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Key Takeaways
- The average monthly running cost for a new Biofeedback Therapy Clinic in 2026 is projected to be approximately $48,600, dominated by a $29,375 monthly payroll expense.
- Despite high initial expenses and capital needs, the financial model projects reaching cash flow break-even rapidly, within just two months of operation.
- Successfully launching and stabilizing operations requires a substantial minimum cash buffer of $807,000 to cover specialized equipment CapEx and initial working capital deficits.
- Managing the clinic's high variable cost ratio, particularly the 80% of revenue allocated to marketing, is crucial for maintaining profitability targets beyond the initial ramp-up phase.
Running Cost 1 : Staff Payroll (Wages)
Payroll Dominance
Staff payroll is your biggest drag in 2026 at $29,375 monthly for 45 employees. This figure includes the $10,000 Clinic Director salary and compensation for three therapists. Managing this large fixed cost dictates your overall profitability structure.
Cost Inputs
This $29,375 estimate covers 45 FTEs projected for 2026 operations. The primary inputs are headcount planning and specific role compensation, like the $10,000 Clinic Director base pay. This cost is fixed until you scale past 45 people or adjust salary bands.
- Total FTEs: 45
- Director Salary: $10,000 monthly
- Three therapists included
Staff Optimization
Controlling this expense means optimizing utilization, not just cutting headcount. Since this is a fixed cost now, focus on revenue per FTE. Avoid hiring too early; use part-time contractors until utilization hits 85% consistently. Defintely watch overtime accruals.
- Tie hiring to utilization rates
- Negotiate benefits packages carefully
- Avoid premature FTE additions
Actionable Focus
Because payroll is the largest cost at $29,375, every new hire must generate revenue exceeding their fully loaded cost quickly. If a therapist needs 10 sessions per week to cover their salary, ensure marketing targets drive that volume immediately.
Running Cost 2 : Facility Lease (Rent)
Lease Anchor Cost
Your fixed clinic lease is $5,000 monthly. This cost anchors your physical footprint and represents a significant, long-term operational commitment, usually spanning 3 to 5 years. Don't sign without modeling the full term's impact on cash flow.
Inputting Lease Costs
This $5,000 covers your required physical space for therapy delivery. Since it’s fixed, it doesn't change with patient volume. You need signed quotes or the actual lease agreement to lock this number in your Year 1 budget. It's a foundational overhead cost.
Managing Space Commitment
You can't defintely cut this once signed, but negotiation matters upfront. Look for clauses allowing tenant improvements (TIs) paid by the landlord. Avoid signing for more square footage than you need right now; expansion options are better than empty space.
Lease vs. Volume
Because the lease is fixed for 3 to 5 years, it directly impacts your break-even point calculation. If patient volume is low early on, this $5,000 hits payroll ($29,375) and marketing ($6,656 budgeted 2026 spend) hard. You need utilization rates to cover this anchor cost fast.
Running Cost 3 : Patient Acquisition (Marketing)
Marketing Spend Ratio
Marketing spend is your primary lever for filling capacity, budgeted at a steep 80% of revenue. For 2026 projections, expect Patient Acquisition costs to hit roughly $6,656 monthly. This variable cost must be monitored daily against session bookings to ensure therapist utilization remains high.
Cost Inputs
This marketing budget is calculated using 80% of projected revenue, which translates to $6,656 based on the $83,200 revenue baseline for 2026. It covers digital ads to attract new clients needing biofeedback sessions. If revenue drops, this cost drops too, but it must remain high enough to cover therapist schedules.
- Budget is 80% of revenue.
- Cost hits $6,656 monthly in 2026.
- Drives volume to cover payroll.
Controlling Acquisition
Controlling this 80% variable cost requires relentless focus on acquisition efficiency. Avoid broad spending; target specific demographics (adults aged 30-65) known to seek non-drug solutions. A key tactic is leveraging physician referrals to lower Cost Per Acquisition (CPA) significantly, which is defintely cheaper than cold ads.
- Measure CPA against session package value.
- Prioritize physician referral channels.
- Test ad creative weekly for conversion rates.
The Utilization Trap
The risk here is misalignment: high ad spend driving low-value leads means you burn cash covering payroll ($29,375) without filling slots. Your marketing must deliver qualified patients ready to commit to multi-session plans, otherwise, you are just paying for expensive appointments that never happen.
Running Cost 4 : Insurance & Liability
Fixed Risk Cost
Malpractice insurance sets a baseline fixed cost of $1,200 per month for the clinic. This coverage is mandatory for professional services, protecting against liability claims stemming from therapy delivery. It’s a non-negotiable expense required before seeing the first client.
Coverage Inputs
This $1,200 monthly premium covers professional liability (malpractice) for all practitioners delivering biofeedback services. You need quotes based on the number of licensed staff and projected annual revenue to finalize this rate. It sits firmly in the fixed overhead section of your budget, separate from variable sales costs.
- Covers claims from treatment errors.
- Rate depends on practitioner count.
- Fixed cost, paid regardless of revenue.
Managing Spend
You can't reduce this much without risking compliance or coverage gaps. Shop quotes annually between carriers specializing in allied health. Avoid lapses in coverage, as reinstatement fees are steep. Don't skimp here; inadequate coverage can bankrupt the business instantly.
- Benchmark against peer clinics’ coverage limits.
- Bundle liability with general business insurance.
- Review policy annually during budget planning.
Compliance Check
Ensure the policy explicitly covers all modalities used, including neurofeedback and biofeedback techniques specified by the state board. If you hire independent contractors instead of W2 staff, verify that your policy covers their actions or requires them to carry their own coverage. It's defintely a critical compliance gate.
Running Cost 5 : Software Licensing (Direct)
Licensing Cost Baseline
Direct software licensing for specialized equipment, like the Neurofeedback sensors, is a fixed percentage cost tied directly to your service volume. Expect this critical operational expense to consume 15% of revenue, setting your Year 1 monthly cost baseline around $1,248. That’s a material drag if utilization is low.
Calculating Licensing Spend
This fee covers the required software access for operating the specialized biofeedback hardware. You estimate this by taking your projected monthly revenue and multiplying it by the 15% vendor rate. Here’s the quick math: if baseline monthly revenue is $8,320, the cost hits $1,248. It’s a non-negotiable cost of service delivery.
- Rate is 15% of monthly revenue.
- Input is projected service volume.
- Year 1 estimate is $1,248/month.
Managing Software Fees
Since this is a percentage of revenue, controlling it means driving utilization without inflating the base fee structure. Negotiate multi-year agreements for predictable pricing tiers, or look into bundled service packages that might offer a slight discount on the software component. You should defintely review vendor pricing annually for better tiers.
- Seek multi-year commitment discounts.
- Bundle software with hardware service contracts.
- Review vendor pricing annually for better tiers.
Licensing Risk
If your average revenue per session drops below the threshold needed to cover fixed overhead (like the $5,000 lease), this 15% variable licensing cost eats into your contribution margin quickly. You need strong pricing discipline to keep this cost manageable.
Running Cost 6 : Utilities & Maintenance
Fixed Upkeep Costs
Essential operational costs for the clinic run $1,300 monthly, covering basic physical upkeep. This figure bundles $800 for utilities like power and water, plus $500 for clinic maintenance, ensuring the physical space functions reliably. This is a fixed baseline expense you must cover before seeing any revenue.
Cost Breakdown
This $1,300 is a non-negotiable fixed monthly overhead. Utilities ($800) cover essential services like electricity and water needed to run specialized biofeedback equipment. Maintenance ($500) pays for necessary cleaning and upkeep of the clinical environment. This cost is independent of patient volume.
- Utilities: $800/month (power, water).
- Maintenance: $500/month (cleaning).
- Fixed cost, regardless of patient count.
Managing Space Costs
Since utilities are usage-based, focus on energy efficiency to lower the $800 component. Maintenance contracts should be reviewed annually for better fixed pricing. A common mistake is defintely underestimating seasonal spikes in power usage during peak summer months.
- Audit HVAC efficiency now.
- Negotiate cleaning service rates.
- Benchmark utility usage against peers.
Operational Baseline
While $1,300 seems small next to payroll, these fixed operating costs define your minimum viable revenue threshold. If your rent is $5,000 and payroll is $29,375, this $1,300 adds to the baseline burn rate you must overcome every month. Anyway, don't let these small items distract you from the big levers.
Running Cost 7 : Payment Processing Fees
Fee Impact
Payment processing fees are a necessary variable cost hitting 25% of revenue. Based on the $83,200 projected 2026 revenue figure, expect these transaction costs to run $2,080 monthly. This cost hits before you cover fixed overhead like rent or payroll.
Cost Calculation
This expense covers interchange and gateway charges required to accept client payments electronically. To estimate it, multiply your projected monthly collections by the 25% rate. If you process $10,000 in client fees, $2,500 goes straight to the processor, reducing your immediate cash flow.
- Rate: 25% of collected revenue.
- Input: Total monthly client receipts.
- Example: $83,200 revenue yields $2,080 fee.
Fee Management
You can’t eliminate this cost, but you must negotiate the blended rate aggressively. Avoid passing these costs directly to clients via surcharges, as that pushes utilization down. A 25% rate is high for standard medical services, so defintely push for lower interchange tiers immediately.
- Negotiate blended transaction rates.
- Benchmark against 2.0% to 3.0% targets.
- Review statements monthly for errors.
Risk Exposure
Since this is variable, aggressive revenue growth immediately accelerates this outflow. If revenue scales past the baseline, this $2,080 cost scales too. Ensure your session pricing fully absorbs this 25% variable hit while still covering fixed costs like the $5,000 facility lease.
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Frequently Asked Questions
Total monthly running costs average near $48,600 in the first year, primarily driven by the $29,375 payroll expense and $5,000 facility lease;