Physical Therapy Clinic Bookkeeping & Accounting
Fairlight CPA runs the books, payroll, and tax for physical therapy clinics — where shrinking per-visit reimbursements make volume, collections discipline, and cash-pay programs the whole ballgame. We keep per-visit economics and payer reality visible month after month.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems physical therapy practices actually have
Reimbursement per visit keeps compressing
Payer rates drift down while cost per visit drifts up. Without a realized-rate view by payer, clinics discover the squeeze only when cash tightens.
Front-desk collections leak
Copays and patient balances missed at the desk rarely get collected later. The leak is invisible unless patient-responsibility AR is tracked apart from insurance AR.
Plans of care outrun authorizations
Visits delivered past the authorized count are free care. Books tied to the visit log expose it; books tied to deposits never will.
Cash-pay and wellness blur into clinical revenue
Dry needling packages, memberships, and performance programs are a different business with different margins — mixing them into one line hides both.
What Fairlight takes off your plate
The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how physical therapy practices actually make and spend money.
- Realized-rate tracking by payer with denials and adjustments visible
- Patient-responsibility AR separated from insurance AR so desk collections stay honest
- Monthly close by the 15th with per-clinic and per-therapist views
- Payroll for PTs, PTAs, and techs including productivity-linked comp
- Business and personal tax prep, quarterly estimates, and CFO reporting for adding a clinic or a cash-pay line
The three numbers we keep in front of you
No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.
Realized rate per visit
actual collections per visit by payer — not the chargemaster fantasy
Visits per clinician per day
utilization against capacity, the number that carries fixed costs
Patient-responsibility collection rate
what the front desk captures versus what walks out
Revenue cycle & tax notes
Revenue & reconciliation
We reconcile ERA remittances and desk payments to the visit count monthly and age both AR lanes separately, working with your biller so underpayments get chased while they're fresh.
Tax & entity
Equipment (tables, shockwave, laser) and clinic buildouts create depreciation timing choices; multi-clinic owners also face entity and state-registration decisions we plan ahead of the lease signing.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $800/mo. Every fee is quoted and fixed in writing before any work begins.
Physical Therapy accounting FAQs
We want to grow cash-pay — how do the books help?
By splitting it out: cash-pay programs get their own revenue and margin line, so you can see whether the wellness side subsidizes or subsidizes-off the insurance side before you invest further.
Can you tell us our real cost per visit?
Yes — clinical labor, rent, and overhead against delivered visits, updated monthly. It's the denominator every payer-contract decision should sit on.
What does it cost?
Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $800/month. Exact fee fixed in writing after a short call.
Related healthcare specialties
Get the financial side handled
A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for physical therapy practices.
The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.