Psoriasis Treatment Center Break-Even Analysis: Month 14

Fixed costs $96.9K Payroll and overhead

Contribution margin 79% After variable costs

Break-even revenue $123.0K Monthly target

Break-even timing Month 14 Model turns positive

Break-even calculator

Use this calculator to test monthly revenue, variable expenses, and fixed costs for a psoriasis treatment clinic.

Lean Base Full

Monthly revenue Revenue sets the pool that has to cover direct costs and overhead. $ Lower intake Higher intake Variable expenses These are direct costs that rise with treatment volume. $ Lower direct cost Higher direct cost

Money available to cover fixed costs $74,333 $94,333 revenue - $20,000 variable expenses

Margin ratio

79%

Covers fixed costs

$22,592 short

Fixed monthly costs This is the monthly overhead your margin has to cover. $ Lean overhead Heavy overhead

Break-even chart Revenue Total costs

Which psoriasis treatment center expenses are fixed, variable, semi-variable, or semi-fixed at break-even?

Cost classification

Classification matters because fixed overhead sets the monthly hurdle, while drugs, supplies, and marketing change contribution margin. If payroll is modeled as visit-level variable, Month 14 break-even can look safer than it is.

Expense	Cost	Break-Even Treatment	Common Mistake
Clinic Lease	Fixed	Use $12,000 per month in the operating overhead base.	Spreading rent per visit and hiding the true monthly hurdle.
Malpractice Insurance	Fixed	Use $4,500 per month until the policy or coverage level changes.	Treating insurance as a percent of revenue.
Electronic Medical Record Software	Fixed	Use $1,200 per month as recurring software overhead.	Mixing recurring software fees with one-time implementation spend.
Equipment Maintenance	Fixed	Use $1,200 per month for the planning range in the model.	Assuming maintenance rises with every treatment session.
High-Cost Pharmaceuticals	Variable	Model as 38% of first-year revenue, then 37%, 36%, 35%, and 34% by year.	Using a flat dollar amount despite treatment mix and volume changes.
Biologic Administration Supplies	Variable	Model as 12% of revenue across the forecast period.	Putting clinical supplies into fixed overhead.
Marketing and Patient Acquisition	Semi-variable	Model as 30% of first-year revenue, falling to 22% by Year 5 as demand matures.	Leaving acquisition spend flat while patient volume scales.
Provider and Support Payroll	Semi-fixed	Step payroll up as full-time equivalent counts rise for dermatologists, assistants, nurses, technicians, billing, reception, and management.	Treating all payroll as visit-level expense instead of capacity added in blocks.

How does break-even change from lean launch to full clinic scale?

Scenario table

Break-even moves with utilization and staffing. The lean launch year stays below it, the post-ramp year turns positive, and the mature year adds a much wider cushion as revenue grows faster than payroll.

Planning figures only; real break-even will move with payer mix, visit volume, staffing, and reimbursement timing.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch clinic	$94k	$20k	$97k	79%	-$23k	Still below break-even, so cash stays tight.
Base post-ramp clinic	$151k	$29k	$105k	81%	$17k	Clears break-even, so the clinic starts building cushion.
Full mature clinic	$523k	$93k	$197k	82%	$233k	Well above break-even, so the margin buffer is strong.

What breaks the break-even plan for this psoriasis clinic?

Stress test

Year 2 is the first profitable year, but the cushion is thin. A 15% revenue miss or a 10% fixed-cost hike can erase it, and slow referrals, billing delays, underused phototherapy capacity, or hiring ahead of demand are the pressure signs.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$133.3k/mo	$17.3k cushion	The plan clears break-even, but not by much.
Revenue shortfall	Year 2 revenue falls 15%.	$160.0k/mo	$32k gap	A modest referral miss can push the clinic below zero.
Fixed-cost pressure	Fixed costs rise 10%.	$97.6k/mo	$53k cushion	Rent, insurance, and staffing inflation cut profit fast.
Margin pressure	Variable expense load rises to 120%.	$26.6k/mo	$124k cushion	Higher supply and procedure costs compress the margin.
Combined pressure	Revenue falls 15%, fixed costs rise 10%, and variable expense load rises to 120%.	$323.0k/mo	$195k gap	This mix turns a workable plan into a clear loss.

Can this psoriasis clinic clear break-even before you sign the lease?

Founder checklist

Don't sign the lease until referrals, payer setup, and staffing can support about $119K a month in revenue. The model still shows a $271K Year 1 EBITDA loss and needs $230K minimum cash by Month 13, so early underfill will burn cash fast.

1Break-Even Revenue$119K/mo

Verify booked visits can reach this revenue level before you commit, because it is the model's monthly break-even target.

2Fixed Load$22.8K/mo

Check that base overhead stays near this level and that the lease still works once staffing and capex are phased in.

3Referral Flow3 sources

Make sure dermatology, primary care, and rheumatology can send patients from launch, or empty rooms will drag break-even out.

4Payer SetupBefore ramp

Credential payers before you add slots, because billing lag can turn booked visits into slow cash and strain the runway.

5Utilization Ramp45%-85% / $460K

Match hiring and equipment buys to the utilization curve, and stage the $460K capex so phototherapy units and rooms come online with demand.

6Cash Cushion$230K / -$271K

Hold the Month 13 cash floor and fund the Year 1 EBITDA loss, while watching biologic supply, phototherapy room use, and front-desk scheduling each week.