USPH - U.S. Physical Therapy, Inc.

U.S. Physical Therapy, Inc. operates outpatient physical and occupational therapy clinics across the United States under the USPT and partner clinic brands, providing rehabilitative care for musculoskeletal injuries, post-surgical recovery, and sports injuries. The business model is fee-for-service with reimbursement primarily from commercial insurers and Medicare/Medicaid, serving individual patients referred by physicians and orthopedic surgeons. Revenue is approximately $580M annually, concentrated entirely in the U.S. market across roughly 700 clinic locations. The company also operates an industrial injury prevention services segment that contracts with employers for on-site physical therapy and ergonomic assessments.

Past Year Trends

• USPH reported FY2025 Adjusted EBITDA of $95.0 million, up 16.2% year-over-year, while Q4 2025 net revenue from physical therapy operations rose 13.0% to $173.8 million, driven by clinic acquisitions and same-clinic volume gains. (Bullish)
• Despite net income attributable to USPH shareholders rising to $39.6 million in FY2025 from $31.4 million in FY2024, diluted EPS fell to $1.42 from $1.84, reflecting growing non-controlling interest expense from partial-ownership clinic partnerships. (Bearish)
• USPH completed at least four clinic acquisitions in 2025, including a 3-clinic Wyoming practice (~$4.3 million annual revenue) and a 3-clinic practice (~$5.3 million annual revenue), expanding its network to 783 outpatient clinics across 44 states. (Bullish)

Next Year Trends

• In April 2026 USPH closed a $450 million five-year credit facility ($175 million term loan plus $275 million revolver maturing April 2031, upsized from $400 million due to lender demand), materially increasing firepower for tuck-in clinic acquisitions at scale. (Bullish)
• Q1 2026 net income attributable to USPH shareholders dropped 49% year-over-year to $5.0 million despite 7.9% revenue growth to $198.3 million, signaling that non-operating costs and minority-interest dilution from the January 2026 acquisitions could compress reported EPS even if the company hits its FY2026 Adjusted EBITDA guidance of $102–$106 million. (Bearish)
• USPH's January 2026 acquisition of an industrial injury prevention business (~$7.0 million annual revenue, 70% interest) introduces a new employer-direct revenue vertical outside traditional insurance-reimbursed outpatient PT, with integration execution risk but potential to reduce payer concentration if scaled across existing clinic markets. (Neutral)

Red Flags

[Financial Restatement / Auditor Issue] Financial restatement: In March 2017, U.S. Physical Therapy announced it would restate nearly three years of financial results (FY2014, FY2015, and Q1–Q3 2016) after determining its historical accounting for redeemable non-controlling interests of acquired partnerships was materially incorrect. — Block & Leviton LLP press release / PRNewswire, approximately March 2017