Allergy And Immunology Clinic Break-Even: $81K Monthly Revenue

Fixed costs $67.8K/mo base + payroll

Contribution margin 84% after variable costs

Break-even revenue $80.7K/mo monthly target

Break-even timing Month 2 launch ramp

Break-even calculator

Test monthly revenue against direct costs and fixed overhead to see when the clinic clears break-even.

Lean Base Full

Monthly revenue Revenue sets the pool that can cover direct costs and fixed overhead. $ Low book Full book Variable expenses Direct costs here move with patient volume, like supplies, test kits, billing, and marketing. $ Lean costs Heavy costs

Money available to cover fixed costs $90,720 $108,000 revenue - $17,280 variable expenses

Margin ratio

84%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead and staff base that margin must cover. $ Light overhead Heavy overhead

Break-even chart Revenue Total costs

Which expenses are fixed and which move with sales in an allergy and immunology clinic?

Cost classification

Your monthly break-even will be off if you treat $17.4k of facility overhead as volume-driven or ignore 16.0% first-year revenue-linked costs. Payroll is semi-fixed: first-year wages are about $50.4k/month and step up as providers are hired.

Expense	Cost	Break-Even Treatment	Common Mistake
Clinic Rent	Fixed	Use $10,000/month from Month 1.	Tying rent to visit volume.
Utilities	Fixed	Use $1,500/month for baseline facility load.	Ignoring utility load before full schedules.
Malpractice Insurance	Fixed	Use $3,000/month from launch month.	Adding coverage only after volume builds.
Medical Supplies & Test Kits	Variable	Apply 4.0% of first-year revenue.	Using a flat budget while testing rises.
Immunotherapy Vials	Variable	Apply 5.0% of first-year revenue.	Missing vial use as shot visits scale.
Billing Service Fees	Variable	Apply 3.0% of first-year revenue.	Treating billing as fixed back-office overhead.
Marketing & Patient Acquisition	Variable	Apply 4.0% of first-year revenue during ramp.	Cutting acquisition before schedules stabilize.
Staff Payroll	Semi-fixed	Use about $50.4k/month in first-year wages, then step up with FTE hiring.	Treating each hire as a per-visit expense.

How does break-even change across lean, base, and full clinic setups?

Scenario table

More staff, higher use, and a better payer mix push revenue up faster than fixed cost. That’s why the lean setup still misses break-even, while the base and full setups build a clear monthly cushion.

Planning figures only; actual results will move with referral flow, room use, and reimbursement mix.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean staffing case	$750k	$120k	$678k	84.0%	($48k)	Still below break-even, so ramp speed matters.
Base staffing case	$2,375k	$354k	$1,405k	85.1%	$616k	Above break-even with a solid monthly cushion.
Full utilization case	$4,198k	$567k	$1,924k	86.5%	$1,707k	Strong profit coverage if throughput holds.

What breaks first if patient ramp, payroll, or clinic margins slip?

Stress test

The clinic is most exposed to a slow patient ramp and faster staff hiring. If Year 1 revenue lands at $750,000/month instead of about $807,000/month, it starts $57,000 short, and higher variable costs can widen the gap fast.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change in staffing, revenue ramp, or variable load.	$807,000	$0 gap	Breakeven is tight, so small misses matter.
Revenue shortfall	Year 1 revenue lands at $750,000/month instead of about $807,000/month.	$807,000	$57,000 gap	A modest ramp miss turns into a monthly loss.
Fixed-cost increase	Year 2 staffing comes online while revenue stays at the Year 1 level.	$1,405,000	$775,000 gap	Payroll grows faster than patient volume.
Margin pressure	Variable costs stay 5 points above the Year 5 path.	$1,182,000	$375,000 gap	Higher supplies, vial waste, or billing drag squeeze margin.
Combined pressure	Year 2 staffing and higher variable costs hit while revenue stays at $750,000/month.	$2,014,000	$1,207,000 gap	Slow ramp plus payroll and waste can overwhelm cash.

Can this clinic fill enough visits before you sign the lease?

Founder checklist

The model breaks even in Month 2, but cash still bottoms at $705K in Month 5, so don’t sign the lease or hire ahead until referrals and booked treatments are real.

1Referral volume$10K/mo rent

Confirm referral sources can feed enough consults, tests, and shots to cover the $10,000 monthly rent before you commit.

2Room flow3 flows

Verify the exam-room layout supports consults, testing, and immunotherapy shot flow so throughput does not stall at the point of care.

3Nurse load400/mo

Check that one Allergy Nurse can handle 400 Year 1 monthly treatments at 75.0% utilization, because staffing has to match booked demand.

4Contribution84% CM

Use Year 1 costs of 4.0% supplies, 5.0% vials, 3.0% billing, and 4.0% marketing to confirm the clinic still clears strong contribution after wages and rent.

5Launch capital$298K

Budget the full $298,000 for build-out, diagnostic equipment, immunotherapy lab gear, EMR setup, furniture, IT, exam-room furnishings, and emergency equipment before opening.

6Cash cushion$705K

Hold enough cash for the Month 5 low point, and keep payer credentialing plus collection timing in cash planning even though they sit outside break-even math.