SBA lenders approved 1,027 7(a) loans to offices of physical, occupational and speech therapists and audiologists between October 2023 and June 2026, $312,682,500 from 220 lenders. The median loan was $150,000 at a median rate of 10.25%, both in line with the national figures of $150,300 and 10.25%. Start-ups took 19.3% of loans, as licensed therapists open their own clinics. Acquisitions were 6% of loans, below the national 10.4%, at a median of $471,600. There were also 152 SBA 504 loans. Lenders read the payer mix, collections by payer, and the owner's license and referral base.
| Measure | Offices of Physical, Occupational and Speech Therapists, and Audiologists | All industries |
|---|---|---|
| SBA 7(a) loans approved | 1,027 | 162,355 |
| Median loan | $150,000 | $150,300 |
| Middle half of loans | $50,000 – $341,050 | $50,000 – $500,000 |
| Loans of $1 million or more | 6.1% | 12.9% |
| Median rate at approval | 10.25% | 10.25% |
| Middle half of rates | 9.25% – 11.5% | 9.3% – 11.25% |
| Acquisitions (change of ownership) | 62 (6%) | 16,849 (10.4%) |
| Median acquisition loan | $471,600 | $693,000 |
| Lenders that made these loans | 220 | 1,648 |
| SBA 504 loans (real estate, equipment) | 152 | 16,714 |
Approvals FY2024 – FY2026 to date (1 Oct 2023 – 30 Jun 2026), cancelled loans excluded. Source: SBA 7(a) and 504 FOIA loan records, as of June 30, 2026.
- SBA 7(a) loans approved
- 1,027 (Oct 2023 – Jun 2026)
- Median loan
- $150,000 (national $150,300)
- Median rate at approval
- 10.25% (national 10.25%)
- Start-ups
- 19.3% of loans
- Acquisitions
- 62 loans (6%), median $471,600
- SBA 504 loans
- 152, median $424,000
The approvals, read against the national figures
NAICS 621340 covers outpatient practices of licensed physical therapists, occupational therapists, speech-language pathologists and audiologists: orthopedic and sports clinics, pediatric therapy practices, hand therapy, and hearing clinics that test patients and fit hearing aids. From FY2024 through June 2026 SBA lenders approved 1,027 7(a) loans to them, worth $312,682,500, from 220 lenders. The median loan supported 5 jobs, typically an owner who still treats patients, a few staff therapists or assistants, and front-desk and billing staff.
| Figure | Therapy and audiology practices | What it says |
|---|---|---|
| Median loan | $150,000 | Essentially the national $150,300 |
| Middle half of loans | $50,000 to $341,050 | A wide band: equipment and working capital at one end, build-outs at the other |
| 90th percentile | $701,600 | Larger loans are acquisitions, multi-clinic owners and real estate |
| Loans of $1 million or more | 63 (6.1%) | Mostly buildings and practice purchases |
| Median rate | 10.25% (middle half 9.25% to 11.5%) | Matches the national 10.25% |
| Fixed-rate share | 14.2% | Most loans float |
| SBA Express | 38.8% of loans | Fewer than half: many requests go through standard 7(a) |
| Start-ups | 19.3% of loans | Therapists leaving employment to open a clinic |
| Franchises | 7.9% of loans | Therapy and hearing-care franchise systems exist and are used |
| Acquisitions | 62 loans (6%), median $471,600 at 9.78% | Rarer than the national 10.4% |
| SBA 504 | 152 loans, median $424,000 | Clinics buying their own space |
The payer mix is the credit
A therapy practice bills for visits, and most of what it bills is paid by someone other than the patient. A lender therefore reads the practice through its payers: who they are, how fast they pay, and how much of what is billed is actually collected. Charges mean little; collections are the revenue.
| Payer | How it pays | What a lender asks |
|---|---|---|
| Medicare | Set fee schedule; rules on documentation and therapy thresholds | Is the practice enrolled and in good standing? How exposed is it to fee schedule changes? |
| Medicaid | State rates, often low; central to pediatric therapy | How much of revenue depends on one state program? |
| Commercial insurers | Contracted rates; prior authorizations and visit limits | Which contracts matter, and are they in the practice's name? |
| Workers' compensation and auto claims | State fee schedules or claim-by-claim settlement; slower and less certain payment | How old are these receivables, and how many are disputed? |
| Cash pay, including hearing aids | Paid at the visit or at fitting | What margin do device sales carry, and what inventory is on hand? |
The questions that follow are practical. An AR aging by payer shows whether claims are being worked or written off. A denial history shows whether billing is in control. Concentration matters too: a pediatric practice that lives on one state's Medicaid program, or an orthopedic clinic that depends on one surgeon group for referrals, carries a risk a lender will price or decline. Revenue that swings with reimbursement changes is also why lenders test cash flow with some cushion; SBA's floor is debt service coverage of at least 1.15x, and many lenders want to see more.
Start-up clinics: why nearly a fifth of the loans open new practices
Start-ups took 19.3% of loans, a high share for a professional practice, and the reason is the license. A physical therapist or speech-language pathologist with years of clinical work can open a clinic with modest equipment, and lenders will back a licensed clinician with a referral base in a way they will not back an unlicensed newcomer. Franchises took 7.9%, reflecting therapy and hearing-care systems that sell locations to clinicians.
What makes a start-up clinic financeable:
- A license and a following. The owner's state license, clinical history and the physicians, surgeons or schools that will refer patients. Letters or a track record of referrals help.
- Credentialing time in the plan. A new practice must enroll with Medicare and contract with insurers before it can bill them. Months can pass between opening and the first steady collections, and the loan should carry working capital for that gap.
- Equity. SBA requires at least 10% of total project costs as an equity injection for a start-up. Lenders look for the rest of the owner's liquidity too, since a clinic that ramps slowly draws on it.
- Ownership rules. Some states restrict who may own a therapy practice. A structure with a non-clinician investor needs to fit the state's rules before the lender will look at it.
Owning the clinic's space
The trade recorded 152 SBA 504 loans with a median of $424,000, a large number beside its 1,027 7(a) loans. Therapy clinics suit owner-occupied real estate: a medical office condo or a small freestanding building with parking and accessible entry, used for decades. SBA 504 finances owner-occupied real estate typically 50% from a bank, 40% from the CDC and 10% from the borrower, rising to 15% for a new business or a special-purpose property, and 20% for both. The borrower must occupy at least 51% of an existing building, or 60% of new construction. See SBA 7(a) vs 504.
A 7(a) loan can also buy real estate, with a maturity of up to 25 years, and it can combine the building with equipment and working capital in one loan. The choice usually comes down to how much of the project is property. Build-out of leased space, by contrast, is financed on shorter terms and depends heavily on the lease: a lender will want the lease to run at least as long as the loan it is funding.
Buying a therapy or audiology practice
Only 62 loans, 6% of the industry's total, financed a change of ownership, against 10.4% nationally, at a median of $471,600 and a median rate of 9.78%. Practice sales are held back by the same thing that makes start-ups common: patients and referral sources follow therapists, and the seller is often the busiest treating clinician in the building.
That collides with SBA's rules. In a complete change of ownership the seller may not stay on as an owner, officer or employee, so a seller-therapist cannot keep treating patients on payroll after closing. The seller may consult for up to 12 months, extended to up to 24 months under SOP 50 10 8.1 from 1 October 2026. Where the seller wants to keep working, a partial change of ownership is a different structure with its own rules.
The lender will also ask how the practice will bill on day one. Payer contracts and Medicare enrollment do not always move automatically with a sale, and an asset purchase can mean new enrollment for the buyer. A plan for staff therapists to stay, and for referral relationships to be introduced to the buyer, matters as much as the price. The usual acquisition rules apply: at least 10% equity, a seller note counting toward up to half of it only on full standby for the life of the loan, no earnout, and an independent valuation where the amount financed, less appraised real estate and equipment, exceeds $250,000. See financing a physical therapy practice acquisition.
In a therapy practice sale, the lender's first question is who will treat the patients and who will send them once the seller leaves.
Preparing a therapy practice's SBA file
Start from SBA's standard list: business tax returns for 2–3 years, a P&L and balance sheet with a year-to-date P&L through last month-end, a debt schedule with copies of notes being refinanced, and personal tax returns and a personal financial statement for each owner of 20% or more. For this trade, add:
- An AR aging by payer, and a payer mix report for the last full year
- Visits by month and referrals by source, so the lender can see volume, not just dollars
- State licenses for the owner and treating staff, and Medicare enrollment status
- The lease, or for a purchase, the property details and any appraisal
- Quotes for equipment such as treatment tables, rehab equipment or audiology booths
- The owner's resume, which supports Form 1919's management experience
Practices that have bridged slow reimbursement with merchant cash advances face a hard rule: SBA will not refinance an active advance, and from 1 October 2026 one becomes eligible only once converted to a term loan that has amortized for at least 24 months with no new advance since. See refinancing cash advances for healthcare providers, and for receivables timing, lines of credit for medical practices.
Transparent works this file the way an underwriter will read it, payer by payer. Once the documents are in, it builds the lender package — financing model, lender presentation, blind teaser and underwriting memo — in a day, and takes it to lenders among the 278 in its book that write SBA 7(a) and 504. On SBA loans the lender pays Transparent, not the borrower.
Common questions
- What is a typical SBA loan for a physical therapy practice?
- The median 7(a) loan to therapy and audiology practices from October 2023 to June 2026 was $150,000, in line with the national $150,300. The middle half ran from $50,000 to $341,050, and 63 loans, 6.1%, were $1 million or more.
- Can a therapist get an SBA loan to open a new clinic?
- Yes, and many do: start-ups took 19.3% of loans in this industry. Expect to inject at least 10% of total project costs, and to show your license, clinical history and referral sources. Build the time it takes to credential with Medicare and insurers into the working capital request.
- Do lenders care about my Medicare and Medicaid mix?
- Yes. Lenders underwrite collections by payer, not charges. A practice concentrated in one state Medicaid program or exposed to fee schedule changes is read more cautiously, and an AR aging by payer is one of the first documents they ask for.
- Can the selling therapist keep working after I buy the practice with an SBA loan?
- Not as an employee in a complete change of ownership. The seller may consult for up to 12 months, or up to 24 months under SOP 50 10 8.1 from 1 October 2026. If the seller will keep treating patients, a partial change of ownership may fit better.
- Should I use SBA 504 or 7(a) to buy my clinic's building?
- Both work. 504 typically needs 10% down from an existing business and requires you to occupy at least 51% of an existing building. 7(a) can finance the building for up to 25 years together with equipment and working capital. The larger the property share, the more 504 tends to fit.