If you own an outpatient physical therapy practice, the most active buyers today are national and regional outpatient therapy companies and groups backed by private equity that add practices one market at a time. Private equity firms also buy established practices to build new groups on, health systems and orthopedic groups buy practices to bring therapy in-house, and some owners sell to their own partner therapists or clinic directors.

What makes those buyers pay more is mostly predictable: several clinics in one region, a payer mix they are comfortable with, referral sources that do not depend on you, therapists who stay, busy clinics with room to grow, billing and documentation that hold up to review, and clean financials. That holds for multi-clinic groups too, and for practices that also offer occupational or sports therapy.

The short version

  • Who buys: national and regional outpatient therapy companies, private equity backed physical therapy groups, private equity firms, health systems and orthopedic groups, and your own partner therapists or clinic directors.
  • What they pay more for: several clinics in one region, payer mix, referral sources, therapists who stay, visits and capacity, clean billing and documentation, low owner dependence and clean financials.
  • How deals can be structured: some buyers take a majority stake and leave the owners holding the rest, and every buyer will ask how long the owner therapist will stay.
  • How to get the best result: put the practice in front of several of those buyers at once, confidentially, instead of taking the first offer that arrives.

Who has been buying physical therapy practices

The deals below come from public announcements. None of them is a Hello Exit transaction, and naming a buyer here does not mean it works with Hello Exit or is looking for any particular practice. They show who is active and how these deals tend to be structured.

A physical therapy practice is a licensed healthcare business, like a medical practice, a dental practice or a veterinary practice. Those pages show how buyers weigh a practice whose owner is also one of its clinicians.

National and regional outpatient therapy companies

Larger outpatient therapy companies keep buying local practices, often to enter a new market or add clinics near their own.

For example, U.S. Physical Therapy, a publicly traded operator of outpatient clinics, acquired a 67% stake in a twelve-clinic physical therapy practice effective July 1, 2026, with the practice’s current owners keeping the other 33%. The announcement did not name the practice, and said the deal took the company into a new state.

Private equity backed physical therapy groups

Many active buyers are groups owned by private equity firms that already run clinics in several markets and keep adding practices, often keeping the local name and team.

Private equity firms

Private equity firms also buy established practices outright, often as the base for a new group. For example, MBF Healthcare Partners formed Arete Health with Eric DeYoung, now Arete’s chief executive, in September 2025 by acquiring Brunswick Physical Therapy in North Carolina and ProFlex Physical Therapy in Maryland. Arete’s May 2026 acquisitions, above, followed within a year.

Health systems and orthopedic groups

Health systems and physician groups buy practices to bring therapy in-house for their own patients.

Partner therapists and clinic directors

Some owners sell to a partner or senior therapist who already works in the practice, or to the clinic directors who run it, often with part of the price paid over time. That keeps the practice with its people and can be the easiest transition for patients. It is an option to compare against outside offers, not a replacement for testing them.

How selling a physical therapy practice works differently

A few things come up in physical therapy deals that rarely come up elsewhere. These notes explain what buyers will ask about; they are not legal, billing, tax or regulatory advice, so bring your own healthcare attorney and accountant in early.

Payer contracts and Medicare enrollment

Buyers start with where your revenue comes from: Medicare, Medicaid, commercial insurers, workers’ compensation and patients paying directly. Expect a buyer to list every payer contract with its term and renewal date, and to ask whether each one can move to a new owner or whether the buyer will bill under its own contracts.

Noridian, one of the contractors that handles Medicare enrollment, tells physicians, non-physicians and group practices to report a change of ownership within 30 days of the change taking effect, and says a missed report can lead to revocation of the provider’s Medicare record (Noridian). How that applies to your practice, and how each contract moves to a new owner, is a question for your healthcare attorney.

Billing and documentation

Buyers review how your visits are documented and billed, often by sampling patient charts. Medicare, for example, requires a physician or nonphysician practitioner to certify the plan of care for outpatient therapy (CMS Medicare Benefit Policy Manual, chapter 15).

Expect a buyer to check that plans of care, certifications and visit notes support what was billed, and to ask about denials, payer audits and refunds. Problems found late can cut the price or stop a deal.

Referral sources and physician relationships

Buyers want to know where new patients come from. The American Physical Therapy Association reports that patients in all 50 states, the District of Columbia and the U.S. Virgin Islands have some form of direct access to physical therapists without a referral, though some states limit treatment without one, for example by number of visits or time (APTA). Even so, a buyer will ask which physicians, surgeons, employers and other sources send you patients, and whether those relationships run through you.

Physical therapy is also one of the designated health services covered by the federal physician self-referral law, which CMS says prohibits a physician from referring patients for those services, when Medicare pays, to an entity with which the physician or an immediate family member has a financial relationship, unless an exception applies (CMS). If a referring physician owns part of your practice, leases you space or is paid by you in any way, expect a buyer’s attorneys to look closely, and a sale to a physician group raises the same question. Review those arrangements with your healthcare attorney.

Who may own the practice

Each state licenses physical therapists through its own board (APTA), and some states also set rules on who may own a physical therapy practice and in what legal form. California, for example, passed a law in 2013 that lets specified licensed health professionals be shareholders, officers, directors and professional employees of a physical therapy corporation (California AB 1000).

A buyer’s attorneys will check your state’s rules early, because they can affect how the purchase is structured, so have your own healthcare attorney do the same.

Therapists, and your role after the sale

Expect questions about each therapist’s license, pay, tenure and plans, any agreements they have signed, and how you recruit when someone leaves.

If you also treat patients or run the clinics, a buyer will ask how long you will stay and in what role. In some deals the owners also keep part of the practice, as in the U.S. Physical Therapy acquisition above, so ask what that stake could be worth later and how you would sell it.

What physical therapy buyers pay more for

Every buyer looks at earnings first. After that, these are the things that most often move what a physical therapy buyer will pay and how much of the price comes at closing.

Several clinics in one region

Clinics close together can share therapists, front desk staff, managers and referral relationships, and a buyer with clinics nearby may see yours fitting into its own.

A payer mix buyers are comfortable with

Know how much revenue comes from each payer and whether any single payer dominates. A buyer will ask what happens if a large contract changes, because your mix shapes both price and which buyers fit.

Referral sources that do not depend on you

Referrals spread across many physicians, employers and patients who find you directly are worth more than a handful of surgeons who know only you. Track where each new patient came from, by month and by source.

Therapists who stay

Patients are loyal to the therapists who treat them. Buyers look at turnover, how long your therapists have stayed, whether they will stay after the sale, and whether the clinics run well when one leaves. Some of the announcements above said the practice would keep its identity or that patients could keep seeing the same therapists.

Visits per clinic and room to grow

Buyers measure clinics in visits: visits per clinic, per therapist and per day, new patients each month, and how many visits a typical patient completes. A clinic with open treatment hours, space and a waiting list shows a buyer room to grow without new locations.

Clean billing and documentation

Plans of care certified on time, notes that support every charge, low denial rates and a clean audit history make the practice easier to underwrite. Gaps give a buyer reasons to lower the price or ask for added protections.

How much the practice depends on you

If you see the most patients, hold the key referral relationships and run every clinic, a buyer is paying for a practice that may not run without you. Owners who have clinic directors running daily operations usually get better terms, with more of the price paid at closing and less tied to future results.

Clean financials

Buyers will ask for several years of financial statements and detail by clinic, payer and therapist: visits, revenue per visit, collections, labor cost, margins, and personal expenses separated from business costs. Clean books make the practice easier to underwrite and harder to discount.

Why it pays to have several buyers at the table

The same practice can look very different to different buyers. A national outpatient company may value your clinics as a way into your market. A private equity backed group nearby may value your therapists and referral relationships. A health system or orthopedic group may value bringing therapy in-house for its own patients, and a partner therapist may value keeping the practice independent. When you talk to only one of them, you only learn what that one will pay.

Putting the practice in front of several qualified buyers at once, confidentially, tests price and terms against each other, including how much comes as cash at closing and how much as ownership you keep. Buyers learn who you are only after signing an NDA, so therapists, patients and referral sources do not find out early.

Hello Exit is a sell-side M&A advisor for founders selling businesses from $1 million to $400 million, and it is the team behind 1,000+ acquisitions and exits. Every engagement starts from accurate information. Hello Exit’s Exit Report is an advisory estimate that shows the strategic case, where strategic buyers exist, and the financial case side by side, along with an honest read on readiness. If the business is not ready to sell, Hello Exit says so and helps you get there first.

See how the process works, from the first confidential call to closing, and what Hello Exit does.

Size matters too. Below roughly $1 million in value, a marketplace or local business broker is usually the practical route to a sale. Above $400 million, an investment bank is usually the better fit.

Before you talk to buyers

Common questions

Who buys physical therapy practices?

Mostly national and regional outpatient therapy companies, private equity backed physical therapy groups, private equity firms starting new groups, health systems and orthopedic groups, and partner therapists or clinic directors. Which of them fits depends on your size, your number of clinics, your payer mix and your region.

What happens to my payer contracts and Medicare enrollment when I sell?

A buyer will review each contract and ask whether it can move to a new owner or whether the buyer will bill under its own. Medicare has its own rules for reporting a change of ownership, so review the steps and timing with your healthcare attorney before you go to market.

Will I have to keep treating patients after I sell?

Often for a period, so patients, therapists and referral sources move smoothly to the new owner. Some buyers also leave the owners with part of the practice. The more your therapists and clinic directors already carry, the shorter and lighter that commitment tends to be.

Is my physical therapy practice big enough for an M&A advisor?

Hello Exit works with businesses from $1 million to $400 million in value. Below roughly $1 million, a marketplace or local business broker is usually the better route.