US Physical Therapy (USPH) Q4 2025 earnings summary

Executive summary

• Operates 780 owned/managed outpatient physical and occupational therapy clinics across 44 states, making it one of the largest platforms in a fragmented $40B+ U.S. rehab market.

• Achieved strong revenue and gross profit growth in 2025, driven by higher patient volumes, improved net rates, and expansion of the clinic network.

• Demonstrates a proven business model driven by organic growth, de novo clinics, and strategic acquisitions, with a highly retentive partnership structure.

• Announced strategic acquisitions and two exclusive, long-term hospital alliances expected to drive future EBITDA and margin expansion.

• Raised quarterly dividend and executed share repurchases, reflecting confidence in long-term prospects.

Financial highlights

• Full year 2025 net revenue rose 16.3% to $781.0M; gross profit up 20.8% to $149.7M (19.2% margin); adjusted EBITDA increased 16.2% to $95.0M.

• Q4 2025 net revenue grew 13.0% to $173.8M; adjusted EBITDA up 13.5% to $24.8M.

• Net income attributable to shareholders was $39.6M (EPS $1.42), with Q4 net income at $4.2M.

• Adjusted EBITDA margin for 2025 was 15.5%.

• Annual dividend per share was $1.80.

Outlook and guidance

• 2026 adjusted EBITDA expected between $102M and $106M, including $2.5M from Medicare rate increases and contributions from new hospital alliances.

• Hospital affiliations to phase in mid-2026, expected to contribute at least $14M in PT revenue and $7.3M in adjusted EBITDA by year-end.

• Same-store revenue growth projected at 2.5%-3% for 2026, driven by both visit and rate increases.

• Focused on maximizing profits of existing facilities and expanding industrial injury prevention services.

• Wage inflation expected to remain manageable, with no significant pressure anticipated.