What Are the Monthly Running Costs for a Speech Therapy Clinic?
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Speech Therapy Clinic Running Costs
Initial monthly running costs for a Speech Therapy Clinic in 2026 are projected around $75,143, driven primarily by specialized staff payroll This estimate includes $57,500 in wages, $9,900 in fixed overhead (like rent and insurance), and approximately $7,743 in variable costs (supplies, billing fees, and marketing) Despite strong initial revenue, the first year shows an average monthly EBITDA loss of nearly $29,167 due to ramp-up and initial fixed costs, meaning you defintely need a strong cash buffer
7 Operational Expenses to Run Speech Therapy Clinic
#
Operating Expense
Expense Category
Description
Min Monthly Amount
Max Monthly Amount
1
Staff Payroll
Personnel
Total monthly wages for 75 FTEs, making this the primary cost driver at 76% of total expenses.
$57,500
$57,500
2
Clinic Rent
Facility Overhead
Clinic Rent is a fixed $5,000 per month, representing the single largest fixed overhead expense.
$5,000
$5,000
3
EHR & IT
Technology/Software
Fixed software costs total $1,700 monthly, essential for compliance and efficient billing operations.
$1,700
$1,700
4
Patient Marketing
Sales & Marketing
Marketing and Patient Acquisition is budgeted at $4,075 per month based on the initial 2026 revenue forecast.
$4,075
$4,075
5
Insurance/Licensing
Compliance/G&A
Professional Liability Insurance and Credentialing Fees total $1,500 monthly, which are non-negotiable compliance costs.
$1,500
$1,500
6
Supplies & Fees
Cost of Services (COGS)
Variable costs include Therapy Materials (20% of revenue) and Billing Transaction Fees (15% of revenue).
$2,853
$2,853
7
Utilities/Maint.
Facility Operations
Utilities are fixed at $800 monthly, and Clinic Maintenance and Cleaning adds $500 monthly, totaling $1,300.
$1,300
$1,300
Total
All Operating Expenses
$73,928
$73,928
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What is the total monthly operating budget needed to run the Speech Therapy Clinic in the first year?
The initial monthly operating budget needed to run the Speech Therapy Clinic before significant client volume hits is roughly $75,143, derived by summing fixed overhead, payroll, and a high variable cost assumption, which is a critical number to understand before you even look at How Much Does It Cost To Open And Launch Your Speech Therapy Clinic?. To be fair, this estimate assumes variable costs run high at 95% of revenue, which is something we need to watch closely.
Monthly Cost Breakdown
Fixed overhead sits at $9,900.
Total payroll commitment is $57,500.
Variable costs are estimated at 95% of revenue.
Summing these gives the initial burn of $75,143.
Operational Levers
That 95% variable cost projection is extremely high.
Payroll drives the majority of the monthly spend.
Focus must be on maximizing therapist utilization rates.
If onboarding takes 14+ days, churn risk rises defintely.
Which cost category represents the largest recurring expense and how can it be optimized?
Therapist utilization directly sets your variable margin ceiling.
We see projected capacity for Pediatric SLPs reaching 650% by 2026 in some models.
Track delivered sessions versus maximum capacity constantly.
Every point gained in utilization lowers the effective cost per service hour.
Control Overhead Headcount
Administrative FTE growth must lag clinical revenue growth.
Watch the ratio of support staff to billable therapists closely.
Keep initial fixed overhead low to hit break-even faster.
Use software to automate intake and billing, limiting admin hires now.
How much working capital is required to cover the negative cash flow until the clinic reaches break-even?
You need approximately $1.08 million in working capital to fund the Speech Therapy Clinic through its 37-month journey to profitability, ensuring you maintain the required minimum cash reserve, which is a critical step before you even look at how Can You Effectively Open And Launch Your Speech Therapy Clinic To Serve Children And Adults With Communication Disorders?. This calculation covers the projected cumulative operating losses until the clinic hits its break-even point.
Cumulative Burn Rate
The average monthly loss projected for the first year is $29,167.
The path to reaching break-even operations is estimated to take 37 months.
This runway capital must cover every dollar lost during that entire period.
If utilization rates fall short of the forecast, this timeline extends, requiring more cash.
Total Capital Required
Cumulative losses amount to $1,075,779 ($29,167 multiplied by 37 months).
You must add the required minimum cash balance of $4,000 set for December 2028.
The total working capital needed to survive until profitability is $1,079,779.
Founders should defintely raise 15 percent more than this baseline to handle unexpected delays.
If patient volume is 20% lower than forecasted, what immediate running costs can be reduced without impacting core service quality?
If patient volume for the Speech Therapy Clinic falls 20% below forecast, your immediate action is to freeze non-essential variable spending and defer planned administrative hiring to maintain therapist utilization rates; this preserves the core service delivery capability, which is the primary revenue engine, something worth comparing against benchmarks like How Much Does The Owner Of Speech Therapy Clinic Typically Make?
Cut Discretionary Variable Spend
Marketing currently consumes 50% of revenue; cut this spend by at least half immediately.
Professional Development, budgeted at 10% of revenue, is a good place to pause spending.
These cuts don't impact core therapy quality, only outreach and internal training budgets.
If revenue is $100k, you defintely save $50k from marketing and $10k from PD.
Defer Fixed Headcount Expansion
Do not hire the Administrative Assistant or Billing Specialist FTEs planned for 2027.
If volume is down 20%, your existing admin staff can absorb the lower workload for now.
Delaying hiring preserves salary overhead, which is a major fixed cost drain.
Focus on maximizing utilization of your existing certified speech-language pathologists first.
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Key Takeaways
The initial monthly running cost for a Speech Therapy Clinic in 2026 is projected to be $75,143, driven overwhelmingly by personnel expenses.
Specialized staff payroll represents the largest recurring expense, accounting for over 76% of the total operational budget.
Founders must plan for a substantial 37-month runway to reach the break-even point, requiring significant working capital to cover the average first-year monthly EBITDA loss of $29,167.
Optimization efforts should immediately focus on maximizing therapist utilization rates and carefully managing high initial variable spending, such as the 50% of revenue allocated to marketing.
Running Cost 1
: Specialized Staff Payroll
Payroll Dominates Costs
Payroll is your biggest lever. In 2026, monthly wages hit $57,500, consuming 76% of all operating costs. This expense covers 75 full-time equivalents (FTEs) delivering therapy services. Managing this headcount efficiently drives profitability.
Staffing Cost Breakdown
Staffing is the core capital outlay for this clinic. The $57,500 monthly wage budget includes specialized roles like the Lead Speech-Language Pathologist (SLP) at $9,167 and two Pediatric SLPs costing $14,167 combined. This number is derived from the required 75 FTEs needed to meet projected patient volume in 2026.
Input: Total FTE count (75).
Input: Specific role salary benchmarks.
Input: Monthly wage projection for 2026.
Controlling Wage Spend
Controlling payroll requires optimizing therapist utilization, not just cutting headcount. High fixed costs mean every idle therapist erodes margin quickly. Avoid over-staffing early in the year before patient volume ramps up fully. Defintely focus on maximizing billable hours per clinician.
Benchmark utilization rates against peers.
Use part-time staff for demand spikes.
Ensure efficient scheduling software is used.
The Leverage Point
Since payroll represents 76% of expenses, any small efficiency gain here drastically improves the bottom line. If you can increase the average revenue per FTE by just 5% through better scheduling, the impact on net income is substantial, given the high fixed nature of this cost base.
Running Cost 2
: Clinic Facility Rent
Rent as Fixed Overhead
Clinic rent is a fixed $5,000 monthly cost. This expense is your primary fixed overhead, demanding rigorous negotiation against local commercial square footage prices to protect profitability.
Inputs for Rent Cost
This $5,000 covers the physical space for the Speech Therapy Clinic operations. To accurately forecast this, you need the agreed-upon square footage and the prevailing cost per square foot in your desired zip code. It is a non-negotiable fixed input unless lease terms change.
Fixed at $5,000 monthly
Tied to square footage
Local commercial rates matter
Managing Rent Exposure
Since rent is fixed at $5,000, management focuses on the initial lease terms. Ensure the agreement clearly defines the square footage allocated to therapy versus administrative use. Honestly, if you can negotiate a lower rate per square foot, that saving flows straight to contribution margin.
Prioritize lease flexibility
Negotiate tenant improvement dollars
Avoid long initial commitments
Rent's Budget Weight
Compared to total fixed overhead, which includes $1,700 for IT subscriptions and $1,500 for insurance, this $5,000 rent consumes over 50% of that non-payroll bucket. High rent defintely pressures your utilization rate targets needed to cover the massive payroll expense.
Running Cost 3
: EHR & IT Subscriptions
Fixed Tech Overhead
Your essential technology overhead for compliance and operations clocks in at $1,700 monthly. This covers the core Electronic Health Record (EHR) system at $700 and $1,000 dedicated to IT support and general software needed to run billing efficiently. This fixed spend must be covered before you see profit.
EHR and IT Cost Breakdown
This $1,700 is non-negotiable fixed overhead supporting compliance and data management. It breaks down to $700 for the base EHR platform and $1,000 for necessary IT support and general software licenses. Compared to rent ($5,000), this software stack is smaller but equally critical for smooth operations.
Monthly EHR Base: $700
Monthly IT/Software Support: $1,000
Total Fixed Software Cost: $1,700
Controlling Software Spend
Managing this cost means scrutinizing the IT support scope. Ensrue the $1,000 IT budget covers only essential compliance maintenance, not unnecessary feature creep. If you onboard slowly, watch out for minimum seat requirements that inflate costs before you reach full capacity.
Negotiate IT support SLAs upfront.
Audit software licenses quarterly.
Avoid vendor lock-in clauses.
Fixed Cost Context
This fixed software spend, alongside rent and insurance, establishes your baseline burn rate. If your 2026 revenue forecast of $81,500 is missed, these $1,700 monthly technology costs become a much larger percentage of your contribution margin.
Running Cost 4
: Patient Acquisition Marketing
Marketing Spend Profile
Patient acquisition spending starts high, hitting 50% of revenue in 2026, which is about $4,075 monthly on projected $81,500 revenue. This spend must drop to 30% by 2030 because better patient retention lowers the constant need for new clients, defintely improving unit economics.
Acquisition Cost Inputs
This marketing budget covers bringing in new clients for therapy sessions. For 2026, it uses the $81,500 revenue forecast allocated at 50%, resulting in $4,075 monthly. This covers digital ads and outreach targeting parents seeking services for children aged 2-18.
Reducing Acquisition Rate
To cut this high initial cost, focus on client lifetime value (LTV). If retention improves, the required monthly marketing percentage naturally falls from 50% to 30% over four years. Poor onboarding definitely increases churn risk, spiking acquisition costs again.
Cash Flow Reality
Spending half your revenue on marketing means your early Customer Acquisition Cost (CAC) is steep. You need strong utilization rates from your 75 FTEs to cover the $5,000 facility rent and $57,500 payroll before marketing spend stabilizes.
Running Cost 5
: Insurance and Licensing
Compliance Floor
Compliance costs are a fixed $1,500 per month for your clinic. This covers $1,200 for Professional Liability Insurance and $300 for Credentialing and Licensing Fees. These are non-negotiable operating necessities you must cover monthly.
Cost Inputs
This $1,500 monthly cost is pure fixed overhead, meaning it doesn't scale with treatment volume. You must budget this amount regardless of patient volume, so it directly pressures your initial cash runway before you see revenue.
Liability Insurance: $1,200 monthly quote.
Licensing Fees: $300 for credentialing.
Total fixed compliance: $1,500/month.
Fee Control
You can't defintely negotiate the liability premium much, as that depends on your risk profile. The key saving opportunity is optimizing the timing of credentialing renewals to avoid late penalties or paying for licenses for staff who aren't treating patients yet.
Bundle insurance quotes annually.
Track all renewal dates closely.
Ensure licenses match active staff.
Fixed Cost Reality
This $1,500 expense is a critical fixed cost that must be covered before any revenue hits. It's small compared to payroll, but it directly reduces your operating leverage until you hit utilization targets.
Running Cost 6
: Therapy Supplies & Billing Fees
Variable COGS Structure
Your Cost of Goods Sold (COGS) is split between physical materials and digital transaction costs, totaling 35% of revenue. Based on 2026 revenue forecasts, this amounts to about $2,853 monthly. This expense moves directly with how many treatments you deliver, so watch volume closely.
Inputs for COGS Calculation
This variable cost is driven by two inputs tied to service delivery. Therapy Materials use 20% of revenue, covering consumables needed for sessions. EHR Billing Transaction Fees take another 15% of revenue for processing claims. You need accurate revenue forecasts to nail this $2,853 estimate for 2026.
Materials: 20% of service revenue
Transaction Fees: 15% of service revenue
Total Variable Rate: 35% of revenue
Controlling Material Spend
Since these costs scale directly, controlling the inputs is key. Negotiate better vendor rates for supplies, aiming to push that 20% material cost down by a few points. For billing fees, check if your EHR offers volume discounts; defintely don't accept flat rates if volume is high. You must keep utilization high to absorb fixed costs.
Bulk purchase materials for savings
Audit EHR fee structure yearly
Don't overstock specialized items
Margin Risk Check
Because these costs scale 1:1 with volume, rising material costs immediately eat into your contribution margin. If revenue projections slip, this 35% variable cost will quickly erode profitability before fixed overhead like payroll even factors in. Know your break-even volume based on this rate.
Running Cost 7
: Utilities and Maintenance
Facility Upkeep Baseline
Facility upkeep is a fixed commitment of $1,300 monthly, combining utilities and cleaning. This baseline cost must be covered before revenue from therapy sessions starts flowing. For a clinic, these operational necessities represent predictable, non-negotiable overhead you must budget for every month.
Upkeep Cost Breakdown
This cost covers essential services for the physical clinic space. Inputs are fixed monthly quotes: $800 for Utilities (electricity, water, gas) and $500 for Maintenance and Cleaning. Together, these form a predictable $1,300 component of your initial fixed startup budget. It’s defintely necessary spending.
Utilities: $800/month fixed.
Cleaning: $500/month fixed.
Controlling Facility Spend
Since these costs are fixed, optimization centers on initial negotiation and efficiency, not volume adjustments. Avoid locking into long-term maintenance contracts until patient volume stabilizes past the first six months. A common mistake is over-specifying cleaning services for a small initial footprint.
Benchmark cleaning against local clinics.
Monitor utility usage closely in Q1.
Fixed Cost Leverage
At $1,300 monthly, this fixed upkeep is tiny compared to payroll ($57,500) but still demands consistent revenue coverage. If you only hit 50% of your utilization target, this cost represents a larger percentage of your marginal profit than you might expect.
Initial monthly running costs are approximately $75,143, with payroll accounting for over $57,500 of that total, making staff utilization the key profitability lever;
The model forecasts 37 months to break-even, reaching profitability in January 2029, requiring founders to fund an average monthly EBITDA loss of $29,167 in the first year;
Clinic Rent is the largest fixed overhead at $5,000 per month, followed by Professional Liability Insurance at $1,200 monthly
Marketing and Patient Acquisition is budgeted at 50% of revenue in 2026, which is $4,075 based on the $81,500 initial revenue forecast;
The projected Return on Equity (ROE) is 058, indicating a strong return once the clinic scales and achieves positive EBITDA in Year 4 ($433k);
The clinic starts with 6 full-time equivalent (FTE) therapists, including the Lead SLP, two Pediatric SLPs, one Adult Neuro SLP, one Fluency Voice SLP, and one Diagnostic SLP
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