The Most Overlooked Expenses When Starting a Pediatric Therapy Company

Launching a pediatric therapy practice, whether ABA, speech or occupational therapy, is exciting, but it comes with a complex web of expenses. While rent and salaries are obvious costs, there are several less obvious expenses that new practice owners often overlook. Missing these can lead to cash flow challenges, delayed growth or even compliance issues.

This guide covers the most overlooked expenses for pediatric therapy startups and provides tips for staying organized and financially prepared.

Hidden Expenses Table

Expense	Why It Matters	How to Handle It
Insurance & Liability	Protects your practice from lawsuits and claims, covering therapists, clients and staff.	Budget for professional liability, general liability, and workers' compensation upfront. Consider annual renewals and any additional coverage needed as your team grows.
Credentialing & Licensing	Required to bill insurance and see clients; missing deadlines can delay revenue.	Plan to factor in costs of state licenses, payer credentialing fees (per payor and provider) and recredentialing fees. The NPI registration will be free.
Technology & Software	Supports scheduling, client and employee management, clinical documentation, billing and secure storage.	Research practice management systems, like Passage Health, billing software, and scheduling platforms. Include recurring subscription costs in your budget and ensure HIPAA compliance.
Marketing & Business Development	Attracts clients and builds your practice's visibility.	Budget for website design, SEO, social media, and community outreach. Treat marketing as an ongoing investment, not a one-time expense.
Office Setup & Supplies	Creates a functional, welcoming environment for clients and staff.	Include furniture, therapy equipment, assessment tools and office supplies in your startup budget. Factor in ongoing replacement or upgrade costs.
Staff Recruitment & Training	Ensures your team is qualified, engaged and compliant.	Account for hiring ads, recruiter fees, background checks, onboarding, and continuing education. Proper investment reduces turnover and supports quality care.
Compliance & Legal Fees	Avoids fines, audits, and legal challenges.	Budget for HIPAA compliance, policy manuals, employment contracts and legal consultations for leases, contracts, and risk management.

Starting a pediatric therapy company requires planning for both obvious and hidden expenses. From insurance and credentialing to technology, marketing and compliance, these costs can add up quickly, but staying organized ensures your practice is ready to succeed.