What is the average EBITDA multiple for PT clinics?

Breakwater notes that platforms such as ATI Physical Therapy, Upstream Rehabilitation and US Physical Therapy have spent the past decade buying clinics, but no association or index publishes physical therapy transaction multiples the way ADA publishes dental economics data. What exists is estimates from the M&A advisory firms working the sector. We build on Breakwater M&A because it segments by adjusted EBITDA, which is the number a multiple actually gets applied to, rather than by revenue. Its 2026 table runs: $150K to $500K at 2.5–4x for a single owner-operated location, $500K to $1M at 4–6x once a professional manager is in place, $1M to $3M at 5–7x for a platform practice with a regional footprint, and $3M+ at 6–8x+ for a roll-up or consolidator target. Breakwater sums the market up as "2.5x to 8x EBITDA" in 2026. Note where that table starts. Below $150K of adjusted EBITDA there is no published band at all, and the honest answer for a clinic that small is that nobody publishes a multiple for it. Peak Business Valuation states that "EBITDA multiples for physical therapy practices typically range from 3.0x to 6.0x EBITDA" and puts SDE multiples at 2.0x to 4.0x. Peak publishes no breakdown by practice size, so 3.0x to 6.0x is a whole-market range and not a single-location band; use it as a sanity check on the middle of Breakwater's ladder. Breakwater, citing WebPT industry analysis, also reports that the average PT EBITDA multiple over the past five years has been 3.6x. That figure reaches us second-hand, and so does Breakwater's second table, the one cut by owner dependency rather than by size, which Breakwater footnotes as "based on Scope Research 2025 analysis and WebPT industry data." On reimbursement: therapy codes are paid under the Medicare physician fee schedule, so they took the schedule-wide conversion-factor cuts of recent years along with everything else, and APTA calls the CY 2026 rule the first fee schedule pay bump in five years. CMS also split the conversion factor in two for CY 2026: $33.57 for qualifying APM participants and $33.40 for everyone else, both up from $32.35. The headline move is larger than what lands in a PT clinic. APTA reports physical therapists average a 1.75 percent increase in reimbursement under the 2026 schedule, against the 3.26 percent rise in the non-qualifying conversion factor, so do not put the conversion-factor percentage into a revenue projection. Buyers still underwrite reimbursement risk. Breakwater lists payor mix among the five things that set a PT multiple and says clinics with a mix of commercial insurance, Medicare and cash-pay patients are less exposed to cuts from any single payor; it adds that practices with a specialty focus may attract additional premiums, without putting a number on them. Owner dependence moves the number more visibly: where the owner generates more than 50% of revenue, Breakwater says the practice may be valued closer to 2.5x to 3.5x EBITDA, regardless of other factors. Regional roll-ups continue acquiring single and two-clinic owners. To see where your clinic lands on Breakwater's ladder, run your numbers in the PT valuation calculator before you take any offer seriously. It subtracts the cost of replacing your own clinical hours, which is the adjustment most single-location owners miss.