HOUSTON–(BUSINESS WIRE)–U.S. Physical Therapy, Inc. (“USPH” or the “Company”) (NYSE, NYSE Texas: USPH), a national operator of outpatient physical therapy clinics and provider of industrial injury prevention services, today reported results for the fourth quarter and full year ended December 31, 2025.
FINANCIAL HIGHLIGHTS
Year Ended December 31, 2025 versus Year Ended December 31, 2024
- Adjusted EBITDA (1), a non-Generally Accepted Accounting Principles (“GAAP”) measure, was $95.0 million for the year ended December 31, 2025 (“2025 Year”), an increase of $13.2 million or 16.2%, from $81.8 million for the year ended December 31, 2024 (“2024 Year”).
- Net income attributable to USPH shareholders (“USPH Net Income”), a GAAP measure, was $39.6 million for the 2025 Year compared to $31.4 million for the 2024 Year. Under GAAP, increases and decreases in the value of redeemable noncontrolling interests (related to ownership interests of our partners in subsidiaries that are not fully owned by USPH), net of taxes, are not included in net income, but they are included in the calculation of earnings per share. The Company’s improved performance in 2025 increased the value of these ownership interests, net of taxes, by $18.0 million, which reduced earnings per share. Earnings per share was $1.42 for the 2025 Year and $1.84 for the 2024 Year.
- Operating Results (1), a non-GAAP measure, was $40.0 million for the 2025 Year compared to $36.9 million for the 2024 Year. On a per share basis, Operating Results was $2.63 for the 2025 Year compared to $2.45 for the 2024 Year.
Fourth Quarter Ended December 31, 2025, versus Fourth Quarter Ended December 31, 2024
- Non-GAAP Adjusted EBITDA (1) was $24.8 million for the three months ended December 31, 2025 (“2025 Fourth Quarter”) an increase of $3.0 million, or 13.5%, from $21.8 million for the three months ended December 31, 2024 (“2024 Fourth Quarter”).
- USPH Net Income was $4.2 million for the 2025 Fourth Quarter compared to $9.2 million for the 2024 Fourth Quarter, with the decrease attributable to the change in fair value of contingent earnout consideration quarter over quarter – a net loss of $5.2 million in the 2025 Fourth Quarter compared to a net gain of $5.1 million in the 2024 Fourth Quarter. Under GAAP, increases and decreases in the value of redeemable noncontrolling interests, net of taxes, are not included in net income, but they are included in the calculation of earnings per share. The Company’s improved performance in the 2025 Fourth Quarter increased the value of these ownership interests, net of taxes, by $10.8 million, which reduced earnings per share. Loss per share was $0.44 for the 2025 Fourth Quarter compared to earnings per share of $0.52 for the 2024 Fourth Quarter.
- Non-GAAP Operating Results (1) was $10.2 million for the 2025 Fourth Quarter compared to $7.8 million for the 2024 Fourth Quarter. On a per share basis, Non-GAAP Operating Results was $0.67 for the 2025 Fourth Quarter compared to $0.51 for the 2024 Fourth Quarter.
- Net revenue from physical therapy operations for the 2025 Fourth Quarter increased $20.0 million, or 13.0%, to $173.8 million from $153.8 million for the 2024 Fourth Quarter. Physical therapy operations’ gross profit was $35.2 million for the 2025 Fourth Quarter, an increase of $7.1 million, or 25.3%, from $28.1 million for the 2024 Fourth Quarter.
- Net rate per patient visit for the 2025 Fourth Quarter was $106.49 compared to $104.73 for the 2024 Fourth Quarter.
- Total patient visits were 1,593,336 for the 2025 Fourth Quarter, an 11.2% increase from 1,432,801 for the 2024 Fourth Quarter.
- Average daily patient visits per clinic, which does not include home-care visits, was 32.7 for the 2025 Fourth Quarter, a record-high volume per clinic for a fourth quarter, compared to 31.6 for the 2024 Fourth Quarter.
- Industrial injury prevention services (“IIP”) revenue was $28.9 million for the 2025 Fourth Quarter, an increase of 8.7% as compared to the 2024 Fourth Quarter. IIP gross profit was $5.0 million for the 2025 Fourth Quarter, an increase of $0.5 million, or 11.5%, from $4.4 million for the 2024 Fourth Quarter.
- The Company added 11 and closed 10 owned and/or managed clinics in the 2025 Fourth Quarter bringing its total count to 780 as of December 31, 2025, compared to 761 as of December 31, 2024.
- The Company repurchased 81,322 of its own shares of common stock for total consideration of $5.6 million on the open market during the 2025 Fourth Quarter, demonstrating its confidence in the long-term prospects of the Company.
- On January 2, 2026, the Company acquired an eight-clinic practice currently generating approximately $8.0 million in annual revenue and 66,000 in annual visits. USPH acquired a 50% interest and 50% was retained by the previous owners.
- On January 31, 2026, the Company acquired an industrial injury prevention business currently generating approximately $7.0 million in annual revenue. USPH acquired a 70% interest and 30% was retained by the previous owner.
- On February 2, 2026, the Company announced a 10-year strategic alliance between its subsidiary partner, MSO Metro LLC (“Metro”), and a prominent New York hospital system, whereby 60 of Metro’s existing outpatient physical therapy clinics will become part of the hospital system’s clinical services network. See “Strategic Hospital Alliances” below for more information.
- On February 25, 2026, the Company announced a 10-year strategic alliance between another of its subsidiary partners and a local hospital system whereby the subsidiary partner’s existing 10 outpatient physical therapy clinics will become part of the hospital system’s clinical services network. See “Strategic Hospital Alliances” below for more information.
- The Company’s Board of Directors raised the Company’s quarterly dividend rate from $0.45 per share to $0.46 per share, effective immediately, and declared a quarterly dividend for the first quarter of 2026 at the higher rate. The dividend will be payable on April 10, 2026, to shareholders of record on March 13, 2026.
- Management currently expects the Company’s Adjusted EBITDA for 2026 to be in the range of $102.0 million to $106.0 million. See “2026 Earnings Guidance” below for more information.
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| (1) | These are non-GAAP Measures. Please refer to the section titled “Reconciliation of Non-GAAP Measures to the Most Directly Comparable GAAP Measure” for the definition and reconciliation of Adjusted EBITDA, Operating Results and other non-GAAP measures to the most directly comparable GAAP measure. |
MANAGEMENT’S COMMENTS
Chris Reading, Chief Executive Officer, said, “Our team delivered a strong finish to a solid year where we made progress around a number of key initiatives which helped to deliver revenue growth of more than 16%, gross profit growth of over 20%, and margin and net rate improvements, among other positive developments. Additionally, we have recently announced several acquisitions as well as new, important hospital relationships in key markets which will create long-term value and increase our ability to serve patients in those areas. We have a very clear plan for the year ahead and we are excited to bring those plans to fruition with the capable help of our partners and our support teams around the country.”
2025 Fourth Quarter Versus 2024 Fourth Quarter
Additional details are available in the “Supplemental Financial and Performance Metrics” section of this release.
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Physical Therapy Operations |
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Three Months Ended |
Variance |
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December 31, 2025 |
December 31, 2024 |
$ |
% |
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(In thousands, except percentages) |
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Revenue related to: |
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Mature Clinics (1) |
$ |
133,497 |
$ |
131,589 |
$ |
1,908 |
1.4% |
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Clinic additions (2) |
|
35,694 |
|
17,080 |
|
18,614 |
* |
(9) |
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Clinics sold or closed (3) |
|
484 |
|
1,391 |
|
(907) |
* |
(9) |
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Net Patient Revenue |
|
169,675 |
|
150,060 |
|
19,615 |
13.1% |
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Other (4) |
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4,103 |
|
3,747 |
|
356 |
9.5% |
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Total |
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173,778 |
|
153,807 |
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19,971 |
13.0% |
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Operating costs (5) (7) |
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138,599 |
|
125,723 |
|
12,876 |
10.2% |
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Gross profit |
$ |
35,179 |
$ |
28,084 |
$ |
7,095 |
25.3% |
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Financial and operating metrics (not in thousands): |
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Net rate per patient visit (1) |
$ |
106.49 |
$ |
104.73 |
$ |
1.76 |
1.7% |
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Patient visits (1) |
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1,593,336 |
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1,432,801 |
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160,535 |
11.2% |
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Average daily visits per clinic (1) |
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32.7 |
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31.6 |
|
1.1 |
3.5% |
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Gross Profit Margin (7) |
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20.2% |
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18.3% |
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Adjusted gross profit margin (4)(5)(6)(7) |
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20.5% |
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18.6% |
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Adjusted salaries and related costs per visit (6)(8) |
$ |
62.15 |
$ |
62.85 |
$ |
(0.70) |
(1.1)% |
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Adjusted operating costs per visit (6)(8) |
$ |
85.56 |
$ |
86.06 |
$ |
(0.50) |
(0.6)% |
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(1) See Glossary of Terms – Revenue Metrics for definitions. |
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(2) Includes 47 owned clinics added during the year ended December 31, 2025 and 96 owned clinics added during the year ended December 31, 2024. See “Clinic Count Roll Forward” for additional information. |
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(3) Includes 23 owned clinics closed during the year ended December 31, 2025 and 45 owned clinics closed during the year ended December 31, 2024. See “Clinic Count Roll Forward” for additional information. |
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(4) Includes revenues from management contracts. |
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(5) Includes costs from management contracts. |
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(6) Excludes $0.4 million for the 2025 Fourth Quarter and $0.5 million for the 2024 Fourth Quarter of certain incentive costs related to the Metro acquisition and gains or losses related to clinic closures, as applicable. See “Reconciliation of Non-GAAP Measures to the Most Directly Comparable GAAP Measure”. |
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(7) Amortization of certain intangible assets was reallocated between the physical therapy operations and IIP segments. Prior year amounts were reallocated to conform with current presentation. |
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(8) Per visit costs exclude management contract costs. |
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(9) Not meaningful. |
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Net revenue from physical therapy operations increased $20.0 million, or 13.0%, to $173.8 million for the 2025 Fourth Quarter from $153.8 million for the 2024 Fourth Quarter. Net rate per patient visit for the 2025 Fourth Quarter was $106.49 compared to $104.73 for the 2024 Fourth Quarter.
Operating costs from physical therapy operations increased $12.9 million, or 10.2%, to $138.6 million for the 2025 Fourth Quarter from $125.7 million for the 2024 Fourth Quarter. Excluding certain incentive costs related to Metro and clinic closures costs for both periods, adjusted salaries and related costs per visit (1) was $62.15 for the 2025 Fourth Quarter compared to $62.85 for the 2024 Fourth Quarter while adjusted total operating costs per visit (1) was $85.56 in the 2025 Fourth Quarter compared to $86.06 for the 2024 Fourth Quarter.
Gross profit from physical therapy operations increased $7.1 million, or 25.3%, to $35.2 million for the 2025 Fourth Quarter as compared to $28.1 million for the 2024 Fourth Quarter.
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| (1) | These are non-GAAP Measures. Please refer to the section titled “Reconciliation of Non-GAAP Measures to the Most Directly Comparable GAAP Measure” for the definition and reconciliation of Adjusted EBITDA, Operating Results and other non-GAAP measures to the most directly comparable GAAP measure. |
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Industrial Injury Prevention Services |
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Three Months Ended |
Variance |
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December 31, 2025 |
December 31, 2024 |
$ |
% |
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(In thousands, except percentages) |
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Net revenue |
$ |
28,948 |
$ |
26,640 |
$ |
2,308 |
8.7% |
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Operating costs (1) |
|
23,995 |
|
22,197 |
|
1,798 |
8.1% |
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Gross profit |
$ |
4,953 |
$ |
4,443 |
$ |
510 |
11.5% |
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Gross profit margin |
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17.1% |
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16.7% |
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(1) Amortization of certain intangible assets was reallocated between the physical therapy operations and IIP segments. Prior year amounts were reallocated to conform with current presentation. |
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IIP revenue increased $2.3 million, or 8.7%, to $28.9 million for the 2025 Fourth Quarter as compared to $26.6 million for the 2024 Fourth Quarter. Gross profit from IIP operations for the 2025 Fourth Quarter increased $0.5 million, or 11.5%, to $5.0 million from $4.4 million for the 2024 Fourth Quarter. Gross profit margin from IIP operations was 17.1% for the 2025 Fourth Quarter compared to 16.7% for the 2024 Fourth Quarter.
Corporate Office Costs and Other Expenses
Corporate office costs increased to $18.1 million for the 2025 Fourth Quarter from $15.6 million for the 2024 Fourth Quarter, primarily to support the larger number of clinics in 2025, as well as costs associated with acquisition integration and the implementation of a new financial and human resources system. Implementation costs associated with the new financial and human resources system are expected to continue through the end of 2026. As a percentage of net revenue, corporate office costs was 8.9% for the 2025 Fourth Quarter compared to 8.6% for the 2024 Fourth Quarter. Excluding the acquisition integration costs and costs associated with the implementation of the new financial and human resources system of $1.0 million and $0.5 million in each comparative quarter, corporate office costs was 8.5% and 8.3% of net revenue for the 2025 Fourth Quarter and the 2024 Fourth Quarter, respectively.
The Company revalued contingent consideration related to certain acquisitions and recognized a net loss (an increase in the related liabilities) of $5.2 million for the 2025 Fourth Quarter compared to a net gain (a decrease in the related liabilities) of $5.1 million for the 2024 Fourth Quarter.
A non-cash impairment charge of $2.4 million was recognized during the 2024 Fourth Quarter related to the impairment of assets held for sale. No impairment was recorded during the 2025 Fourth Quarter.
Operating income was $16.8 million for the 2025 Fourth Quarter compared to $19.7 million for the 2024 Fourth Quarter. Excluding the impact of certain costs discussed above, adjusted operating income (1) increased $5.4 million or 30.3% to $23.4 million for the 2025 Fourth Quarter from $17.9 million in the 2024 Fourth Quarter. See “Reconciliation of Non-GAAP measures to the Most Directly Comparable GAAP Measure”.
Interest expense increased by $0.3 million to $2.3 million for the 2025 Fourth Quarter compared to $2.0 million for the 2024 Fourth Quarter due to a higher average outstanding balance on our revolving credit facility for the 2025 Fourth Quarter. The interest rate associated with borrowings on the Company’s credit facilities was 4.8% in each of the 2025 Fourth Quarter and the 2024 Fourth Quarter, with an all-in effective interest rate (including all associated costs) of 5.6% and 5.5% over the same periods, respectively.
Interest income was $0.1 million during the 2025 Fourth Quarter compared to $0.3 million for the 2024 Fourth Quarter.
The Company revalued a put-right liability related to the future purchase of an IIP business and recognized a net non-cash gain (a decrease in the related liability) of $0.1 million in both the 2025 Fourth Quarter and the 2024 Fourth Quarter.
The provision for income taxes was $5.8 million for each of the 2025 Fourth Quarter and 2024 Fourth Quarter. Income tax expense for the 2025 Fourth Quarter included an adjustment of $1.2 million to revalue the Company’s deferred tax assets and liabilities using the most current statutory income tax rate.
USPH Net Income and Non-GAAP Measures
Net income attributable to non-controlling interest (temporary and permanent) was $5.0 million for the 2025 Fourth Quarter compared to $3.3 million for the 2024 Fourth Quarter.
USPH Net Income was $4.2 million for the 2025 Fourth Quarter compared to $9.2 million for the 2024 Fourth Quarter, with the decrease attributable to the change in fair value of contingent earnout consideration quarter over quarter. Under GAAP, increases and decreases in the value of redeemable noncontrolling interests, net of taxes, are not included in net income, but they are included in the calculation of earnings per share. The Company’s improved performance in the 2025 Fourth Quarter increased the value of these ownership interests, net of taxes, by $10.8 million, which reduced earnings per share. Loss per share was $0.44 for the 2025 Fourth Quarter compared to earnings per share of $0.52 for the 2024 Fourth Quarter.
Non-GAAP Adjusted EBITDA (1) was $24.8 million for the 2025 Fourth Quarter, an increase of $3.0 million or 13.5%, from $21.8 million for the 2024 Fourth Quarter. Non-GAAP Operating Results (1) was $10.2 million, or $0.67 per share, for the 2025 Fourth Quarter compared to $7.8 million, or $0.51 per share, for the 2024 Fourth Quarter.
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| (1) |
These are non-GAAP Measures. Please refer to the section titled “Reconciliation of Non-GAAP Measures to the Most Directly Comparable GAAP Measure” for the definition and reconciliation of Adjusted EBITDA, Operating Results and other non-GAAP measures to the most directly comparable GAAP measure. |
2025 Year Versus 2024 Year
Net revenue for the 2025 Year increased $109.6 million, or 16.3%, to $781.0 million from $671.3 million for the 2024 Year while operating costs increased $83.9 million, or 15.3%, to $631.3 million from $547.4 million over the same periods, respectively. Gross profit for the 2025 Year was $149.7 million, or 19.2% of net revenue, compared to $123.9 million for the 2024 Year, or 18.5% of net revenue.
Net revenue from physical therapy operations increased $92.2 million, or 16.0%, in the 2025 Year versus the comparable prior year period. Additionally, net rate per patient visit increased to $105.76 for the 2025 Year from $104.71 for the 2024 Year. Gross profit from physical therapy operations increased $22.1 million or 20.9% to $128.1 million, or 19.2% as a percent of net revenues, for the 2025 Year as compared to $105.9 million, or 18.4% as a percent of net revenues, for the 2024 Year. Excluding certain incentive costs related to the Metro acquisition, which occurred on October 31, 2024, and clinic closures, the adjusted gross profit margin (1) increased $18.5 million or 16.8%. to $129.0 million, or 19.4% as a percent of net revenues for the 2025 Year compared to $110.5 million, or 19.2% as a percent of net revenues, for the 2024 Year.
Revenues from IIP increased $17.5 million, or 18.0%, to $114.4 million for the 2025 Year from $96.9 million for the 2024 Year. Gross profit from IIP operations increased $3.6 million, or 20.2%, to $21.6 million for the 2025 Year from $18.0 million in the 2024 Year. The gross profit margin from IIP operations was 18.9% for the 2025 Year compared to 18.6% for the 2024 Year.
Corporate office costs were $69.3 million for the 2025 Year compared to $58.3 million for the 2024 Year. As a percentage of net revenue, corporate office costs were 8.9% and 8.7% over the same periods, respectively. Excluding acquisition integration costs and the costs associated with the implementation of the new financial and human resources system of $2.4 million and $0.8 million in the comparative years, corporate office costs was 8.6% of net revenue for the 2025 Year and the 2024 Year.
The Company revalued contingent consideration related to certain acquisitions and recognized a net gain (a decrease in the related liabilities) of $6.2 million for the 2025 Year compared to a net loss of $0.2 million for the 2024 Year (an increase in the related liabilities).
Operating income was $86.7 million for the 2025 Year compared to $63.0 million for the 2024 Year. Excluding the certain costs discussed above, adjusted operating income (1) increased to $84.1 million for the 2025 Year from $71.0 million for the 2024 Year, an increase of 18.4%. See the “Reconciliation of Non-GAAP Measures to the Most Directly Comparable GAAP Measure”.
Other expenses were $8.9 million for the 2025 Year compared to $2.8 million for the 2024 Year, with the increase primarily due to higher interest expense as a result of increased borrowings and lower interest income as the excess cash available during the 2024 Year has been deployed to fund acquisitions since that time. Additionally, the Company revalued a put-right liability related to the future purchase of an IIP business and recognized a net non-cash expense (an increase in the related liability) of $1.3 million for the 2025 Year compared to net non-cash expense of $0.1 million for the 2024 Year.
The provision for income tax was $19.8 million, or an effective tax rate of 33.4%, for the 2025 Year and $14.6 million, or an effective tax rate of 31.7%, for the 2024 Year. Income tax expense for the 2025 Year included an adjustment of $1.2 million to revalue the Company’s deferred tax assets and liabilities using the most current income tax rate.
USPH Net Income was $39.6 million for the 2025 Year as compared to $31.4 million for the 2024 Year while earnings per share was $1.42 for the 2025 Year compared to $1.84 for the 2024 Year.
Non-GAAP Adjusted EBITDA (1) increased $13.2 million to $95.0 million for the 2025 Year from $81.8 million for the 2024 Year while non-GAAP Operating Results (1) increased $3.1 million to $40.0 million, or $2.63 per share, for the 2025 Year from $36.9 million, or $2.45 per share, for the 2024 Year.
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| (1) | These are Non-GAAP Measures. Please refer to the section titled “Reconciliation of Non-GAAP Measures to the Most Directly Comparable GAAP Measure” for the definition and reconciliation of Adjusted EBITDA, Operating Results, and other non-GAAP measures to the most directly comparable GAAP measure. |
For additional information on the 2025 Year results, please refer to the Company’s Annual Report on Form 10-K which is expected to be filed with the Securities and Exchange Commission on February 27, 2026.
BALANCE SHEET AND CASH FLOW
Total cash and cash equivalents were $35.6 million as of December 31, 2025, compared to $41.4 million as of December 31, 2024. The Company had $161.8 million in outstanding borrowings and $144.5 million in available credit under the Company’s revolving facility as of December 31, 2025. This compares to $151.6 million of outstanding borrowings and $164.0 million in available credit under the Company’s revolving facility as of December 31, 2024.
The Company repurchased 81,322 of its own shares for total consideration of $5.6 million on the open market during the 2025 Fourth Quarter, demonstrating its confidence in the long-term prospects of the Company.
RECENT ACQUISITIONS
On January 2, 2026, the Company acquired an eight-clinic practice currently generating approximately $8.0 million in annual revenue and approximately 66,000 in annual visits. USPH acquired a 50% interest and 50% was retained by the previous owners.
On January 31, 2026, the Company acquired an industrial injury prevention business currently generating approximately $7.0 million in annual revenue. USPH acquired a 70% interest and 30% was retained by the previous owner.
The Company’s strategy is to continue acquiring multi-clinic outpatient physical therapy practices and home-care physical and speech therapy practices, to develop outpatient physical therapy clinics as satellites in existing partnerships, and to continue acquiring companies that provide industrial injury prevention services.
STRATEGIC HOSPITAL ALLIANCES
On February 2, 2026, the Company announced a 10-year strategic alliance between its subsidiary partner, MSO Metro, LLC (“Metro”), and a prominent New York hospital system. Under the agreement, 60 of Metro’s existing outpatient physical therapy clinics in New York will become part of the hospital system’s clinical services network. The alliance is expected to begin operations with an initial group of clinics in mid-2026, with all 60 clinics anticipated to be operational by year-end 2026.
On February 25, 2026, the Company also announced a 10-year strategic alliance between another of its subsidiary partners and a local hospital system. Under the agreement, the subsidiary partner’s existing ten clinics will become part of the hospital’s clinical services network. The alliance is expected to begin operations by mid-2026, with all ten clinics anticipated to be operational by year-end 2026.
Contacts
U.S. Physical Therapy, Inc.
Carey Hendrickson, Chief Financial Officer
email: chendrickson@usph.com
Chris Reading, Chief Executive Officer
(713) 297-7000
Three Part Advisors
Joe Noyons
(817) 778-8424
