Therapy Practice KPIs: 10 Numbers That Tell You If Your Practice Is Healthy

If you’ve ever felt allergic to the word “metrics,” you’re not alone. Many clinicians chose this profession to work with people, not dashboards. Spreadsheets can feel cold, corporate, and detached from the human work of healing.

But here’s the truth: a small practice doesn’t need a finance department to be healthy. It needs clarity. Metrics aren’t about becoming corporate overlords; they are about reducing anxiety. When you know what is actually happening in your practice—how many people are calling, how many are staying, and how much is coming in—you stop guessing. You stop making decisions based on 3 AM panic.

This guide simplifies the data. You don't need complex software. A simple spreadsheet (or a good EHR report) is enough to track the pulse of your business.

Who this is for

This guide is for solo owners and small group owners who want a simple way to understand the health of their practice without turning everything into numbers.

What you’ll walk away with

You’ll get a list of the 10 most critical Key Performance Indicators (KPIs) for therapy practices, the formulas to calculate them, and benchmarks for what "healthy" looks like.

1. Scheduled Sessions per Week (Capacity Reality)

This is your baseline. It tells you what your practice is actually holding, not what you hope it’s holding. It matters because it prevents burnout; if you "feel" busy but only have 12 sessions scheduled, the stress might be coming from admin, not clinical load. Conversely, if you have 30 scheduled, you are likely heading for compassion fatigue. Your goal should be a consistent number that matches your income needs, for example, 20 sessions per week.

2. Kept-Session Rate (Show Rate)

This is the percentage of scheduled sessions that actually happen, calculated by dividing Kept Sessions by Scheduled Sessions and multiplying by 100. A low rate means lost revenue and disjointed care. You should aim for greater than 90%. If it falls below 85%, check your reminder system or your cancellation policy. It often indicates that clients don't feel a strong enough commitment to the slot, or that your logistics are creating friction.

3. Cancellation Rate vs. No-Show Rate

You should track these separately because they mean different things. A cancellation is with notice; a no-show is without. High cancellations suggest scheduling chaos or maybe ambivalence—perhaps the therapy is getting "too hard" or life is getting in the way. High no-shows are more serious; they often suggest disengagement, therapeutic rupture, or poor admin processes. Ideally, no-shows should be near 0%.

4. New Inquiries per Week (Top-of-Funnel)

This tracks how many people are reaching out to you. It predicts your future caseload; if inquiries drop to zero, you will likely have a gap in your schedule in six weeks. The goal depends on your capacity, but even when full, a trickle of inquiries (1-2 per week) is healthy to maintain a waitlist. If this number is zero for months, your marketing or referral engine has stalled.

5. Consult-to-Intake Conversion Rate

This measures how many of the people who call or consult actually schedule a first session. Calculate it by dividing First Sessions Scheduled by Consults Held and multiplying by 100. If you do 10 consults and only 1 books, you might be targeting the wrong audience, or your pitch might need work. Generally, a rate greater than 50% implies a good fit. A very low rate suggests a mismatch between your website promise and your actual service.

6. Average Revenue per Kept Session

This tells you how much you actually make when you sit in the chair. Calculate it by dividing Total Revenue by Total Kept Sessions. This reveals the impact of sliding scales and insurance write-offs. You might charge $150, but if your average is $85 due to insurance contracts, you need to know that for budgeting. This number helps you decide if you can afford to take another sliding scale client.

7. Days to Payment (Cash Flow Stress)

This measures how long it takes between the session and the money hitting your bank. Private pay via credit card is usually 2 days, while insurance can be 30-60 days. A long lag creates cash flow stress even if you are "profitable" on paper. Your goal is to keep this as short as possible. If this number creeps up, your billing process is broken.

8. Outstanding Balances (Aging)

This tracks how much money is owed to you. You should track it in buckets: Current (0-30 days), Late (31-60 days), and Problem (61-90+ days). Money over 90 days past due is rarely collected. Catching it early prevents awkward conversations later. If this bucket grows, you are effectively giving free therapy, which is not sustainable.

9. Average Sessions per Client (Retention)

This measures how long clients stay with you. It defines your business model. If clients stay for 2 years, you need very few new clients. If they stay for 6 sessions, you need a high-volume marketing engine. Neither is "wrong," but you need to know which one you are. A sudden drop in this number might indicate a clinical issue or a problem with the client experience.

10. Owner Admin Hours per Week (The Burnout KPI)

This tracks how many hours you spend on non-clinical work. If you are seeing 20 clients and doing 15 hours of admin, you are working two jobs. This is the single biggest predictor of burnout. For a solo practice, the goal should be less than 5 hours per week. If it's higher, you need to automate, delegate, or simplify.

How to Use These Without Turning Into a Robot

Do not check these every day. That is anxiety, not management.

The Monthly Review: Set a "CEO Date" once a month (e.g., the last Friday). Spend 30 minutes updating your spreadsheet. Ask yourself four questions: What went up? What went down? Why? What is one thing I will change next month? This ritual keeps you in control without letting the numbers run your life.

Practical Next Steps

Start simple by picking just 3 KPIs to track this month, such as Scheduled Sessions, Revenue per Session, and Admin Hours. Next, automate by seeing if your EHR can generate these reports for you. Finally, set a date by putting your "Monthly Review" on the calendar for the next 3 months.

The bottom line

KPIs aren’t about pressure. They’re about peace. When you can see your practice clearly, you stop managing from panic and start managing from truth. You can rest knowing the business is healthy.

Sources

• (Based on standard small business accounting principles and practice management best practices.)