Pediatric OT & PT Practice, 35-Year Virginia Two-Location Clinic

$3.3M

Revenue

$1.1M

SDE

4.9x

Multiple

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Full Editorial Writeup

This is a pediatric occupational and physical therapy practice operating for more than 35 years across two leased locations in a large Mid-Atlantic metro (Virginia). The clinic delivers roughly 2,000 treatment visits per month, treating developmental, sensory, motor, feeding, and gait needs from infancy through young adulthood. Beyond core OT and PT, it runs differentiated specialty programs, virtual options, and parent education that distinguish it from smaller independents in a fragmented market.

Trailing-twelve-month revenue through July 2026 was approximately $3.27 million with adjusted EBITDA near $1.13 million, a roughly 34% margin. The model is asset-light with minimal COGS, and revenue has recovered from a temporary 2025 staffing dip thanks to improved reimbursement and renewed clinician capacity. An 80-patient waitlist plus recently hired clinicians ramping toward full caseloads represent visible near-term upside without needing to buy new demand.

The practice is largely owner-light, with the owner spending only 10 to 15 hours per week on leadership and strategy while clinical leadership, billing, scheduling, and administration run day to day. No single patient or referral source is a material concentration, and demand flows from decades of referral relationships, insurance participation, digital marketing, and word of mouth. The seller is exiting to focus on family priorities, not distress, and is positioning this as a platform acquisition for a PT/OT group or PE-backed roll-up.

Why we like it

Earnings quality is strong for a service business: $1.13 million EBITDA on $3.27 million revenue is a 34% margin with minimal COGS and only $25k of FF&E, meaning nearly all cash flow drops to the operator. No individual patient or referral source is a material concentration, which de-risks the revenue base far more than most single-clinic deals.
Durability comes from 35-plus years of operating history, two established locations, and entrenched referral relationships that are extremely hard for a new entrant to replicate. Pediatric therapy is medically necessary and insurance-reimbursed, so families and payers keep funding it through downturns rather than cutting it like discretionary care.
Market tailwinds are real: rising diagnosis rates for developmental and sensory conditions plus persistent clinician shortages mean demand structurally outpaces supply. The 80-patient waitlist is proof of unmet demand sitting on the table today, not a projection.
The operator advantage here is unusual for the price point: the owner works only 10 to 15 hours a week and clinical leadership, billing, and scheduling already run without them. A buyer with recruiting and payer-contracting muscle inherits a functioning platform rather than a job, and can bolt on additional locations.

How to improve it

Attack the 80-patient waitlist immediately by prioritizing clinician onboarding and caseload ramp. Every waitlisted patient converted is incremental high-margin revenue against a fixed cost base, and closing that gap alone should move EBITDA within the first two quarters.
Fix the root cause of the 2025 staffing decline by building a durable clinician recruiting and retention engine. The single largest constraint on this business is therapist capacity, so referral bonuses, competitive comp, and a clinical training ladder directly translate into revenue you already have demand for.
Run a full reimbursement and collections audit across all payer contracts within 90 days. The listing flags 'optimizing reimbursement and collections' as upside, which usually means underpriced contracts and leakage; renegotiating rates and tightening denial management can add margin without adding a single patient.
Expand the highest-margin specialty programs (feeding, gait, sensory) and market them explicitly to referring pediatricians. These differentiated services command better economics and deepen referral stickiness versus commodity OT/PT visits.
Add capacity within the existing two-location footprint before paying for new real estate. Extended hours, better room utilization, and telehealth for appropriate cases increase visits per site and improve return on the leased space you already control.
Build a repeatable de novo or acquisition playbook to add a third and fourth location in the same metro. With owner-light infrastructure and centralized billing already in place, incremental locations should leverage existing overhead and expand the eventual exit multiple.
Institute monthly KPI reporting on visits, cancellation rates, clinician productivity, and days sales outstanding. A practice this size run owner-light likely lacks tight operational dashboards, and visibility is the fastest way to catch capacity and collections slippage early.

Diligence notes

Scrutinize the 2025 staffing-related revenue dip in detail: understand which clinicians left, why, whether they were replaced, and whether the departures took referral relationships or patients with them. The recovery story is central to the valuation, so confirm the ramp is real and not a temporary bounce.
Verify the EBITDA adjustments and owner add-backs line by line, since SDE is listed as 'Not Disclosed' and only adjusted EBITDA is shown. Confirm the owner's 10 to 15 hour role is genuinely replaceable and that no clinical revenue is personally tied to the owner treating patients.
Analyze the full payer mix, contracted rates, authorization requirements, and aging of receivables. Pediatric therapy reimbursement varies widely by insurer and Medicaid participation, and denial rates or slow-paying payers could materially change the true collectible revenue.
Assess clinician tenure, licensure, non-competes, and caseload dependence across the 33 full-time employees. In a therapist-shortage market, retention risk is the biggest threat to this deal, so understand who the key clinicians are and whether they stay post-close.
Confirm the lease terms, remaining runway, and renewal options on both locations, since no real estate is included. Two leased sites with a 4.89x multiple mean a buyer needs pricing certainty and enough term to justify the capacity-expansion plan.

Source

Originally listed on BizBuySell. View original listing →