A full book measures demand, not margin. Four numbers decide whether your physio practice pays you, and none of them is new clients.
Here is the short answer. A physiotherapy practice is profitable when four numbers line up: what each physio hour earns, how many rostered hours are actually billed, how many planned sessions clients actually attend, and what each room costs you to keep open. Get those four right and the owner gets paid. Get one wrong and a booked-out practice can still leave you short at the end of the month.
This is the physio version of the five numbers that decide whether your clinic pays you. The framework is the same. The inputs are different, because physio has consult lengths, rebates, care plans and compensable schedules that a skin clinic never has to think about.
Not revenue per consult. Per hour. A 30 minute standard consult and a 60 minute initial are not the same thing, and neither is a private fee versus a care plan or WorkCover schedule where the amount you receive is capped.
Work it out like this. Take everything a physio billed in a week, at what you actually received rather than your list price, and divide it by the hours they were rostered. Rostered, not booked. Empty slots and no-shows are part of the answer.
Worked example, illustrative only. A physio is rostered 38 hours. She bills 26 hours of consults across a mix of initials, standards and care plan appointments and the practice receives $3,120 for the week. Revenue per rostered hour is $3,120 divided by 38, which is $82. Revenue per billed hour is $120. That $38 gap between the two is the cost of the empty and cancelled slots, and it is the first place to look.
Once you have this number for each physio, compare them. Two physios on the same roster with different revenue per hour is not a personality difference. It is a diary mix, fee mix or attendance difference, and all three can be fixed.
Hours billed divided by hours rostered. In the example above that is 26 divided by 38, or 68 percent.
The trap is measuring the wrong denominator. If your physios are rostered 38 hours but four of those are note-writing, team meetings and lunch, use 34. The point is not to hit a magic number. The point is to measure it the same way every week and watch it move.
Utilisation is where most physio practices find their first real win, because it costs nothing to fix. A waitlist that actually gets used, a cancellation list that gets called, a deposit on initial consults, and a receptionist who knows that a Tuesday 2pm gap is worth $120. Five points of utilisation on three physios is real money.
Empty slots are not free. They are the most expensive thing in your practice.
This is the one physio owners undercount, and it matters more than rebooking.
Rebooking tells you whether a client made a next appointment. Attendance to plan tells you whether they completed the course of care you recommended. A client who needs six sessions and attends three has had half the treatment, and your practice has earned half the revenue on a client you already paid to acquire.
Worked example, illustrative only. A practice sees 40 new clients a month, recommends an average of six sessions, and clients attend an average of 3.5. That is 100 planned sessions a month not attended. At $120 a session, that is $12,000 a month of revenue the practice already earned the right to, walking out the door. Lifting average attendance from 3.5 to 4.5 is worth $4,800 a month, with no new clients and no marketing spend.
Fixing it is a conversation, not a campaign. Book the whole plan at the initial. Explain why. Send the reminder. Follow up the drop-offs. Your physios will tell you clients are the ones who stop coming, and that is partly true. The other part is that nobody asked them to stay.
Every room in your practice has a cost whether or not a physio is standing in it. Rent, outgoings, fit-out, equipment, software, the share of reception that supports it.
Work it out like this. Add up the fixed costs of running the practice for a month, divide by the number of rooms, then divide by the hours each room is available. That is what an empty hour costs you.
Worked example, illustrative only. A two-room practice has fixed costs of $9,000 a month. Each room is available 45 hours a week, or about 195 hours a month. That is $4,500 per room per month, or $23 per available room hour. If a room is only used 25 hours a week, the cost per used hour is closer to $42. Now put that next to your revenue per billed hour and the physio's wage and super for that hour, and you can see exactly what each consult contributes after the room is paid for.
This is also the number that answers the growth question. Extend hours in the rooms you have, or add a room? Add a physio to the empty Tuesday afternoons, or wait? Cost per room hour, alongside utilisation, gives you the answer on paper before you spend the money.
Here is how they connect. Revenue per physio hour, less the physio's wage and super for that hour, less the room cost for that hour, is what one hour of your practice actually earns. Multiply by billed hours and you have your gross contribution. Take off the overheads that are not already in the room cost, and take off your own wage for the hours you spend in the room, and what is left is profit.
If that final number is small or negative, one of the four is out of line. In most physio practices I look at, it is fees that have not moved with wages, or attendance to plan that nobody is measuring. Both are fixable in a quarter.
You do not need a coach to work out the first three. Pull one week of billing per physio, count planned versus attended sessions for your last twenty discharged clients, and divide last month's fixed costs by available room hours. The free clinic calculators do the arithmetic. If you would rather work through what the four numbers are telling you with someone who reads practice numbers for a living, that is what the free Profit Strategy Call is for, and it is exactly the conversation I have with owners as a physiotherapy business coach.
There is no single right number, because it depends on how much admin, note-writing and travel sits inside a rostered day. What matters is that you measure it the same way every week: hours billed divided by hours rostered. Once you have a baseline, a few points of improvement on each physio is usually worth more than a new marketing campaign.
Take everything a physio billed in a week, including the rebated and schedule-capped consults at what you actually received, and divide it by the hours they were rostered. Rostered, not billed. That way empty slots and no-shows are already inside the number, and it tells you what an hour of that physio's time actually earns the practice.
Rebooking measures whether a client made a next appointment. Attendance to plan measures whether they finished the course of care you recommended. A client who books six and attends three has done half the treatment and paid for half the revenue. Closing that gap is better for the client and, in most practices, it is the largest untouched number in the business.
At minimum, what it would cost to hire someone to do your clinical hours, plus super. That figure belongs in your costs before you look at profit. If the practice cannot carry it, the problem is fees or utilisation, not you.
These four numbers are the physiotherapy version of the five numbers that decide whether your clinic pays you. If you would rather work through them with someone who reads practice numbers for a living, that is what I do as a physiotherapy business coach and allied health business coach for practice owners across Australia and New Zealand.
Related: how to choose an allied health business coach, when to hire staff in your clinic, and why a deposit beats a cancellation policy.
This article is general information for clinic and practice owners. The figures in the worked examples are illustrative, not industry statistics. It is not tax, legal or financial advice. Your own numbers, structure and obligations are a conversation for your accountant.
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