Speech Therapy Clinic Break-Even Analysis: $76K Monthly Revenue

Fixed costs $67.4K Month 1 base

Contribution margin 91% After variable costs

Break-even revenue $74.1K Monthly target

Break-even timing Month 37 Cash breakeven

Break-even calculator

Test monthly revenue, variable expenses, and fixed costs to see when a speech therapy clinic crosses break-even.

Lean Base Full

Monthly revenue Monthly billings set the margin left to cover fixed costs. $ Lower volume Higher volume Variable expenses Direct costs that rise with visits, supplies, marketing, and billing. $ Lower costs Higher costs

Money available to cover fixed costs $74,877 $81,300 revenue - $6,423 variable expenses

Margin ratio

92%

Covers fixed costs

$250 short

Fixed monthly costs Monthly payroll and overhead the clinic must cover. $ Lean clinic Bigger clinic

Break-even chart Revenue Total costs

Which speech therapy clinic expenses are fixed, and which move with session volume?

Cost classification

Break-even only works if payroll, rent, supplies, and billing fees are placed in the right buckets. Here, fixed overhead starts at $9,900/month before payroll, while visit-linked costs run as revenue percentages.

Expense	Cost	Break-Even Treatment	Common Mistake
Therapist payroll	Semi-fixed	Treat speech-language pathologist salaries as capacity blocks that rise with headcount, from 6 clinical FTE in the first year to 22 by the fifth year.	Treating all therapist payroll as variable per session.
Clinic rent	Fixed	Include $5,000/month in fixed monthly break-even costs for Month 1 through Month 60.	Spreading rent across sessions and hiding true overhead.
Administrative staffing	Semi-fixed	Model the clinic manager, administrative assistant, and billing specialist as staffing steps tied to operating scale, not each treatment.	Waiting too long to add admin support as volume grows.
Electronic health record billing transaction fees	Variable	Apply as a revenue-linked percentage: 1.5% in the first year, declining to 1.1% by the fifth year.	Ignoring billing fees when estimating contribution margin.
Therapy materials and supplies	Variable	Apply as a session-linked revenue percentage: 2.0% in the first year, declining to 1.5% by the fifth year.	Putting supplies in fixed overhead instead of visit-level spend.
Marketing and patient acquisition	Variable	Use the model’s revenue percentage, starting at 5.0% in the first year and declining to 3.0% by the fifth year.	Assuming referrals fill every added therapist without acquisition spend.
Software and IT support	Fixed	Include the $700/month electronic health record base subscription and $1,000/month IT support in fixed monthly costs.	Mixing the base subscription with transaction fees.
Insurance, utilities, cleaning, and credentialing	Fixed	Include professional liability insurance, utilities, cleaning, and credentialing as fixed monthly overhead totaling $2,800/month.	Putting one-time build-out items into operating break-even.

How does break-even change from a lean launch to the base case and full clinic model?

Scenario table

More therapists, higher prices, and fuller schedules lift revenue faster than variable costs, but payroll and overhead also rise. So the lean launch stays below break-even, the base case gets close, and the full model builds a cushion.

Planning assumptions only. Real collections, no-shows, and staffing gaps can move break-even.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch	$52,080	$8,072	$67,400	84.5%	-$23,392	Below break-even; fixed payroll still outruns clinic revenue.
Base case	$162,947	$12,873	$119,483	92.1%	$30,591	Near break-even; small demand swings can flip profit.
Full model	$374,685	$23,605	$198,400	93.7%	$152,680	Above break-even; higher volume gives a wider cushion.

What breaks the break-even plan for a speech therapy clinic?

Stress test

The clinic starts about $24k a month below break-even, so slow referrals or no-shows can widen the loss fast. Fixed rent and staffing are the main drag, and a small margin slip makes the gap harder to close.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change from the launch case.	$76,318	$24,238 gap	The clinic opens below break-even, so ramp speed matters.
Revenue shortfall	Monthly revenue falls 10% to $46,872.	$76,318	$29,446 gap	Slow referrals and no-shows widen the monthly loss fast.
Fixed-cost pressure	Fixed costs rise 10% before utilization catches up.	$83,948	$31,868 gap	A rent or staffing bump bites hard before schedules fill.
Margin pressure	Variable expense pressure rises 3 percentage points.	$78,933	$26,853 gap	Billing friction or overtime pushes the clinic deeper into loss.
Combined pressure	Revenue falls 10%, fixed costs rise 10%, and variable pressure lifts.	$81,832	$34,960 gap	This is the danger zone if several launch issues hit together.

What should a speech therapy clinic founder verify before signing the lease and hiring?

Founder checklist

Check the lease, staffing, payer setup, and workflow before you commit. The model carries $9.9K in monthly fixed costs, about $203K in startup spend, Year 1 EBITDA of -$350K, and break-even in Month 37, so a weak launch can push payback out fast.

1Lease Load$5.0K/mo

Verify the lease fits the $5,000 monthly rent inside the $9.9K fixed-cost base before the clinic is full, or overhead gets locked in too early.

2Staffing Ramp8.5 FTE

Confirm Year 1 coverage includes 2 pediatric SLPs, 1 adult neuro SLP, 1 fluency voice SLP, 1 diagnostic SLP, 1 lead SLP, plus admin, billing, and manager support.

3Revenue FlowPre-launch

Confirm payer contracting, credentialing, intake, scheduling, no-show follow-up, and billing work before revenue ramps, so visits turn into cash without delay.

4Margin Mix90.5% CM

Check the first-year service mix still leaves about 90.5% contribution margin after 3.5% COGS and 6.0% variable expense, because fixed payroll is the real break-even hurdle.

5Room Capacity450/mo

Verify room and schedule capacity can handle 450 monthly treatments in Year 1 and 550 by Year 5, or growth will hit a physical ceiling before demand does.

6Cash Cushion$553K

Keep runway for the $203K startup spend plus the $350K Year 1 EBITDA loss, because the model does not reach break-even until Month 37.