Physical Therapy Clinic Acquisition & Underwriting Model – Excel XLSX

BENEFITS OF THIS DOWNLOADABLE EXCEL DOCUMENT

1. The CQ modifier is priced per visit rather than described: a PTA saving of $11.8789 nets $0.2029 on a Medicare visit and $11.8789 on a commercial one, so the plan is worth what the payer mix allows.
2. The model prices the deal twice, $693,650 on the seller's pro-forma and $508,501 on financeable cash flow, and prints the $185,148 difference as the overpay you avoid.
3. Four DSCR readings sit side by side, true 1.4827x, naive 3.2798x, 1.1407x at the pro-forma price and 0.8375x in the down-case, against a 1.15x SBA floor and the 1.25x lender convention.

INTEGRATED FINANCIAL MODEL EXCEL DESCRIPTION

Physical Therapy Clinic Acquisition & Underwriting Model is an Excel template (XLSX) with a supplemental PDF document available for immediate download upon purchase.

This is an acquisition underwrite for an outpatient physical therapy clinic, built for a buyer financing the purchase with an SBA 7(a) loan and for the lender sizing it.

The valuation error it intercepts is a pro-forma price that rests on margin improvements the payer mix will not allow. The seller's pro-forma prices the clinic at $693,650. The cash flow a bank will actually finance prices it at $508,501, a difference of $185,148, or 26.69% of the ask. Two unrealized improvements create the gap. The first is converting visits from PT to PTA to cut labour cost. On a Medicare book that is worth almost nothing: since 1 January 2022 Medicare pays 85% for services furnished in whole or in part by a PTA under the CQ modifier, and the haircut consumes almost the entire labour saving. The model measures it exactly: the PTA saving is $11.8789 per visit, but after the CQ reduction of $11.676 the net on a Medicare visit is $0.2029, against $11.8789 on a commercial visit. The same plan is worth 58.55 times more on a commercial book than on a Medicare one, and the headline saving of $33,261 becomes $23,322 bankable, a 70.1% capture. The second improvement is recovering slots lost to cancellations and no-shows, which at 12% is 1,091 visits, $115,464, or 51.1% of the SDE.

The engine runs 8,000 completed visits a year, 32.0 a day, through a payer mix (Commercial 40%, Medicare 25%, Medicaid 10%, workers compensation 10%, self-pay 10%, other 5%) to a blended allowed amount of $110.37 per visit, a CQ differential of minus $2,840 and net revenue of $846,667 at a net rate of $105.83 per visit. SDE is $226,001 (26.69%), and after the owner-PT production replacement of $113,832 the Adjusted EBITDA is $112,169 (13.25%). The SBA 7(a) loan of $463,135 at 76.59% leverage carries $68,907 of annual debt service over ten years at 8.50%, giving a true DSCR of 1.4827x against a naive 3.2798x, 1.1407x if you pay the pro-forma price, and 0.8375x in the down-case. Break-even sits at 31.39 visits a day against 32.0 run, a cushion of 0.61.

Inside: an 11-sheet workbook with 345 formulas and 210 named ranges, Excel and Google Sheets compatible with no macros, a roughly 23-page PDF guide with numbers read live from the model, and a README. A three-way payer-mix toggle (Medicare-Heavy Suburban, Balanced Commercial, Workers Comp and Cash-Forward) moves the multiple, the blended rate, SDE, DSCR and the PTA capture rate from 47.9% to 84.9%.

What the model does not claim: 1.15x is the SBA regulatory DSCR floor while 1.25x is a lender convention, not a rule, and at the pro-forma price the deal fails both. Adjusted EBITDA of 13.25% is stated as below the 19.2% gross margin of a listed multi-clinic platform, because a single clinic does not have that scale. The no-show band is contested, 20.6% in one study against a sub-10% industry target, and the model shows both instead of picking one. There is no IRR anywhere in the workbook. Educational planning tool, not financial, legal, tax or medical advice.

Source: Best Practices in Integrated Financial Model Excel: Physical Therapy Clinic Acquisition & Underwriting Model Excel (XLSX) Spreadsheet, ProformaWorks