What to do first when you open a PT practice

Foundations come first

Before seeing a single patient, you need the practice to exist and to be able to hold money and bill under its own name: the legal entity, its tax ID, the provider identifiers (your own NPI, and a second one for the practice when it is a separate entity), a business bank account, and malpractice coverage. These sound like paperwork, but payer applications ask for most of them, and a mistake here quietly delays everything downstream. Do them in the right order and the rest of your business has something to stand on.

Get the payer applications in early

The lever you control on your opening date is starting credentialing sooner. Enrolling with Medicare, attesting your provider profile, and filing your commercial applications all run on the payer's clock, not yours, and that clock can run for weeks to months. File these early and the wait runs alongside your build instead of after it. Start late and you risk being unable to bill.

Set up and test your billing systems

While the applications work through the queue, you build the machine that turns visits into money: the documentation system configured for a physical therapy practice, the clearinghouse enrolled, and a test claim pushed through to confirm the setup works before real claims arrive. It does not confirm that a real claim is covered or coded correctly. This sounds boring, but it is the difference between claims that pay and claims that bounce for a setup reason no one catches until the money is late.

Get launch-ready

Now the practice becomes findable and runnable: a real online presence so patients can find and book you, the paperwork masters a clinic uses every day, and a simple operations playbook so the practice runs the same way whether or not you are in the room. This is the step that turns a filed entity into a business that opens its doors. Before that day, two Florida questions and one federal one need answers: clinic licensure or the exemption under chapter 400, the direct-access plan-review clock, and the Medicare enrollment decision. The Launch guides cover each.

Check that the first payments reach the bank

The build is done when the first insurance payments reach the practice's bank account and match the deposits. For an insurance practice, until money has moved from a payer into your bank, the build is unproven. For a cash-only practice, the test is the first patient seen, paid, and documented.

What a real launch looks like

Homefield grew out of the business side of running a real practice, and the timeline belongs to the payers. From filing the entity to the first paid claim runs months, not weeks, and credentialing is the longest single wait. When you want to plan your own timeline, book a call and we will work through it with your numbers.

This is a general operational roadmap, not legal, tax, or compliance advice. Requirements and timelines vary by state and by payer, and your situation may differ.