Sell your in-home therapy agency

Who buys in-home and mobile therapy agencies

Most buyers already run outpatient therapy clinics and see home visits as a way to reach patients who cannot drive to a clinic. U.S. Physical Therapy, a public company with more than 770 clinics, bought an 80% interest in an in-home physical, occupational and speech therapy practice in April 2025 and told investors its strategy includes acquiring home-care physical and speech therapy practices. Its October 2024 purchase of half of a 50-clinic New York group also covered therapy delivered in patients' homes.

Other buyers include private equity backed outpatient platforms building regional density, contract therapy companies that staff home health agencies and senior living communities, and home health agencies that want to bring therapy in house instead of paying contractors. Each group values a different part of your agency, so the right buyer depends on whether your revenue is Medicare Part B visits, home health contracts or pediatric Medicaid.

What drives the value of an in-home therapy agency

Buyers start from adjusted EBITDA (earnings after normalizing owner pay and one-time costs) and then decide what multiple it deserves. In home-based therapy the gap between a strong and a weak multiple usually comes from productivity and risk, not from revenue size alone.

Visits per clinician per day

Drive time is unpaid time. Tight routes and scheduling that keep clinicians treating rather than driving lift margin directly.

Payer mix

Medicare Part B, Medicare Advantage, commercial, Medicaid and home health contract rates each behave differently. Buyers want to see the split and the trend.

Referral concentration

If one physician group, hospital or home health agency sends most of your patients, buyers will price the risk of losing it.

Clinician model

Retention, licensure and whether clinicians are W-2 employees or 1099 contractors all get reviewed. Misclassification is a common diligence issue.

Documentation

Plans of care, certifications, KX modifier use and therapy assistant modifiers need to hold up to a claims audit.

Medicare rules buyers check in diligence

For 2026 the Medicare KX modifier threshold is $2,480 for physical therapy and speech-language pathology combined and $2,480 for occupational therapy. Claims above it need the KX modifier and documentation of medical necessity, and targeted medical review applies above $3,000. Services furnished in whole or in part by a physical or occupational therapy assistant are paid at 85% of the fee schedule amount, so your PTA and OTA mix changes revenue per visit.

In-home therapy billed under Part B also has to respect home health consolidated billing: while a patient is under a home health plan of care, Medicare pays the primary home health agency for therapy, not an outside therapy provider. Buyers will test whether your intake process screens for open home health episodes.

Where in-home therapy fits for buyers

In-home therapy covers several models that buyers treat differently: mobile outpatient therapy billed to Medicare Part B in the patient's home, therapy-focused home health, pediatric therapy in the home (often Medicaid funded), and contract therapy staffing into home health agencies and senior living communities. Before you talk to buyers, be clear about which model produces your revenue, because it decides who will pay the most for it.

Outpatient therapy platforms are the most active buyers. U.S. Physical Therapy bought an 80% interest in an in-home physical, occupational and speech therapy practice with about $2.1 million in annual revenue in April 2025, calling home-based outpatient therapy a natural extension of its clinics, and its August 2025 results named home-care physical and speech therapy practices as an acquisition target. In October 2024 it bought half of a management company serving 50 clinics, mostly in New York, that also treat patients at home, with about $64.0 million in revenue and $12.0 million in EBITDA. Deals like these are often partnerships where the owner keeps a minority stake, so think early about whether you want to sell all of the agency or keep a share.

Clinician supply supports demand for agencies that already have a working team. BLS projects physical therapist employment to grow 12% from 2025 to 2035, and home healthcare services employ 11% of physical therapists. Medicare Advantage now covers 55% of eligible Medicare beneficiaries in 2026, so buyers will look closely at your Medicare Advantage contracts and rates, not only traditional Part B.

Medicare payment rules that shape earnings

Part B therapy in the home is paid under the Medicare Physician Fee Schedule. For 2026 the nonqualifying APM conversion factor is $33.40, up 3.26% from $32.35, which includes a one-year 2.5% statutory increase. Buyers will ask how your earnings look if that temporary increase is not repeated.

Several rules reduce what a visit pays. The multiple procedure payment reduction cuts the practice expense portion of the second and later always-therapy units on the same day by 50%. Services furnished in whole or in part by a PTA or OTA, beyond a 10% de minimis share, carry the CQ or CO modifier and are paid at 85%. Above the $2,480 KX threshold, claims need the KX modifier and support for medical necessity, and targeted medical review applies at $3,000.

Home health consolidated billing matters for mobile Part B providers. While a patient is under a home health plan of care, Medicare pays the primary home health agency for physical, occupational and speech therapy, and claims edits reject outside therapy claims in that period. A buyer will want to see that your intake process checks for open home health episodes. Direct access, which APTA reports exists in some form in all 50 states, can reduce reliance on physician referrals, but Medicare still requires a certified plan of care.

Preparing an in-home therapy agency for sale

Most of the work is making earnings and compliance easy to verify. Start six to twelve months before you plan to go to market. Treat the list below as preparation, not legal or tax advice, and involve a healthcare attorney and CPA.

How Lartico fits in

Lartico is a confidential marketplace, not a broker. You list your in-home therapy agency anonymously, approved buyers such as outpatient therapy platforms and strategics request access, and you decide who signs an NDA and sees your details. Owners pay nothing and sign no exclusivity; the buyer pays Lartico's fee at closing.