When an outpatient clinic considers using a physical therapy staffing agency, the hourly bill rate is usually the first number that gets attention. It is important—but it is not the same thing as the staffing company’s profit, and it is not the only number a clinic should compare.
A useful cost comparison looks at what is included in the staffing arrangement, the cost of leaving the position unfilled, and the clinic revenue that additional coverage can help preserve.
What is included in a therapy staffing bill rate?
The exact structure varies by company and assignment. A staffing rate may account for clinician compensation as well as recruiting, screening, credential verification, payroll-related costs when applicable, insurance, administrative support, and the ongoing work of maintaining the assignment.
That means comparing an agency bill rate directly with an employee’s hourly wage can be misleading. A direct employee has additional costs and responsibilities that do not appear in the wage alone.
Compare staffing cost with the fully loaded cost of hiring
Depending on the employment arrangement, direct-hire costs can include payroll taxes, benefits, paid time off, workers’ compensation, recruiting expenses, job advertising, credentialing, onboarding, HR administration, and management time. There is also financial risk when a new hire leaves shortly after onboarding.
A temporary staffing arrangement generally trades some of that long-term commitment for flexibility. The clinic pays an agreed rate for coverage during the period it needs the clinician.
The cost of an empty treatment schedule matters
The relevant question is often not, “Is a contract therapist more expensive per hour than an employee?” It is, “What happens financially if we do not have a therapist?”
An unfilled PT position can mean fewer evaluations, longer wait times, declined referrals, reduced treatment capacity, additional pressure on existing clinicians, and lost downstream visits. Those effects can continue for every week the vacancy remains open.
Calculate the break-even point for your own clinic
Rather than relying on a generic national estimate, use your clinic’s actual numbers. Estimate the net collectible revenue generated during one therapist hour, then compare it with the contract staffing cost and any incremental expenses associated with that additional volume.
For example, a clinic treating more than one patient per therapist hour may evaluate the economics very differently from a clinic built around one-on-one hour-long appointments. Payer mix, coding, reimbursement, cancellations, productivity, and support staffing all affect the result. Clinics should use their own billing data rather than assuming a particular reimbursement amount.
When does contract PT staffing make the most sense?
Contract coverage can be particularly useful when the clinic has established patient demand but does not have enough clinical capacity. Common examples include maternity leave, an unexpected resignation, a new location, a growing waitlist, seasonal volume, difficulty filling a permanent position, or the need for coverage on specific days.
The clinic can maintain capacity without making a permanent staffing decision solely because it is under immediate pressure.
Questions to ask when comparing staffing quotes
Ask whether the quoted rate changes based on specialty, schedule, duration, guaranteed hours, or employment structure. Clarify what happens if the clinician is unavailable, how replacements are handled, whether there are conversion or buyout provisions, and what notice is required to end or extend the assignment.
The lowest hourly quote is not necessarily the lowest-cost solution if the company cannot consistently provide qualified coverage.
Get an outpatient staffing quote from DTS
Distinctive Therapy Services provides PT, OT, and SLP staffing for outpatient clinics throughout the Chicago metropolitan area. We structure coverage around the facility’s schedule and clinical needs rather than forcing every clinic into the same model.
Learn more about outpatient therapy staffing, or contact DTS to discuss the position, hours, specialty, and expected duration of coverage.