US Physical Therapy (USPH) Q4 2024 earnings summary

Executive summary

• Achieved record-high demand and patient volume, with a 13% year-over-year increase in total patient visits and a Net Promoter Score of 93 across the network.

• Net income attributable to shareholders rose to $31.4M for 2024 from $28.2M in 2023, with EPS increasing to $1.84 from $1.28 year-over-year.

• Completed seven acquisitions in 2024, including entry into new states and a significant expansion in New York via the Metro PT deal.

• Closed 45 underperforming clinics and completed two significant acquisitions, expanding managed and owned clinic footprint to 768.

• Injury prevention business (IIP) delivered strong growth, with Q4 revenue up over 32% and full-year revenue up nearly 24%.

Financial highlights

• Total net revenue for 2024 increased 11.0% to $671.3M; operating costs rose 13.3% to $547.4M.

• Adjusted EBITDA for Q4 2024 was $21.8 million, up from $19 million in Q4 2023; margin held steady at 15.2%.

• Adjusted EBITDA (non-GAAP) for 2024 was $81.8M, up $3.9M from 2023; Q4 Adjusted EBITDA was $21.8M, up $2.8M year-over-year.

• Physical therapy revenues in Q4 2024 reached $153.8 million, a 14.2% increase year-over-year.

• Net rate per visit in Q4 2024 was $104.73, up $1.05 from Q4 2023, despite a 1.8% Medicare rate reduction.

Outlook and guidance

• 2025 EBITDA expected in the range of $88–$93 million, with Q1 typically the lowest quarter due to seasonality.

• 2025 Medicare rate reduction (~2.9%) expected to reduce revenue by $6.5M and EBITDA by $5.7M, but anticipated to be offset by acquisitions, rate negotiations, and volume growth.

• Anticipates continued volume growth of 2–3% at mature clinics and rate increases from commercial payers, despite a 2.9% Medicare rate cut.

• Full-year contribution from 2024 acquisitions and ongoing double-digit growth in IIP expected to drive EBITDA growth.