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Las Vegas, NV 89102
Talk with a health professional who truly cares about the medical field.
We're ready and eager to meet your billing needs.
Physical therapy billing services typically cost 4% to 8% of what you collect, according to the 2026 guide from the quote marketplace Medical Billing Rates (updated July 2026; a market range, not ePT's price). One full-time in-house biller costs about $5,125 a month: the $46,630 median wage BLS reports for billing clerks in therapy offices (May 2025), plus 31.9% for benefits, our calculation from BLS employer cost data (June 2026). ePT Billing charges 4.75% of collections.
Quick answer, at $80,000 collected a month:
Every number below shows its inputs, so you can redo the math with your own collections, your own biller's pay and any quote you have in hand. The estimator does it for you.
On this page: Where the costs meet (estimator) | The BLS math behind $5,125 | Any quote as an effective rate | Medicare clocks | What ePT charges | FAQ
Enter your monthly collections and the fee you were quoted. The in-house side starts from the BLS figures explained below; change the wage, benefits rate or headcount to match your market, and add your software and other monthly costs. If you outsource, add the office time you would still pay for.
Outsourced vs in-house billing cost
Results update as you type. Every result shows its math.
Billing company fee
$3,800 a month
4.75% of $80,000 in collections.
In-house billing
$5,125 a month
1 full-time biller at $46,630 a year plus 31.9% for benefits. That is 6.4% of collections.
Which costs less
Outsourced, by $1,325 a month
That is $15,905 a year.
Break-even collections
$107,903 a month
At 4.75%, the fee equals this in-house cost at $107,903 of monthly collections. Below that outsourcing costs less; above it in-house costs less, if the same staff can handle the extra claims.
How we got there
Estimates only, not a quote, and not tax or legal advice. The in-house figure covers pay and benefits plus whatever you enter as other costs; the outsourced figure covers the fee plus whatever you enter as office time. Wage: BLS OEWS, May 2025. Benefits: BLS ECEC, June 2026. Estimator by ePT Billing.
The break-even point is the in-house cost divided by the fee rate. One biller at $5,125.41 a month ÷ 4.75% = about $107,900 of monthly collections. Below that, a 4.75% fee costs less than one biller's pay and benefits. Above it, one biller costs less, but only if one person can keep up with every claim, EOB and denial at that volume. At two billers the break-even point doubles to about $215,800. Office time you still pay for after outsourcing comes off the in-house cost before you divide, so it lowers the break-even point; the estimator does that step when you enter it.
| Fee rate | vs 1 biller ($5,125.41) | vs 2 billers ($10,250.83) |
|---|---|---|
| 4% (low end of market range) | $128,135 | $256,271 |
| 4.75% (ePT's published rate) | $107,903 | $215,807 |
| 8% (high end of market range) | $64,068 | $128,135 |
Here is the comparison at three collection levels. Every input is listed, so you can check each result with a calculator.
Inputs used in every column:
| Monthly collections | $25,000 | $60,000 | $150,000 |
|---|---|---|---|
| Outsourced at 4.75% | $1,188 | $2,850 | $7,125 |
| Outsourced at 4% to 8% (market range, not ePT's price) | $1,000 to $2,000 | $2,400 to $4,800 | $6,000 to $12,000 |
| In-house, 1 full-time biller | $5,125 (20.5%) | $5,125 (8.5%) | $5,125 (3.4%) |
| In-house, 2 full-time billers | $10,251 (41%) | $10,251 (17.1%) | $10,251 (6.8%) |
| 1 biller minus the 4.75% fee | In-house costs $3,938 more | In-house costs $2,275 more | In-house costs $2,000 less |
| 2 billers minus the 4.75% fee | In-house costs $9,063 more | In-house costs $7,401 more | In-house costs $3,126 more |
BLS publishes no standard for how many claims one biller can carry, so the staffing is your call. Put your own headcount, wage and other costs in the estimator above.
One full-time biller costs a PT practice about $61,505 a year, or $5,125 a month, in pay and benefits at the national median wage for therapy offices. Software, clearinghouse fees, a workstation and cover for time off come on top, and those you have to price from your own invoices.
The closest federal job category to a practice biller is billing and posting clerks (code 43-3021), who "prepare billing invoices for services rendered," in the BLS definition. Medical coders sit in a separate category. In offices of physical, occupational and speech therapists and audiologists (industry 621340), BLS counts 6,640 billing and posting clerks, with a median wage of $22.42 an hour, or $46,630 a year (mean $48,580). Across all industries the median is $48,500. These are May 2025 estimates, published in 2026. BLS turns hourly pay into annual pay at 2,080 hours, which is 52 weeks of 40 hours, so for a full-time biller the annual figure already includes paid vacation and holidays.
BLS's Employer Costs for Employee Compensation, Table 4 (June 2026) breaks down what private health care and social assistance employers spend per hour worked on office and administrative support staff:
| Cost | Per hour worked |
|---|---|
| Wages and salaries | $23.50 |
| Paid leave (vacation, holiday, sick and personal leave) | $2.71 |
| Supplemental pay | $0.67 |
| Insurance | $4.63 |
| Retirement and savings | $0.78 |
| Legally required benefits (Social Security, Medicare, unemployment, workers' comp) | $2.29 |
| Total compensation | $34.59 |
ECEC counts paid leave as a benefit, but the 2,080-hour annual wage already pays for it, so adding it again would count vacation twice. The benefits to add are the other four: $0.67 + $4.63 + $0.78 + $2.29 = $8.37 an hour. Measured against the pay those 2,080 hours cover ($23.50 + $2.71 = $26.21), that is $8.37 ÷ $26.21 = 31.9%. This is our calculation from BLS figures, not a BLS number.
One full-time biller, the math:
The figure is pay and benefits only. Add what your practice actually pays each month for billing software or the billing module of your EHR, clearinghouse fees, patient statements, a computer and desk, and training. Also plan for cover: when your one biller takes vacation or quits, claims and EOBs wait. Put those costs in the "Other in-house costs" box of the estimator.
Owner billing time is not free. BLS puts the median wage for physical therapists in the same offices at $46.71 an hour (May 2025). Example Five hours of billing a week is 5 × 52 × $46.71 = $12,145 a year, about $1,012 a month in wages alone, before counting the visits that time could have covered.
Billing companies quote in one of three ways: a percentage of collections, a fee per claim, or a flat monthly fee. Some add a monthly minimum to the percentage. To compare quotes, turn each one into dollars at your own volume, then divide by what you collect. That share is the effective rate, and it is the number to compare.
The worked example below uses one practice for all three models. Example inputs $80,000 collected a month from 1,000 claims, so $80 collected per claim on average. Swap in your own numbers.
| Pricing model | Market range | Math at $80,000 and 1,000 claims | Monthly fee | Effective rate |
|---|---|---|---|---|
| Percentage of collections | 4% to 8% of collections (PT) | $80,000 × 4% to $80,000 × 8% | $3,200 to $6,400 | 4% to 8% |
| Per claim | $4 to $8 per claim | 1,000 × $4 to 1,000 × $8 | $4,000 to $8,000 | 5% to 10% |
| Flat monthly fee | $1,000 to $5,000 a month | Same fee whatever you collect | $1,000 to $5,000 | 1.25% to 6.25% |
The fee moves with the money you actually receive, so a slow month costs less. The formula is collections × rate: $80,000 × 4.75% = $3,800. Before you compare two percentages, find out what each one is taken from. That base is covered below.
To compare a per-claim price with a percentage, divide the fee by what you collect per claim. At $80 collected per claim, $4 a claim is 5% of collections ($4 ÷ $80) and $8 is 10%. At $120 per claim, the same $8 is 6.7%. Ask whether a corrected or resubmitted claim counts as a new claim, for example one resent after a missing GP modifier or a unit fix.
A flat fee is easy to budget, and its effective rate falls as you grow: $3,000 a month is 12% of $25,000 but 2% of $150,000. Ask what claim volume the flat fee covers and what happens when you pass it.
Example terms, not a quote A 5% rate with a $2,000 monthly minimum, at $25,000 of collections: 5% would be $1,250, so the $2,000 minimum applies. That is an effective rate of 8% ($2,000 ÷ $25,000). Run the minimum against your slowest month, not your average one. Our 12-question checklist for hiring a PT billing service covers the rest of the fee schedule.
Outsourcing does not take every billing task out of your office. Your front desk still collects copays at the visit, and with ePT Billing your office scans EOBs, which ePT then posts within 24 hours. Price that staff time into the outsourced side, counting only the work an in-house biller would otherwise do, such as scanning EOBs. Your desk collects copays under either setup, so that time does not change the comparison. Enter the monthly dollar figure in the estimator's "Office time still needed after outsourcing" box.
Two quotes at the same rate can cost very different amounts, because the rate is taken from different money. Example inputs A practice bills $150,000 in charges and collects $80,000 in a month. At 4.75% of collections the fee is $3,800. At 4.75% of charges it is $7,125, which is 8.9% of what the practice actually received ($7,125 ÷ $80,000).
Ask every billing company, including us, these questions and get the answers in writing:
| Question to ask | Why it changes your cost |
|---|---|
| Is the fee taken from money collected, or from charges billed? | Charges are usually higher than what payers pay, so the same rate costs more on charges, as in the example above. |
| Do copays, coinsurance and deductibles paid at your front desk count? | Your own staff collects this money at the desk. Find out whether the billing company takes a percentage of it too. |
| Are refunds and payer takebacks subtracted? | If a payer recoups a payment or you refund a patient, ask whether the fee on that money comes back off the base. |
| What happens to claims from before the start date? | Old accounts receivable may be worked at the same rate, a different rate, or not at all. Ask which, and from what date of service. |
| Which claims carry the fee after you leave? | Claims sent before the end date keep paying for weeks or months. Ask whether the fee applies to them and for how long. |
| Is credentialing included, or billed per payer? | Adding a new therapist or payer can come with a separate fee per payer, per provider. |
| Is there a setup fee, a monthly minimum, or a fee to leave? | A minimum raises your effective rate in slow months. Setup and exit fees belong in the first-year total. |
| Are software, clearinghouse and patient statements included? | If they are billed separately, add them to the fee before you compare it with in-house. |
| Where will Medicare deposits go? | See the Medicare rule below. |
Medicare may pay a billing agent directly only if the agent's pay "is not related in any way to the dollar amounts billed or collected" (42 CFR 424.73(b)(3), applied to suppliers such as PT practices by 42 CFR 424.80(b)(5)). Those conditions do not apply when the agent "merely prepares bills" and does not receive and negotiate the checks (Medicare Claims Processing Manual, chapter 1, section 30.2.4). So if you pay a percentage of collections, Medicare payments should land in your practice's account, not the billing company's.
Three Medicare clocks set what slow billing costs: 1 calendar year to file, 120 days to appeal, and a 13-day wait before Medicare can pay a clean electronic claim. Each one is priced below.
Medicare requires a claim to be filed no later than 1 calendar year after the date of service (42 CFR 424.44; the claims manual, chapter 1, section 70, says 12 months). Commercial payers set their own limits in your contracts. A claim past the limit is written off. Example One written-off claim worth $80 costs as much as a 4.75% fee on $1,684 of collections ($80 ÷ 4.75%).
A Medicare redetermination, the first level of appeal, must be filed within 120 days of receiving the initial determination, and receipt is presumed 5 days after the notice date (42 CFR 405.942). Once that window closes, Medicare can extend it only if you show good cause (405.942(b)). Example Ten wrongly denied claims worth $80 each, left past the window, are $800 lost, as much as a 4.75% fee on about $16,842 of collections ($800 ÷ 4.75%). Fixes for the PT-specific denial codes are in our guide to physical therapy denial codes and the usual causes are in 10 reasons PT claims get denied.
Medicare cannot pay a clean electronic claim before the 14th day after it arrives (the 29th day for paper claims), and must pay or deny it within 30 days (claims manual, chapter 1, sections 80.2.1.2 and 80.2.1.1). Both clocks start only when Medicare receives the claim. Example A practice collecting $80,000 a month brings in about $2,630 per calendar day ($80,000 × 12 ÷ 365), so each day claims wait to go out pushes about that much cash back by a day.
An EOB that has not been posted hides two things: the patient balance you can now bill, and any denied lines on it. The 120-day appeal clock runs whether or not anyone has read the EOB.
Everything in this box is what ePT Billing publishes on its own site, nothing more.
Those turnaround steps are aimed at the Medicare clocks above: late claims, unappealed denials and unposted EOBs. For anything this list does not cover, including the questions in the percentage table, ask us and get the answer in writing. See what ePT Billing handles for PT practices, or contact ePT Billing.
The 2026 Medical Billing Rates PT guide (updated July 2026) says physical therapy billing typically costs 4% to 8% of collections, a market range, not ePT's price. ePT Billing charges 4.75% of collections. Use the estimator above to turn any quote into dollars at your volume.
Multiply your monthly collections by the rate, then add any minimum, setup or per-payer fees. At $80,000 collected a month, the 4% to 8% market range (not ePT's price) is $3,200 to $6,400, and ePT's published 4.75% is $3,800. Check any minimum against your slowest month, not your average one.
It depends on your collections. One full-time biller at the BLS median wage for therapy offices (May 2025), plus benefits from BLS employer cost data (June 2026), costs about $5,125 a month before software and space, the same as a 4.75% fee on about $107,900 of monthly collections. Below that the fee costs less; above it one biller costs less, if one person can keep up with the claims. Office time you still pay for after outsourcing lowers that point.
BLS puts the median wage for billing and posting clerks in physical, occupational and speech therapy offices at $46,630 a year (May 2025). Adding 31.9% for benefits other than paid leave (our calculation from BLS employer cost data for office and administrative staff in private health care and social assistance, June 2026) brings it to about $61,505 a year, or $5,125 a month. Software, clearinghouse fees, a workstation and cover for time off come on top.
It is when the fee costs less than the staff and tools you would need, and claims, denials and EOBs get worked faster. Compare the fee with your full in-house cost first. Then compare results: claims written off for late filing, denials appealed inside Medicare's 120-day window, and how fast payments get posted.
Read this next: before you sign with anyone, run their answers through the 12 questions to ask a PT billing service. To check unit math on your own claims, use the 8-minute rule calculator.