8-K: U.S. Physical Therapy Reports Strong 2025, CFO Resigns

U.S. Physical Therapy, Inc. reported robust financial results for the full year 2025, including significant revenue and EBITDA growth, alongside the announcement of its CFO's resignation and new strategic hospital alliances.

Summary

• Full Year 2025 Adjusted EBITDA increased 16.2% to $95.0 million, up from $81.8 million in 2024.
• Full Year 2025 Net Revenue grew 16.3% to $781.0 million, compared to $671.3 million in 2024.
• Q4 2025 Adjusted EBITDA was $24.8 million, a 13.5% increase from $21.8 million in Q4 2024.
• Q4 2025 Net Income attributable to USPH shareholders decreased to $4.2 million from $9.2 million in Q4 2024, primarily due to a $5.2 million net loss on contingent earnout consideration revaluation.
• Total patient visits in Q4 2025 increased 11.2% to 1,593,336, with average daily patient visits per clinic reaching a record high of 32.7 for a fourth quarter.
• Carey Hendrickson, Chief Financial Officer, resigned effective April 24, 2026, to pursue another CFO position, with Jason Curtis appointed interim CFO.
• The Board of Directors raised the quarterly dividend from $0.45 to $0.46 per share.
• The company announced two 10-year strategic alliances with hospital systems, expected to be accretive to revenue, EBITDA, and margins upon full integration by year-end 2026.
• Recent acquisitions include an eight-clinic practice (50% interest) generating $8.0 million in annual revenue and an industrial injury prevention business (70% interest) generating $7.0 million in annual revenue.
• Management expects 2026 Adjusted EBITDA to be in the range of $102.0 million to $106.0 million.

Sentiment

Score: 8

Explanation: StockSavvy.ai views this as a strong report, demonstrating robust operational growth and strategic expansion through acquisitions and hospital alliances, despite the non-cash accounting impacts on GAAP net income and the CFO transition. The increased dividend and positive 2026 guidance reinforce a positive outlook.

Positives

• Full Year 2025 Adjusted EBITDA increased 16.2% to $95.0 million from $81.8 million in 2024.
• Full Year 2025 Net Income attributable to USPH shareholders increased to $39.6 million from $31.4 million in 2024.
• Full Year 2025 Net Revenue increased 16.3% to $781.0 million from $671.3 million in 2024.
• Q4 2025 Adjusted EBITDA increased 13.5% to $24.8 million from $21.8 million in Q4 2024.
• Q4 2025 Physical Therapy Net Revenue increased 13.0% to $173.8 million from $153.8 million in Q4 2024.
• Q4 2025 Physical Therapy Gross Profit increased 25.3% to $35.2 million from $28.1 million in Q4 2024.
• Net rate per patient visit increased to $106.49 in Q4 2025 from $104.73 in Q4 2024.
• Total patient visits increased 11.2% to 1,593,336 in Q4 2025 from 1,432,801 in Q4 2024.
• Average daily patient visits per clinic reached a record high of 32.7 for a fourth quarter, up from 31.6 in Q4 2024.
• Industrial Injury Prevention (IIP) revenue increased 8.7% to $28.9 million in Q4 2025.
• IIP gross profit increased 11.5% to $5.0 million in Q4 2025.
• The company added 11 and closed 10 owned and/or managed clinics in Q4 2025, bringing its total count to 780 as of December 31, 2025.
• Repurchased 81,322 shares of common stock for $5.6 million in Q4 2025, demonstrating confidence in long-term prospects.
• Acquired an eight-clinic practice on January 2, 2026, generating approximately $8.0 million in annual revenue.
• Acquired an industrial injury prevention business on January 31, 2026, generating approximately $7.0 million in annual revenue.
• Announced two 10-year strategic alliances with hospital systems, expected to be accretive to revenue, EBITDA, and margins.
• Quarterly dividend rate raised from $0.45 per share to $0.46 per share.
• 2026 Adjusted EBITDA guidance of $102.0 million to $106.0 million indicates continued growth.

Negatives

• Q4 2025 Net Income attributable to USPH shareholders decreased to $4.2 million from $9.2 million in Q4 2024, primarily due to a $5.2 million net loss on change in fair value of contingent earnout consideration (compared to a $5.1 million net gain in Q4 2024).
• Loss per share was $0.44 for Q4 2025 compared to earnings per share of $0.52 for Q4 2024, partly due to a $10.8 million reduction from the increased value of redeemable noncontrolling interests.
• Full Year 2025 earnings per share decreased to $1.42 from $1.84 in 2024, impacted by a $24.5 million reduction from the increased value of redeemable noncontrolling interests.
• Corporate office costs increased to $18.1 million in Q4 2025 from $15.6 million in Q4 2024, partly due to acquisition integration and new financial and human resources system implementation costs.
• Interest expense increased by $0.3 million to $2.3 million in Q4 2025 due to a higher average outstanding balance on the revolving credit facility.
• Interest income decreased to $0.1 million in Q4 2025 from $0.3 million in Q4 2024.
• Total cash and cash equivalents decreased to $35.6 million as of December 31, 2025, from $41.4 million as of December 31, 2024.
• Outstanding borrowings on the revolving facility increased to $161.8 million as of December 31, 2025, from $151.6 million as of December 31, 2024.
• Available credit under the revolving facility decreased to $144.5 million as of December 31, 2025, from $164.0 million as of December 31, 2024.
• Chief Financial Officer Carey Hendrickson is resigning from his position, effective April 24, 2026.

Risks

• Changes in Medicare rules, guidelines, and reimbursement, or failure of clinics to maintain Medicare certification and/or enrollment status.
• Revenue from Medicare and Medicaid being subject to potential retroactive reduction.
• Changes in reimbursement rates or payment methods from third-party payors, including government agencies, and changes in patient deductibles and co-pays.
• Private third-party payors adopting payment policies that could limit future revenue and profitability.
• Compliance with federal and state laws and regulations relating to patient information privacy (HIPAA) and corporate practice of medicine/fee splitting, with associated fines and penalties.
• Competitive, economic, or reimbursement conditions in markets requiring clinic reorganization or closure, incurring losses and/or write-downs of goodwill and other intangible assets.
• The impact of a termination of one or more of the company's hospital affiliation arrangements.
• The impact of future public health crises and epidemics/pandemics.
• Certain acquisition agreements containing put-rights related to a future purchase of significant equity interests in subsidiaries or separate companies.
• The impact of future vaccinations and/or testing mandates at federal, state, and/or local levels on staffing, revenue, costs, and results of operations.
• Debt and financial obligations adversely affecting financial condition, ability to obtain future financing, and ability to operate the business.
• Changes as a result of government-enacted national healthcare reform.
• The ability to control variable interest entities for which the company does not have a direct ownership.
• Governmental and other third-party payor inspections, reviews, investigations, and audits, which may result in sanctions or reputational harm and increased costs.
• Contingent consideration provisions in certain acquisition agreements, the value of which may impact future financial results.
• Legal actions, which could subject the company to increased operating costs and uninsured liabilities.
• General economic conditions, including but not limited to inflationary and recessionary periods.
• Actual or perceived events involving banking volatility or limited liability, defaults, or other adverse developments that affect the U.S. or international financial systems, potentially resulting in market-wide liquidity problems.
• Dependence on hiring, training, and retaining qualified employees, particularly physical therapists.
• Competitive environment in the industrial injury prevention services business, which could result in termination or non-renewal of contractual service arrangements.
• The ability to identify and complete acquisitions, and the successful integration of the operations of acquired businesses.
• Impact on the business and cash reserves resulting from retirement or resignation of key partners and resulting purchase of their non-controlling interest.
• Maintaining information technology systems with adequate safeguards to protect against cyber-attacks and security breaches.
• Maintaining clients for management, industrial injury prevention, and other services, as a breach or termination of those contractual arrangements could cause operating results to be less than expected.
• Maintaining adequate internal controls.
• Maintaining necessary insurance coverage.
• Use of generative artificial intelligence.
• Availability, terms, and use of capital.
• Weather and other seasonal factors.

Future Outlook

Management expects the company's Adjusted EBITDA for 2026 to be in the range of $102.0 million to $106.0 million. This guidance includes an estimated $2.5 million in incremental revenue from a 1.75% Medicare rate increase effective January 1, 2026, and a modest contribution from the strategic hospital alliances due to their phased ramp-up beginning mid-2026. The implementation costs associated with the new financial and human resources system are anticipated to continue through the end of 2026. The strategic hospital alliances are projected to be fully operational by year-end 2026, with the Metro alliance expected to contribute at least $6 million incremental annualized EBITDA to USPH and the second alliance at least $1.3 million.

Management Comments

• Chris Reading, Chief Executive Officer, stated, "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."
• Chris Reading also commented, "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."
• Chris Reading further added, "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."
• Chris Reading, Chairman and Chief Executive Officer, commented on the CFO transition, "We are grateful for Careys many contributions to USPH over the past 5 years. We wish him well in his future endeavors."

Industry Context

StockSavvy.ai notes that U.S. Physical Therapy's strong revenue and EBITDA growth in 2025, coupled with strategic acquisitions and hospital alliances, positions it well within the consolidating and increasingly integrated healthcare services sector. The focus on expanding outpatient physical therapy clinics and industrial injury prevention services, alongside partnerships with hospital systems, reflects a broader industry trend towards value-based care and integrated networks. The increase in Medicare rates also provides a tailwind for providers in this segment, indicating a favorable regulatory environment for core services.

Management Changes

Corporate Governance

Stakeholder Impact

• Shareholders: Positive impact from increased dividend, share repurchases, strong financial performance (revenue, EBITDA growth), and positive future outlook/guidance. Potential concern from GAAP EPS decline and CFO transition.
• Employees: Potential positive impact from company growth and expansion (new clinics, acquisitions). Interim CFO appointment from within the company may provide continuity.
• Customers (Patients): Positive impact from expansion of clinics and strategic hospital alliances, increasing access to physical therapy services.
• Creditors: Increased borrowings on the revolving credit facility, but strong EBITDA growth suggests continued ability to service debt.

Next Steps

• Conduct a comprehensive search for a permanent Chief Financial Officer.
• Begin operations with initial clinics for the strategic hospital alliances in mid-2026.
• Achieve full operational integration of all 60 Metro clinics and 10 other clinics by year-end 2026.
• Continue implementation of the new financial and human resources system through the end of 2026.
• File the Annual Report on Form 10-K for the year ended December 31, 2025, with the SEC on February 27, 2026.
• Host a conference call on February 26, 2026, to discuss financial results.
• Pay the quarterly dividend of $0.46 per share on April 10, 2026.
• Continue acquiring multi-clinic outpatient physical therapy practices and home-care physical and speech therapy practices.
• Develop outpatient physical therapy clinics as satellites in existing partnerships.
• Continue acquiring companies that provide industrial injury prevention services.

Key Dates

Recommendation

The company demonstrates strong operational performance with significant revenue and Adjusted EBITDA growth, strategic expansion through acquisitions and hospital alliances, and an increased dividend. The 2026 guidance is positive. However, the GAAP EPS decline for both Q4 and the full year, primarily due to non-cash revaluation of redeemable noncontrolling interests and contingent earnout consideration, introduces a layer of complexity that might warrant a 'Hold' rather than a 'Buy' for some investors until the full impact of these non-cash items and the CFO transition are absorbed and understood by the market. The increased debt also bears watching.

Keywords

Physical Therapy, Outpatient Clinics, Industrial Injury Prevention, Healthcare Services, SEC Filing, Earnings Report, Financial Results, EBITDA, Dividend, CFO Resignation, Hospital Alliances, Acquisitions, USPH