How To Start An OT Private Pay Practice

Video Poster Image

Curious on how to start your own OT Private Pay Practice? Here are the 3 things you must focus on to start your OT practice with confidence.


LINKS: some of these are affiliate links which pays me a small portion at no extra cost to you. I only recommend things we personally use:

👉The powerhouse website builder we use to support our clients

👉Book recommendation

Let's simplify what's most important when starting your OT Private Pay Practice. Because the truth is that you can do it in shorter time than you thought and with less money than you thought as well.

In this video, Doug Vestal, Ph.D., breaks down the 3 most important things you must have for your OT private pay practice. This video is not intended as professional or legal advice.

Be sure to seek the services of a professional and understand the risks you are undertaking.


Transcript of Video:

Starting an OT private pay practice is actually quite simple.  It’s a lot simpler than starting a practice that takes insurance. 

And, depending upon where you live, you can get started for under a thousand dollars and be up and running in a month or so.

Hi, my name is Doug Vestal, and I help OTs just like you start and grow thriving private pay practices.  My wife and I own a private pay OT practice and I make these videos so you can learn from our mistakes and our success so you can get started faster and with more confidence.


I love categorizing things and breaking them up into smaller pieces that are in their distinct buckets.  I find this makes it less overwhelming and easier to see yourself following through with the steps


Starting an OT private pay practice really comes down to just 3 items:

  • Doing all the legal stuff to make sure you are covered and legitimate
  • Putting a marketing plan in place to attract your clients
  • Retaining clients


That’s really it.  Let’s break this down.

So, the first step is obviously making sure you do all the legal stuff and are a legitimate business. 


These are things like establishing and forming your business entity, getting your type 2 NPI number and an EIN.  Checking for what business licenses you need.  Getting insurance.  Opening a business bank account.


It is normally this part that just completely intimidates OTs. 


But, the good news is these are pretty much all one time things.  They are one and done for the most part.


And – if you go to my website,, I have a free 13 point checklist that shows you all these logistics and the order in which to do things.

Establishing the business entity is the step that really trips up a lot of people.  There are a few different choices such as PLLC versus LLC and it does require research on your part, especially with your state’s practice act. 

And there’s a few different ways to do it.  You can do it yourself, you know if you are a DIY type person.  You can also use online services such as bizfilings.  Or, you could hire a lawyer.  Obviously, DIY will be the cheapest but also carries with it the risk you may miss something.

In my course Private Pay MBA I go extensively through the different business entity options, their pros and cons and what we’ve seen most OTs do.  I’ll leave a link to that in the description below.


These logistics just give you the business shell.  They really are just there to protect you, and the client in terms of HIPPA, make your business official and give you a way to accept payment.


But, while these logistics are super important, and you don’t want to skip them, they won’t in of themselves bring any clients into your private pay practice.


You can’t just, you know establish the entity and those things and then think that patients will start automatically coming in your door.


So – the second thing that’s super important is developing your OT marketing plan.  Marketing is critical because that is in fact how your clients will find out about your practice and start to book with you – which, after all is what you need and want.


To start your marketing plan, you have to be very clear about who your ideal client is.  Marketing is all about language.  The language you use in your marketing has the ability to have someone immediately raise their hand and say “Oh, that’s what I’m dealing with, going through – I better call them.”


And, the only way to have that type of response is to use very specific language.  If you are general in your language than you will appeal to know one.  They will just ignore it.


And the only way to use specific language is to know specifically who you are targeting – that is, your ideal client.


So – let me give you an example.  Our private pay practice is called The Functional Pelvis and we provide pelvic floor therapy.

But – we don’t target just anyone with a pelvic floor – that would be everyone. 

If we targeted everyone, we would have to use very generic language like “we provide pelvic floor therapy to everyone who is suffering from issues.”

That’s just not compelling enough to get people to identify themselves as needing our services.

So instead, our ideal clients are Moms, a much smaller subset of people with pelvises. 

And that allowed us to change our language to something like this “we help new Moms regain trust in their core, eliminate embarrassing leaks and enjoy pain free intimacy without going on medication or needing surgery.”

If you were a new Mom who was experiencing leaking, this message would resonate so much more with you than the previous generic one which was “we provide pelvic floor therapy to everyone who is suffering from issues”

And that is the power of getting super specific in the very beginning on who your ideal client is.  Your clients want to feel like they are understood.  And you do that by talking specifically to them about their problems, their needs, and their desires.


Once you have established your ideal client, it is really a matter of figuring out where your ideal client hangs out and offering value to them.  That’s the marketing.

This means offering workshops geared towards your clients.  It means identifying who else in your community currently interacts with your potential clients and developing relationships with them.  It means developing educational material that you hand out at community events where your ideal client hangs out.


Your marketing plan should simply be based upon what value you can provide to your client before they ever pay you, before they ever book with you, and getting that information into their hands by knowing where they currently hang out and who they currently interact with.


And the plan is there to ensure you are doing it consistently each week to attract clients.


Once you have clients coming into the door, you want to move onto the next phase which is retaining your clients


You know from working in other places that it can be difficult to get clients to follow through with a plan of care. 


But, getting your private pay clients to follow through with a complete plan of care is critical.

The first reason is obvious – if they don’t follow through a complete plan of care then it is very likely that they didn’t reach the goals they wanted.  You will of course feel better, like you made more of a difference, when you know they’ve reached their goals.  And if they didn’t reach their goals with you, then that’s not going to be good for your word of mouth.


And the second reason is that if you constantly have people dropping off your schedule you have to replace them with new people coming in.


Compare the practice that sees someone just 3 times to someone else who sees people 6 times.


The first practice has to have twice, twice!, the number of clients to equal the revenue of the second one.


That is absolutely huge.


So – focusing on retaining your clients, providing amazing service to them, following up with them between appointments, and keeping their motivation high is absolutely crucial.