Start (and Grow) Your OT Private Practice

The occupational therapy profession depends on private practice owners—not only to drive innovation and improve the quality of our care, but also to keep the profession itself moving forward. In the rapidly changing healthcare landscape, there are always new opportunities for us to serve our clients.

Entrepreneurship is exciting and fulfilling, and it takes you on a journey that is unlike anything else you will ever experience.

But, taking that plunge can be downright scary—and justifiably so!

Luckily, we’ve witnessed a major sea change over the past few years.

While we business owners used to be largely left to our own devices, we now enjoy access to countless resources and experts to help us get our business ideas off the ground in the first place—and then take them to the point of thriving.

That’s why we rounded up resources for occupational therapy professionals who are interested in starting and growing private practices.

There are hundreds of OT private practice owners 

We want you to know you are not alone, when you start an OT private practice. Occupational therapy private practices are part of a $53 billion outpatient PT, OT, and SLP  industry. An exact number of OT private practices is hard to estimate, but based on our OT Directory data, about 35% of our members tag themselves as having private practice as one of their settings. If this percentage holds true across our United States workforce of around 150,000 therapists, then there could be as many as 50,000 OT professionals working in a private practice.

Check out our map below to see the members of our OT directory who have tagged “private practice” as their setting.

What will 2026 hold for private practice OT? 

The resources that you will find below in this blog post have been assembled over many years. And, many of these resources have withstood the test of time.

Opening a private practice requires you to become an entrepreneur.  And entrepreneurship can be a scary proposition for many.  While you might not have studied entrepreneurship in OT school, it is 100% a skill you can learn.

In fact, Alyson Stover, the AOTA President from 2022-2025 was the first AOTA President to also own a private practice.

So, before you dive into the resources below, checkout this interview with AOTA President Alyson Stover on why entrepreneurship is the future of Occupational Therapy:

How much money can an OT private practice owner make?

Money is such a taboo topic, isn’t it?

And one of the reasons it remains taboo is we aren’t used to having open and frank conversations about it.

How much you can make as an OT private practice owner depends on a lot of factors.  Here are just a few:

• How much do you charge per session?

• Do you accept insurance or are you private pay?

• How many clients do you see a week/month?

• Do you have other therapists working for you that you need to pay?

• Do you have support staff (e.g. front desk, etc.) that you need to pay?

• What are your fixed monthly expenses?  This includes items like real estate, cleaning services, software, etc.

Now, most of us didn’t go to business school but there’s some simple concepts we should all know.

• Revenue: this is how much money your private practice brings in from the services you provide.  This is adding up all the money the business brought in that year.

• Expenses: this is exactly what it sounds like!  You simply add up all the costs associated with your practice.

• Income (or Profit): this is just Revenue – Expenses.  Having a profit in your private practice means that you can invest in growing it.

One of the biggest changes for an OT opening their private practice is that the way you get paid changes!

As an employee it is very easy to get used to earning a fixed amount.  But, as an OT private practice owner you should expect that your earnings will vary month to month.

Things like seasonality, cancellations, new referral sources, etc., will all mean that your revenue will vary month to month.

To manage this, many private practice owners will pay themselves a lower, fixed amount each month (in the expense category).  And then once a quarter, or once a year they will determine the profit the practice is making and pay themselves additionally from that category.

But – this type of variability is actually good!

And it is good because it means you have the ability to increase how much you are paid.

By focusing on increasing your practice revenue, managing expenses wisely, and providing amazing client care then you can see your profits increase – which directly contributes to how much you can make.

An OT private pay practice is the most straightforward to make financial projections on as it is a fee for service model.  In an insurance based private practice your revenue will depend heavily on insurance reimbursement.  However, with private pay, you charge and collect a fixed amount at the time of service which eliminates guesswork on how much you can make per session.

Additionally, with a private pay practice you will most likely see no more than 24 clients per week since each session is typically one-one and for 1 hour.

In that spirit, let’s do some quick math for how much you could make as a private pay OT:

As you can see, the owner’s pay for a OT private practice owner who sees 24 clients/week can easily vary from $86,400 up to $172,800 depending on what their cost is per session. We did some digging on what OTs are charging at their practices, and on OTsalary.com (where OTs self-report their income) we found self-employed OTs shared they made anywhere from $42/hour to $225/visit.

If you go the route of insurance-based practice, credentialing with insurance panels is a critical (and often lengthy) process, though one that is absolutely do-able yourself. See our Therapy Credentialing Guide for PT, OT, SLP, & Mental Health for step-by-step insurance credentialing guidance.

Tax Advantages of Being an OT Business Owner

I know, the word “taxes” is about as exciting as a mandatory inservice on proper handwashing techniques.  But, hear me out because there are some incredible benefits that can change your life.

In my book “Financial Freedom for OTs: A Guide to Building Wealth Without Burnout” I talk about the financial advantages of owning an OT private practice.  I’ll repeat those advantages here in case you haven’t read my book.

The two main advantages are the following:

• There are many expenses you currently incur which are tax deductible when run through your business.  Items like continuing education, cell phone, books, licensing fees, memberships (e.g. AOTA, etc.) are all tax deductible through your practice.

• If you are a solo practice owner, you can take advantage of tremendous retirement savings via an individual 401(k).

Let’s dive more completely into the individual 401(k).

If your practice only employs you and your spouse, then you can open an individual 401(k) which will supercharge your retirement savings.

As of 2025, here are the contribution limits:

• As an employee, you can contribute $23,500 before taxes to your individual 401(k).

• As the employer, you can match 25% of your salary in 401(k) contributions.

This last part is what makes it so incredible.  Most employers only match 3 – 7% for their employees 401(k).  But, inside an individual 401(k), you are allowed to match up to 25%!

In my book, I detail a comparison between an OT employee and an OT business owner which I’ll repeat here:

The example is based upon the OT business owner seeing 20 clients/week and charging $200/visit and working 48 weeks/year.  You can see from the above table that the OT business owner would be saving almost twice as much in their 401(k) ($50k vs $27k) AND still having an after tax take home pay that’s more than 50% higher ($64k vs $41k).

From the tax advantages to the retirement savings, pursuing a private practice can not only allow you to provide exceptional client care, but also accelerate your financial success.

Is being an OT business owner right for you?

Most occupational therapists that I’ve spoken with who have taken the plunge into owning their own business have two things in common: they see a need to serve and they desire an ability to have more autonomy in their work.

Many occupational therapists who become business owners will tell you that they feel called to entrepreneurship.

But the reasons they feel called vary from person to person.

Some want just a small practice that gives them more control over their schedule.  And they have no desire to grow big.  They want flexibility in their schedule while also providing great care for clients.

Others have a desire to manage people and one day even own multiple locations.

And there are a few questions that you can ask yourself:

• Can you take a long-term view?  Building a business takes time.  It takes time to build referral relationships.  It takes time to learn how to manage your time between working IN your business (seeing clients) and working ON your business (the things you need to do such that clients find you).  It takes time to learn how to manage employees.  Starting a business will not immediately replace your income. But, over the course of 3 – 5 years you can build something that gives you more freedom.

• Are you willing to acquire new skills?  Marketing.  Sales.  Finances.  These are all typically new skills for most occupational therapists.  And no doubt they can be intimidating.  But, deciding to become a business owner is deciding that you can acquire these skills.  And guess what?  You can!  These are skills just like any other and business owners truly embrace the growth mindset that they can figure it out or find someone to learn them from.

• Can You Handle Uncertainty? Starting a business comes with unknowns—there’s no guaranteed paycheck, and there will be months that feel unpredictable. But successful business owners embrace uncertainty as part of the journey. Instead of fearing the unknown, they learn how to problem-solve, adapt, and make decisions with incomplete information. If you can tolerate some risk while focusing on long-term gains, entrepreneurship can be an incredibly rewarding path.

Resources to get you started! 

Here are great resources out there to get your creative juices flowing, as you consider if business ownership is right for you!

Podcasts

The therapy podcasts listed below all focus on the business of therapy, and feature interviews with therapists who have been in the trenches growing their own practices.

If your business idea is in incubation, there are great resources out there to get your creative juices flowing.

• The Brave OT Podcast | Carlyn Neek, OT

• Health, Wealthy and Smart | Karen Litzy, PT, DPT

• OTs in Pelvic Health | Lindsey Vestal, OTR/L

• The Cash-Based Practice Podcast | Dr. Jarod Carter, PT

• Therapy Entrepreneurs and Leaders of Color | Tomeico Faison

• The OTPreneur Podcast | Jayson Davies and Sarah Putt

Books

Here are books that members of our OT Entrepreneurs FB group recommended as being critical to their own business journey.

• Financial Freedom for OTs: A Guide To Building Wealth Without Burnout | Doug Vestal

• BE 2.0 (Beyond Entrepreneurship 2.0): Turning Your Business into an Enduring Great Company | Jim Collins

• Dare to Lead | Brene Brown

• Profit First for Therapists | Julie Herres

• The Prepared Leader | Erika H. James and Lynn Perry Wooten

Consultants and Coaches

Once you are ready to launch or grow your business, you may desire additional in-depth or one-on-one help.

Whether you are looking for an ebook, a mastermind, a coach, or a consultation, there is someone out there to help. Here are a few therapists who can help you take your business to the next level!

(Myself!) Doug Vestal, PhD

Doug helps OTs start and grow thriving Private Pay practices so they can attain treatment freedom, time freedom and money freedom.

Doug and his wife built a highly successful OT private pay practice in NYC which allowed them to payoff their student loan debt, save for retirement and achieve occupational choice without burnout.

For OTs looking to remove the treatment shackles of insurance, Doug offers both paid and free resources, through Freedom of Practice, to learn how to price your services with confidence, develop authentic marketing plans based on relationship building and operate your OT business smoothly.

You can learn with Doug with these resources:

• The OT Freedom Foundation Checklist – A FREE checklist of the 13 steps you need to legitimize your OTPrivate Pay business.

• The OT Private Practice One Page Business Plan – A FREE video training on how to create a simple one-page business plan for your OT Private Pay practice with the 5 most critical components.

• The Freedom of Practice School – It’s no secret that OT school doesn’t teach business skills. The Freedom of Practice School fixes this with weekly, free videos, released specific to OT business.

• Private Pay MBA – The fastest way to build your OT Private Pay practice – guaranteed. A step-by-step online and group coaching program tailored specifically to OTs wanting to start their own Private Pay practice.

• Financial Freedom for OTs: A Guide to Building Wealth Without Burnout – Doug Vestal (the lead author of this blog post) wrote the first and ONLY personal finance book specifically addressing the financial challenges that occupational therapy practitioners face.  Additionally, this book is now required reading at several OT and OTD programs across the United States.

Tomeico Faison, OT

Here’s Tomeico’s mission in her own words:

“As a business consultant and coach, my goal is to partner, guide and support health and human service entrepreneurs so that they can freely provide quality services in their dream businesses while still making a profit—it is possible. It is my hope that more therapists and health care providers will start more businesses that focus on serving and meeting unmet needs and I am available to help make that happen!”

You can check out the OT Entrepreneurs facebook group that she manages.

Laura Park Figueroa 

Laura Park Figueroa is a business coach who works with pediatric practitioners who want to start profitable nature-based outdoor businesses. Her own nature-based practice, Outdoor Kids OT, quickly grew to multiple 6-figures in revenue and has been profitable every single year.

If you’re interested in taking your work with children outdoors into nature, join the free Therapy in the Great Outdoors Community for tons of nature-based therapy resources and support!

Iris Kimberg, MS PT, OTR

Iris is a veteran in the business end of the therapy world. She grew her own practice (from scratch) into a $14M multi-branch therapy company that she sold to a Fortune 500 Company.

She now consults privately with therapists across the country and also offers affordable workbooks, live and on-demand webinars, and generic business-related templates for contracts and forms. You can find her materials at https://nytherapyguide.com/.

Iris’ goal is to help therapists set up fiscally and legally sound practices, as well as offer actionable ideas on how best to strategically grow and eventually sell private practices.

Emmy Vadnais, OTR/L- Holistic OT

Emmy helps health care practitioners who would like to integrate holistic/integrative health care into their practices—or begin a private practice with a holistic/integrative, prevention, or health and wellness approach.

She has been studying and practicing holistic/integrative health care for nearly 20 years. She has provided care in both mainstream health care and holistic/integrative health care settings, and now blends the two.

Through her business, Holistic OT, her mission is to bring holistic/integrative health care into mainstream health care. She provides coaching/mentoring, individual sessions, continuing education, and guidance for OTs and health care practitioners on how to integrate these approaches into their practices–– whether in private practice, as coaches or consultants, or in employed positions.

Patrice Maynard, OTD, OTR/L

Special shout out to Patrice Maynard for her work running the OT Entrepreneurs of Color (OTEC) instagram and facebook group! You can sign up for the mailing list here. And, keep on the look out for a return on the annual conference…possibly in fall 2024.

Website building resources

Having a great website is a tremendous asset to your business. Building OT Potential has been life changing for me.

I’m very passionate about helping fellow OTs build their own websites either for their private practice or other entrepreneurial endeavors.

If you are beginning the website creation process, I encourage you to check out our occupational therapy websites blog. This page showcases websites from OTs around the world.

I also encourage you to consider if you can start without full website. Maybe you just need a landing page, like the one bundled with with Therabyte. Then once your business has been validated, you can consider the help of someone like Corey Hiben or you can also check out my SquareSpace template called: OT Website in a Box.

Copywriting and Marketing for Your OT business

Once your company is launched, the work of marketing and bringing in leads can feel like a full time job unto itself. Luckily there are several OTs, who are focused on helping you with this stage of your business as well!

Krista Frahm, MOT/L

Krista helps clinicians diversify their income and increase their impact through human-centered, conversion-focused copywriting. (Yes, your marketing can be ethical, authentic, and effective!)

Her copywriting specialties include sales pages, email marketing, and launch strategy for clinicians with online courses, coaching programs, memberships and mentorships.

She has 10 years of clinical OT experience, working with adults from the ICU to outpatient and every setting in between. After moving to a rural area with limited career and childcare options, she started Krista Frahm Agency and began supporting clinicians who are serving clients in innovative ways.

Krista’s Resources:

• Leveraging Testimonials to Supercharge your Health & Wellness Marketing — Free training!

• Website in a Weekend — Template + course to get your new OT business online without the headache.

• Uncommon OT Podcast interview — get to know Krista

Jenny Gill, MS OTR

If you’re an OT business owner, Jenny is here to turn your word vomit into words & ideas of marketing magic. As an outpatient OT-turned-copywriter, Jenny dove into the world of online entrepreneurship and launched Jenny Gill Copywriting.

Her signature offer is a Brand Message Intensive that gives you the clarity and words that sell your brand across your marketing efforts. And if you’re looking for a website that captures the voice of your brand, her services include website consulting and done-for-you website copy that gets found in Google while connecting with the hearts of ideal clients.

Forever a believer in the value of OT, Jenny views marketing and communication as the key to sharing that value. That’s why she offers training and resources tailored to the needs of OT business owners who want to confidently build an online presence that shares their message and services with the world. 
Just like a first impression, the first line of copy is the most important. Grab the free Hooks, Headlines and Subject Line Idea Guide to nail that opening line so you get more opens, reads, and views for every piece of content.

For some more concrete ins and outs on marketing, you can check out our full blog post on the topic: Marketing Your OT Practice.

Conclusion

I’m incredibly passionate about seeing fellow OTs pursue entrepreneurship. I hope this article has been helpful to you as work toward making your dreams a reality.

If you are looking for a step-by-step guide on the exact steps to take them you’ll want to check out this 13 step checklist by Doug Vestal.

If I am missing any resources that have helped you grow your occupational therapy business, please contact us.