Chronic Pain Management Clinic Break-Even Analysis: $127K/Month

Fixed costs $23.1K/mo Base overhead

Contribution margin 86% After variable costs

Break-even revenue $27.0K/mo Monthly target

Break-even timing Month 13 First breakeven

Break-even calculator

This calculator tests monthly revenue against variable expenses and fixed monthly costs to show where the clinic breaks even.

Lean Base Full

Monthly revenue Revenue sets the pool left after direct costs to cover fixed overhead. $ Lower sales Higher sales Variable expenses These are costs that rise with each treatment, like supplies, billing, and patient acquisition. $ Lower direct cost Higher direct cost

Money available to cover fixed costs $168,716 $194,138 revenue - $25,422 variable expenses

Margin ratio

87%

Covers fixed costs

$48,884 short

Fixed monthly costs This is the monthly cost base the clinic must cover before profit starts. $ Lower overhead Higher overhead

Break-even chart Revenue Total costs

Which chronic pain clinic expenses are fixed, and which move with patient volume?

Cost classification

Break-even gets reliable only when rent and software stay fixed while supplies, drugs, billing fees, and acquisition spend move with treatments. Provider payroll is semi-fixed because headcount rises by year, not with each patient visit.

Expense	Cost	Break-Even Treatment	Common Mistake
Clinic Facility Lease	Fixed	Use $15,000 per month in fixed overhead from Month 1 through Month 60.	Tying rent to patient visits and understating the monthly break-even floor.
Utilities	Semi-fixed	Start with the $2,500 monthly base, then review when hours, rooms, or equipment use expand.	Modeling utilities as purely variable when most of the bill exists before the next visit.
EHR Software Subscription	Fixed	Include $1,800 per month as stable operating overhead for the relevant planning range.	Spreading the subscription across treatments as if each visit creates a new charge.
IT Support Services	Fixed	Use $1,200 per month as fixed support unless the model adds a new service tier.	Letting support rise with revenue without a staffing or vendor trigger.
Clinic Insurance	Fixed	Carry $1,000 per month in fixed overhead during the operating break-even period.	Excluding insurance because it does not attach to a single treatment.
Medical Supplies	Variable	Apply as treatment-driven COGS: 5.0% of revenue in the first year, declining to 4.0% by mature year.	Putting supplies in overhead and hiding the margin hit from higher procedure volume.
Billing System Fees	Variable	Apply as a revenue-linked fee: 2.5% in the first year, declining to 2.0% by mature year.	Treating billing fees as fixed even though they move with collections activity.
Provider Payroll	Semi-fixed	Model payroll in staffing steps, from 1 interventional physician and 2 physical therapists in the first year to higher FTE counts by year.	Treating all payroll as patient-level spend and overstating contribution margin stability.

How does break-even change as a chronic pain management clinic moves from a lean launch to base and full scale?

Scenario table

Break-even gets easier as provider count and utilization rise. The lean setup still sits below break-even, the base case turns positive, and the full case builds a much wider cushion.

Planning assumptions, not guarantees.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch	$116,330	$16,873	$108,933	85.5%	-$9,476	Still below break-even; fixed cost load is too heavy.
Base expansion	$251,196	$34,916	$165,600	86.1%	$50,680	Past break-even; revenue now covers fixed costs.
Full utilization	$1,029,096	$118,345	$369,767	88.5%	$540,984	Wide cushion; utilization and payer mix matter most.

What breaks the break-even plan if referrals lag or costs rise?

Stress test

Year 1 revenue of $116,330 sits about $11,100 below the $127,407 break-even point. If referrals slow, insurance cash drags, or staffing comes on before volume, that gap can widen fast and strain the Month 12 cash trough of $338,000.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change: Year 1 revenue is $116,330 and fixed costs stay at $108,933 a month.	$127,407	$11,077 gap	Thin cushion; the plan only works with a full ramp.
Revenue shortfall	Year 1 revenue runs 10% below plan at $104,697.	$127,407	$22,710 gap	Slower referrals or weak collections double the shortfall.
Fixed-cost pressure	Monthly fixed costs rise 10% to $119,826.	$140,147	$23,817 gap	Hiring ahead of booked volume pushes break-even out fast.
Margin pressure	Variable expenses rise from 14.5% to 16.5% of revenue.	$130,457	$14,127 gap	Billing fees, supplies, and acquisition spend eat more margin.
Combined pressure	Revenue slips 10%, fixed costs rise 10%, and variable load moves to 16.5%.	$143,502	$38,805 gap	This is the failure zone: demand, cash collection, and staffing all miss at once.

What should a chronic pain clinic founder verify before signing the lease and hiring the full team?

Founder checklist

Before you lock in the lease or hire the full staff, make sure the referral flow, billing, and cash runway can support the Year 1 model. If the clinic can’t reach about 364 monthly visits and hold $338K by Month 12, delay the big commitment.

1Referral volume364 visits/mo

Verify referral sources can fill about 364 monthly visits in Year 1 across the five service lines, or the schedule will miss the model fast.

2Fixed load$23.1K/mo

Verify the lease, utilities, software, IT, insurance, supplies, and cleaning stay near the modeled fixed load, because that cost starts before payroll can flex.

3Margin mix85.5% CM

Verify supplies, pharmaceuticals, billing fees, and patient acquisition stay at 14.5% of revenue so each visit still leaves room for payroll and rent.

4Staff ramp11 FTE

Verify you can ramp to 11 full-time roles in Year 1, because payroll reaches about $85.8K a month once the team is fully in place.

5Cash cushion$338K

Hold the Month 12 minimum cash need of $338K, since breakeven lands in Month 13 and payback takes 28 months.

6Launch spend$625K

Phase the $625K build-out, equipment, furniture, IT, EHR setup, computers, security, and signage across Months 1 to 10, and delay capacity spend if credentialing or referrals slip.