USPH Q3 2026 Revenue Hits $223M as Visits Set Record

U.S. Physical Therapy, Inc. reported third-quarter 2026 total net revenue of $223 million on November 4, 2026, a 13% increase from the same quarter a year earlier, with patient visits rising 8% to 1.7 million. The Houston-based outpatient physical therapy operator recorded a GAAP loss per share of $1.04, against earnings per share of $0.48 in the prior-year period, while adjusted earnings per share came in at $0.80 versus $0.66. Adjusted EBITDA reached $28 million.

Context — why USPH's Q3 2026 print matters now

U.S. Physical Therapy operates 799 outpatient locations across 45 states and runs an industrial injury prevention business, placing it squarely in the healthcare services sector tracked on Fazen Markets. The quarter's headline revenue growth of 13% is the fastest pace the company disclosed for the period, and the print lands after the completion of its first two hospital affiliation agreements — 72 clinics that were fully integrated by the end of Q3.

The company said those hospital-affiliated clinics generated $25 million in revenue during the quarter. Chairman and CEO Chris Reading said the year-over-year EBITDA improvement "reflects the initial benefit of the completed rollout of our first two hospital affiliations," and management expects that figure to rise as referral volumes build and more clinics are folded into existing agreements.

The macro backdrop for the quarter included persistent cost inflation in employer-sponsored health plans. USPH flagged that cost pressure from its self-insured employee medical program continued in Q3, a headwind that hit physical therapy margins by roughly 150 basis points relative to a favorable experience in the prior-year quarter. That same dynamic weighed on the nine-month figures.

The company responded with expense control efforts that partially offset the overages in Q3, and management said those measures will benefit future periods. The combination — record top-line metrics against a soft bottom-line comparison — is what makes this quarter's optics diverge from its economics.

Data — what the numbers show

Physical therapy net revenue reached $190 million, up 13% year over year, including 6% growth in mature revenue. Revenue per patient visit rose to $111 from $106 a year earlier. Average daily visits per clinic edged up to 33 from 32.

The industrial injury prevention segment posted $33 million in revenue, a 14% increase, or 8% excluding a January 31, 2026 acquisition. IIP margin expanded to 22% from 20%.

Metric	Q3 2026	Q3 2025
Total net revenue	$223M	~$197M
Adjusted EBITDA	$28M	$24M
Adjusted EPS	$0.80	$0.66
GAAP EPS	-$1.04	$0.48
PT revenue per visit	$111	$106

Adjusted physical therapy margin was 19%, up 150 basis points, though reported PT margin was flat at 19%. Corporate expense as a percentage of total revenue was 8%, down from 9%. The company added 21 locations and closed three during the quarter.

For the nine months ended September 30, 2026, total net revenue was $635 million, up 10%, with adjusted EBITDA of $75 million versus $70 million. Adjusted EPS for the period was $2.01 compared to $1.96.

Analysis — what it means for markets and peers

The GAAP loss per share of $1.04 is not an operating loss. Under GAAP, changes in the value of redeemable noncontrolling interests — the ownership stakes held by USPH's clinic partners in subsidiaries the company does not fully own — are excluded from net income but included in the earnings-per-share calculation. Improving performance raises the value of those partner stakes, which dilutes reported EPS.

That accounting mechanic means the headline loss and the adjusted $0.80 per share describe the same underlying business. Investors comparing USPH to other healthcare services operators on GAAP EPS alone would draw a misleading conclusion. The more informative comparison is adjusted EBITDA, which grew 17% year over year to $28 million.

The balance sheet shows the cost of growth. Cash and equivalents stood at $38 million at quarter-end, up from $36 million at December 31, 2025, while credit facility borrowings rose to $247 million from $162 million. That $85 million increase reflects acquisition spending, including the July 1, 2026 purchase of a 67% equity interest in a 12-clinic practice for $16 million.

On September 22, 2026, USPH entered an interest rate swap with a $171 million initial notional value, fixing term debt at 4.6% from June 30, 2027, to April 14, 2031. The swap removes rate uncertainty on a meaningful portion of the company's floating-rate exposure — a positioning signal that management is locking in financing costs ahead of expected clinic expansion.

The counter-argument: hospital affiliations and acquisitions both carry integration and referral-volume risk, and the company's own risk disclosures list termination of hospital arrangements as a material threat. Cost pressure from the self-insured medical program also has not fully abated, which limits how much margin expansion the IIP and PT segments can deliver in the near term.

Outlook — what to watch next

Management reaffirmed full-year 2026 adjusted EBITDA guidance of $102 million to $106 million. That range brackets the $75 million already booked through nine months, implying a fourth-quarter contribution of roughly $27 million to $31 million.

The next catalysts are the Q4 and full-year 2026 results, which will show whether referral volumes at the 72 hospital-affiliated clinics build as management expects, and whether additional hospital prospects convert into new affiliations. USPH's conference call was scheduled for November 5, 2026, with a playback available until February 3, 2027.

Investors will also watch the trajectory of credit facility borrowings and the impact of the swap once it takes effect in mid-2027. A quarterly dividend of $0.46 was declared, payable December 11, 2026, to shareholders of record on November 16, 2026.

Frequently Asked Questions

Why did USPH report a loss per share when revenue rose 13%?

The loss reflects GAAP accounting for redeemable noncontrolling interests, not an operating shortfall. When USPH's partly-owned clinic subsidiaries perform better, the value of partners' ownership stakes rises, and that change is included in the EPS denominator even though it is excluded from net income. Adjusted EPS, which strips this out, was $0.80 in Q3 2026 versus $0.66 a year earlier.

How much revenue do the hospital-affiliated clinics generate?

USPH said the 72 clinics operating under hospital affiliation agreements generated $25 million in revenue during Q3 2026. The company integrated all 72 by the end of the quarter and expects the figure to rise as referral volumes increase and more clinics are incorporated into existing agreements. Management also cited a pipeline of hospital prospects that could produce new affiliations.

What is weighing on USPH's physical therapy margins?

Cost pressure from the company's self-insured employee medical program. USPH said this represented roughly 150 basis points of margin headwind in Q3 2026 against a favorable prior-year comparison, and about 100 basis points of impact over the nine-month period. Expense control efforts partially mitigated the overages in Q3 and are expected to benefit future periods.

Bottom Line

USPH's 13% revenue growth and record visits contrast with a GAAP loss driven entirely by noncontrolling-interest accounting, leaving adjusted EBITDA as the cleaner read on the quarter.

Disclaimer: This article is for informational purposes only and does not constitute investment advice. CFD trading carries high risk of capital loss.