US Physical Therapy (USPH) Q1 2026 earnings summary

Executive summary

• Q1 2026 net revenue grew 7.9% year-over-year to $198.3 million, driven by both physical therapy and industrial injury prevention segments.

• Net income attributable to shareholders was $5.0 million, down from $9.9 million in Q1 2025, impacted by a $2.0 million loss on contingent earn-out revaluation and higher corporate costs.

• Adjusted EBITDA rose to $20.2 million from $19.5 million year-over-year.

• Patient volume increased 6.9% year-over-year, with daily visits per clinic rising to 31.8.

• Strategic initiatives include front desk virtualization, AI-assisted documentation, remote monitoring, and expansion of hospital alliances.

Financial highlights

• Physical therapy net revenue was $167.7 million, up 7.2% year-over-year; industrial injury prevention revenue was $30.6 million, up 11.8%.

• Net patient revenue per visit increased to $106.49.

• Adjusted EBITDA margin was 13.1% in Q1 2026 versus 13.7% in Q1 2025.

• Gross profit increased 5.4% to $32.8 million, but gross margin declined to 16.5% from 16.9% year-over-year.

• Earnings per share was a loss of $0.12, compared to earnings of $0.80 in Q1 2025, due to non-cash adjustments for redeemable non-controlling interests.

Outlook and guidance

• Full-year 2026 adjusted EBITDA guidance reaffirmed at $102–$106 million.

• Guidance includes partial year impact of two new hospital affiliations and Medicare rate increase.

• Hospital alliances expected to add at least $7.3 million in annualized EBITDA upon full integration.

• Management expects continued growth through acquisitions and new clinic development.

• Additional acquisitions and hospital alliances not yet included in guidance could provide further upside.