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Dec 31, 2025
US Physical Therapy Q4 2025 Earnings Report
US Physical Therapy Q4 2025 Earnings Report
Key Takeaways
US Physical Therapy delivered a strong finish to 2025 with record patient volumes and significant margin improvement. The company saw its seventh consecutive quarter of record visits per clinic per day and successfully managed costs despite inflationary pressures, while announcing major long-term hospital affiliation agreements expected to drive substantial growth in 2027.
Achieved record average visits per clinic per day of 32.7 in Q4, the highest in company history.
Physical therapy adjusted gross margin increased approximately 200 basis points to 20.5% in Q4.
Announced two significant hospital arrangements expected to contribute at least $14 million in EBITDA by 2027.
Total patient visits increased 11.2% year-over-year, driven by organic growth and acquisitions.
Revenue by Segment
Forward Guidance
Full year 2026 adjusted EBITDA is expected to be between $102 million and $106 million.
Positive Outlook
- Incremental $2.5 million revenue from Medicare rate increase.
- Implementation of ambient listening documentation AI for efficiency.
- Expected $14 million EBITDA lift from new hospital affiliations by 2027.
- Semi-virtualization of front desk and intake operations to lower costs.
- Return to pressing forward with remote therapeutic monitoring (RTM).
Challenges Ahead
- Hospital affiliations will only begin to phase-in mid-year 2026.
- Continued inflationary environment impacting operating costs.
- IIP margins can be dilutive when signing very large new contracts.
- Implementation costs of $600k for new enterprise-wide financial system.
Historical Earnings Impact
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Avg. Return Before/After Earnings
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