How Much Does a Cash-Based PT Really Make Per Hour?

If you’ve ever wondered whether cash based physical therapy practice owners actually make $150, $200, or even $250 per session—and how that translates to real income—you’re not alone.

Maybe you’re considering going out on your own and thinking, What should I charge per session? Is cash based PT profitable? Or maybe you're already charging private-pay rates but still feel unsure about how much you're actually making once you factor in your time, expenses, and taxes.

In this post, I’m breaking it down. We’re going to cover:

• The difference between gross revenue and real income

• How to calculate your hourly profit

• What to consider when setting your session rate

• How to factor in admin time and business overhead

• Why cash-based PT can lead to more freedom, flexibility, and control—even if you’re not making $250/hour

By the end of this post, you’ll have a clear understanding of how to estimate your hourly cash based physical therapy income—and what it takes to build a business that gives you the financial and lifestyle freedom you’re looking for.

Revenue vs. Real Income: Know the Difference

Let’s start by clearing up one of the biggest misconceptions: the money you collect from clients is not the same as the money you keep.

Many new business owners fall into one of two categories:

• They think they can take home every dollar they earn.

• Or, they’re afraid to touch any of it and leave it all sitting in the business account.

Neither is ideal.

It’s not only okay to pay yourself—it’s essential. I recommend all of the students inside our DPT to CEO program start paying themselves as soon as they make money, even if it’s just $10. It builds the habit and sets the intention that this is a real business that supports your life.

How to Calculate Your Private Practice PT Income

Let’s walk through an example.

Let’s say you charge $150 per session and you see four clients in one day.

150 x 4 = $600 in gross revenue.

But you don’t just work four hours that day. You probably have additional admin work: emails, scheduling, documenting, marketing, and so on. That might bring your total work time to about 6–7 hours.

If we assume 6 hours of total work, that puts your revenue at about $100/hour.

This rate is still better than most outpatient clinic jobs, where the average hourly rate is closer to $30–$45.

Don’t Forget About Expenses

Next, we need to subtract business expenses for your PT practice.

Let’s say your total monthly expenses are $2,000, and you work 80 hours per month.

That’s $25 per hour in expenses.

Now subtract that from the $100/hour you were making earlier.

That leaves you with $75/hour before taxes.

And just to be clear: that’s not your take-home pay either. Taxes still have to come out of that number, depending on how your business is set up.

But this is already a helpful way to compare what you make now with what’s possible in a cash-based practice. Even after expenses, your hourly rate can be 2–3 times higher than in a traditional clinic job.

Want a Simple Rule of Thumb?

Here’s a quick way to estimate your real income:

Take half of what you charge per session. That’s a conservative estimate of your hourly take-home rate.

If you charge $150, plan to keep around $75. This accounts for overhead, admin time, and other costs—even if you’re not working full-time hours.

Of course, your actual expenses might be lower when you’re just starting out. In many cases, $2,000/month in business costs is on the high end for beginners. Rent will likely be your biggest expense, so the lower your rent, the more you take home.

How to Set a Sustainable Session Rate

A lot of PTs ask, How do I know what to charge for my physical therapy services?

You don’t just want to pick a number out of thin air. You need to calculate your minimum required rate based on:

• Your financial goals

• The number of appointments you can take each month

• Your estimated monthly expenses

Once you figure out your minimum viable rate, that becomes your baseline. Don’t price any lower than that—even in a discounted package.

Let’s say you determine that you must charge at least $150 per session to hit your goals. Then:

• Your largest packages (e.g., 10 sessions) should still average $150/session

• Shorter packages (e.g., 6 sessions) could be priced at $165/session

• Single sessions might be $180

• Evaluations might be even higher

This way, your per-session rate never drops below your required minimum, and your discounts don’t eat into your profit margin.

If you’re still not sure how to set your prices, check out our free PT income calculator at the blog post here.

Trading Time for Money—and How to Think Long-Term

It’s also worth mentioning: most business owners don’t want to trade time for money forever.

What we’re doing here is a basic income calculation for the cash based business model so you understand the numbers and feel confident starting out. Later on, you might add new income streams—like digital products, group programs, or mentorship—that allow you to earn without being present for every session or treatment plan.

But knowing your numbers now gives you the power to plan for that future.

Factor in Admin Time (It Adds Up)

Don’t make the mistake of thinking client sessions and cash based services are your only hours worked.

As a business owner, you’re also responsible for:

• Answering messages

• Scheduling

• Bookkeeping

• Marketing and sales

• Cleaning and organizing

• Documentation

For every client you see, expect to spend about one hour of non-client-facing time.

If you plan to see 20 clients per week, that means 20 more hours of behind-the-scenes work.

This is why I don’t recommend planning your pricing around seeing 40–50 clients per week. You’ll end up working 60–70 hours, which defeats the purpose of leaving a clinic job in the first place.

If you need help prioritizing things, like admin time, outside of patient care, check out the blog post here where I walk you through time management as a cash based practice owner.

What About Quality of Life?

Let’s not forget one of the biggest reasons why PTs leave the clinic: burnout.

In most traditional settings, you’re seeing 15–30 patients a day, documenting after hours, and still barely making ends meet. There’s little flexibility, and the risk of burnout is high.

Running your own cash-based practice doesn’t just give you more financial freedom. It also gives you:

• A flexible schedule

• The ability to take breaks or vacations without asking permission

• The chance to work with people you actually want to help

• The opportunity to provide high quality care to those people

• The energy to explore hobbies, relationships, and personal growth

These aren’t just soft perks. They’re what make this career sustainable for the long term. 

Learn more about stress free time off as a practice owner at the blog post here.

What’s More Important Than Revenue?

It’s tempting to focus on gross revenue—the total money your business brings in. But what really matters is profit per hour.

This is the number that gives you options.

It’s what allows you to:

• Pay yourself consistently

• Take time off without stress

• Save for taxes, emergencies, and the future

• Invest in your business (or your life)

And it’s the number that brings stability and freedom—not just hustle and grind.

Final Thoughts: The Big Picture

Being a cash-based PT isn’t just about making more per session. It’s about building a business that works for you—one that meets your financial goals and supports the life you want to live. So how much do physical therapists make in the cash based world? It depends, but this post is a great starting point for any new practice owner.

Here’s your to-do list:

1. Calculate your monthly income goal.

2. Estimate your monthly expenses.

3. Determine how many sessions you can reasonably take.

4. Use those numbers to set your minimum per-session rate.

5. Price your packages accordingly—never go below your baseline.

6. Track your real take-home pay, not just the revenue.

7. Use that data to make confident decisions going forward.

If you need help with any of this—whether it’s pricing, sales, marketing, or setting up your systems—we’d love to support you through the DPT to CEO coaching program.

Listen to this episode on my podcast!