Educational content only. This post explains how financial concepts and published data apply generally to healthcare practices — it does not constitute advice for your specific situation. Consult your accountant, lender, and relevant advisors before making any significant business or financial decisions.
Occupational therapy practices operate in a more complex funding environment than most rehabilitation clinic types. The mix of public funding, third-party payer billing, and private pay varies significantly by province and state — and the funding source determines revenue per visit more than almost any other variable. Understanding this funding landscape is foundational to building a realistic financial model for an OT practice.
The Funding Landscape
Published occupational therapy association resources in both Canada and the US describe OT services as funded through several distinct channels, often within the same practice:
Public health funding (Canada). Provincial health ministries fund OT services delivered in hospitals, long-term care, and publicly funded community programs. Private practice OT — the independent clinic model relevant to this post — is generally not publicly funded in most provinces, meaning most private OT practice revenue is third-party or direct pay.
Third-party billing. Published resources describe motor vehicle accident (MVA) funding through automobile insurance (FSCO in Ontario, ICBC in BC, and equivalents in other provinces and US states) and workplace injury funding through WCB/WSIB (Canada) and workers' compensation programs (US) as significant revenue sources for many OT practices. Published resources note that MVA and WCB/WSIB billing involves specific assessment report requirements and fee schedules that affect both revenue per appointment and administrative overhead.
Extended health insurance. Many Canadians with employer-sponsored benefits have OT coverage through extended health plans. Published resources describe extended health billing as similar in structure to direct-pay from the practice's perspective — payment is received directly or through the patient at standard fees.
Direct pay. Private OT services — home assessments, functional capacity evaluations, return-to-work programs, paediatric OT — are often direct-pay services not covered by any third-party plan.
Revenue Per Visit Characteristics
Published OT association survey data describes revenue per visit as varying significantly by service type and payer. Published data from the Canadian Association of Occupational Therapists (CAOT) and the American Occupational Therapy Association (AOTA) describes hourly rates for private practice OT in North American markets typically ranging from $120–$200 per hour, with MVA and WCB/WSIB assessments sometimes billing at higher rates that reflect the report-writing component included in the fee.
Assessment-based services — functional capacity evaluations, home assessments, ergonomic assessments — typically generate higher revenue per appointment than treatment-only appointments because of the professional time involved in report preparation. Published resources describe assessment-heavy practices as having different revenue-per-visit profiles than treatment-focused practices.
Overhead Structure
Published OT practice management resources describe the overhead structure as similar to physiotherapy at the lean end — primarily facility costs, staff costs, and professional liability insurance, with relatively low supply and equipment costs compared to equipment-intensive specialties. Published resources note that OT practices with significant home visit or community-based work components have different cost profiles than purely clinic-based practices, with vehicle costs and travel time affecting the effective hourly revenue per clinical hour.
Physical Space Requirements
Published resources describe OT clinical space requirements as varying significantly by service type. A practice focused on assessment and therapeutic treatment requires treatment rooms, a reception area, and accessible washrooms — similar to physiotherapy. A practice offering paediatric OT may require a sensory gym with specialised equipment. A practice focused on hand therapy requires minimal specialised infrastructure. The startup cost range for an OT clinic reflects this variation.
→ Related: What Healthy Margins Look Like for a Physiotherapy Practice
Model occupational therapy clinic startup costs for Canadian and US markets — with build intensity, equipment configuration, and ramp-adjusted break-even. Cost inputs vary significantly by service focus — community, paediatric, or hand therapy practices should adjust assumptions accordingly.
Estimate Your OT Startup Costs →Disclaimer: All figures referenced are from published industry sources and represent general patterns — not estimates for any specific practice. KlinDeck is not a financial advisor, accountant, lender, or lawyer. Tools are educational references only. Consult qualified professionals before making significant decisions.