How much does it cost to start a clinic or practice?
About $168,000 all in for a small one, opened by one founder in an American city: $94,000 to open the doors and $74,100 to keep going for the a year it typically takes to pay its way. Below, every item at low, typical and high with where it comes from — and your own quote, for your country, your town, how you start and the money you have.
To open: $94,000
Treatment-room fit-out (2–3 rooms): $50,000 ($20,000–$90,000). Practice guides: treatment rooms $15k–$30k each to fit (sim-launch-costs.ts); PT planning model build-out ~$75,000 (financialmodelslab)
Treatment tables (3): $4,500 ($1,500–$9,000). WebPT: treatment tables around $1,500 each; automatic high-low $3,000; wooden under $500
Therapy modalities (ultrasound / e-stim): $3,600 ($200–$7,000). WebPT: ultrasound muscle stimulators around $3,600; portable units about $100 each
Exercise equipment: $8,000 ($2,000–$25,000). WebPT: upright bikes from $800, treadmills from $1,800; planning model $25,000 exercise equipment
Reception furniture and computers: $8,000 ($3,000–$15,000). PT planning model: furniture $15,000, computer systems $10,000 (financialmodelslab)
Facility permits and registrations: $1,000 ($100–$2,500). WebPT: Arizona business licence $50 + local fees; New York permit to open a PT practice $2,000
Insurance credentialing and billing set-up: $2,000 ($500–$5,000). Our estimate: credentialing consultant / clearinghouse enrolment; payer credentialing lags 60–120 days
Insurance, first year (liability and malpractice): $1,210 ($800–$3,000). WebPT 'How much does it cost to start a PT practice', citing Insureon medians: general liability $42/mo, professional liability $59/mo
EHR set-up and onboarding: $500 ($0–$2,000). Our estimate: no published figure was found for this item.
Website and opening marketing: $5,000 ($2,000–$10,000). SBA-style estimate in sim-launch-costs.ts header: small-business website $2,000–$10,000 by a freelancer (Clutch/UpCity surveys); plus referral-source outreach
Forming the company: $800 ($150–$2,500). An LLC's state filing is $50–$500 (state fee schedules), plus an EIN (free) and a registered agent; the World Bank measured the procedures at about 1% of income per capita, about $850 (Doing Business 2020); a lawyer's formation package $500–$2,000.
Lease deposit: $6,250 ($3,670–$20,000). Two to three months' rent is usual for a first-time tenant (Aquila Commercial; REBusiness, restaurant lease counsel). 1,500 sq ft typical. CBRE Q3 2025: US medical outpatient average asking rent ~$25.20/sq ft (Q4 $25.40 NNN); Transwestern Q2 2025 $22.64; Houston Q4 2025 $30.20
Rent while you fit out, before opening: $3,130 ($0–$20,000). Landlords often give a few months rent-free for a build-out, often used up by permits before work starts (NYC restaurant lease counsel, DHC Legal); none to three months paid.
To keep going until it pays its way: $74,100
Running costs while sales build: $12,700 ($3,210–$58,300). EMR / practice software, Billing service / clearinghouse, Accounting and payroll software, Electricity, water, cleaning, Clinical supplies and linens, Marketing, until it breaks even; sales are taken to grow evenly to cover them, so about half is needed. Break-even: PT practice guides (2025, sources conflict): most practices break even in months 7–12; others 12–24 months, payer credentialing delaying the first cash
Rent while sales build: $18,800 ($6,420–$80,000). The premises' monthly cost above, until it breaks even, half of it covered by sales as they grow.
Your own living costs until it can pay you: $42,700 ($24,900–$85,400). A one-person household spends about $3,560 a month in America (BLS Consumer Expenditure Survey 2021–22); nothing is paid to you until the business breaks even.
All in: $168,000
About $168,000 all in ($68,500–$435,000): $94,000 to open and $74,100 to keep going for the a year it typically takes to pay its way.
With $10,000 of your own you are $158,000 short: borrowed as an SBA 7(a) or bank loan at 11% over 5 years, about $3,440 a month.
The trade's published range, before the months it takes to pay its way: $50,000–$300,000. PT practice cost guides (2025): physical-therapy clinic $50,000–$300,000; MGMA/APTA small private clinic $100k–$500k (sim-launch-costs.ts); planning model build-out ~$75k + equipment ~$65k
How much does it cost to start a clinic or practice?
About $168,000 all in ($68,500–$435,000) for a small one, my own premises, in an American city. To open: Treatment-room fit-out (2–3 rooms) $50,000; Treatment tables (3) $4,500; Therapy modalities (ultrasound / e-stim) $3,600; Exercise equipment $8,000; Reception furniture and computers $8,000; Facility permits and registrations $1,000; Insurance credentialing and billing set-up $2,000; Insurance, first year (liability and malpractice) $1,210; EHR set-up and onboarding $500; Website and opening marketing $5,000; Forming the company $800; Lease deposit $6,250; Rent while you fit out, before opening $3,130 — $94,000. To keep going for the a year it typically takes to break even: running costs while sales build $12,700; rent while sales build $18,800; your own living costs until it can pay you $42,700 — $74,100. The trade's published startup range is $50,000–$300,000 (PT practice cost guides (2025): physical-therapy clinic $50,000–$300,000; MGMA/APTA small private clinic $100k–$500k (sim-launch-costs.ts); planning model build-out ~$75k + equipment ~$65k), which leaves the months before it pays its way out.
What does SparkTower's simulator pay to open it?
The simulator pays the one-off opening costs before the first customer — the running costs and the founder's living it plays month by month: Treatment-room fit-out $50,000; Lease deposit (two months' rent) $1,500; Rent while you fit out, before opening (two months) $1,500; Clinical equipment $40,000; Registration, licensing, insurance $5,000; Practice software $5,000; Forming the practice $3,000; Opening marketing $7,000. A small private clinic (physiotherapy, dental hygiene, GP-style): $100k–$500k (MGMA and APTA practice startup guides); treatment rooms $15k–$30k each to fit. Plus the lease: a deposit of about two months' rent (two to three is usual for a first US tenant, and restaurant landlords ask for at least two — Aquila Commercial; REBusiness, restaurant lease counsel), and rent through the fit-out before the doors open (restaurants usually win three to six months free during a build-out, often used up by permits before work starts — NYC restaurant lease counsel, DHC Legal).
How much of that do you keep?
$90,000 of it — the kit, fit-out or stock it bought — is still yours afterwards, something a buyer would pay for and a lender would lend against; the other $23,000 is spent.
What if my own money doesn't cover it?
With $10,000 of your own you would be about $158,000 short. Borrowed as an SBA 7(a) or bank loan at 11% over 5 years, that is about $3,440 a month. Most founders borrow the rest. A small-business term loan runs about 11% a year over 5 years (SBA 7(a) loans are the prime rate plus 3 to 6.5 points), repaid every month from the start — before the business has found its customers. In SparkTower's clinic or practice simulator the founder starts with $65,000 of their own money. The launch costs take all of it and $76,250 is borrowed — at 11% over 5 years, about $1,658 a month from the first period.
Can you start a clinic or practice with no money?
Not in full: lenders want the owner to put in about 20% (the SBA's own floor for a start-up is 10%), and lend against the kit, fit-out and stock a launch buys, not its marketing or a software build. What a founder with nothing does is open smaller — a therapist renting a treatment room by the session, or visiting patients — on about $11,300 of essentials (portable clinical equipment $6,000; registration, licensing and insurance $4,000; practice software $1,000; forming the practice $300), borrowed as a microloan (the SBA's are up to $50,000, at 8–13%) or, for a few thousand dollars, on a card at about 22%. The rest is bought once the business can afford it. A mobile or cash-based physiotherapy practice: $10k–$30k (APTA private-practice guides; WebPT mobile-practice guide).
Will it earn the money back?
That depends on what you charge, how many customers you win and what your rivals do. The free clinic or practice simulator pays these costs before it opens, borrows what the founder's cash doesn't cover, and plays the business forward against real rivals, so you can see whether it earns them back before you spend them.
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