 9 months of support. There are cheaper options, and there are definitely more expensive ones too.

In my experience, coaching is often the largest single expense when starting a practice—but it’s also the one that pays off the fastest. So there’s definitely pros and cons to weigh when making a decision. I do want to mention though, that most of our clients make back their investment (and more) during the program. If you’re interested, you can learn more about our business coaching student success stories at the blog post here.

So is coaching “worth it”? I’d say that depends on two things:

1. Do you trust the coach and the process?

2. Do you trust yourself to follow through and commit to the work?

If the answer to both is yes, then investing in coaching is not a gamble—it’s a high quality growth strategy.

Final Thoughts: You Don’t Need $50,000 to Start

In conclusion, you can absolutely grow a cash based business that replaces—or exceeds—your current income. But you have to stop waiting for the perfect time and start taking steps toward your goal. 

Starting your own practice doesn’t need to cost $50K. I’m here to tell you that you can launch a solid, legally sound solo business—even with coaching included—for less than $10,000 in many cases. And that investment could pay you back hundreds of thousands over time. So, what are you waiting for?

If you're ready to start your own business within the next 1–2 months and you want a proven roadmap, the DPT to CEO program is built for you. It's a 7-month, high-touch coaching program created by women physical therapists who’ve been exactly where you are.

Inside the program, we walk you step-by-step through:

• Setting up your business legally

• Pricing and packaging your services

• Marketing to your ideal clients

• Learning how to confidently sell

• Booking your first 10+ clients (and beyond)

Click here to apply now and book a consultation call with our team. Spots are limited, and we’d love to help you build the practice—and life—you’ve been dreaming about.

Listen to this episode on my podcast!