Who this is for

Clinic owners who need more than a standard P&L.

PRACTICE 01

ABA clinics scaling past the first center

Single- or multi-center ABA practices where BCBA caseloads, RBT utilization, payor mix, and authorization-to-cash timing all need visibility to make decisions about hiring, expansion, and clinical leadership.

PRACTICE 02

Multidisciplinary pediatric therapy practices

OT, PT, and speech therapy practices, often combined under one roof, where per-discipline margins, evaluation versus treatment mix, and clinician productivity need to be visible side-by-side.

PRACTICE 03

Multi-center operators planning the next stage

Operators with two or more locations preparing for a third or fourth, or considering a sell-side conversation with a PE platform. Center-level P&L, shared overhead allocation, and exit readiness all on the same engagement.

Why standard reporting often falls short

The costs that don’t show up in a standard P&L.

Behavioral and developmental therapy practices have financial patterns that standard accounting reports often do not capture. If your background is BCBA, OT, PT, or SLP, financial reporting in standard accountant-speak is its own language — clinical-leadership context matters as much as the numbers themselves. When the books aren’t shaped around how your clinic generates revenue, the costs show up in places the standard P&L doesn’t flag. Here’s what we see most often:

Center-level P&L blended into one number

Once you have more than one center, a single combined P&L stops telling the truth. Clinical leadership, billing, and regional management costs need to be allocated honestly so each center's true contribution margin is visible. Without it, decisions about a second location or a clinical-director hire run on guesswork.

Payor-mix profitability invisibility

Different payors carry different rates, denial profiles, and days-to-payment. A single line for "insurance revenue" hides the answer to a question that drives material economic decisions: which payor relationships are worth keeping, renegotiating, or exiting.

Authorization-to-cash gaps

The window between authorization, services delivered, claims submitted, and cash received can stretch 60–90 days, varying by payor. Without visibility into that gap, you can be growing on paper and starving for cash at the same time.

Books that lag operational reality

When the monthly close is six weeks behind, you’re looking at financials about a quarter that’s already over. By the time you spot a margin issue, two payor cycles have already booked at the same rate.

Multi-state operations without nexus tracking

School-based contracts, telehealth, and in-home services routinely cross state lines. Each state has its own rules for income tax nexus, payroll registration, and sometimes sales tax on therapy materials. Multi-state activity can be easy to overlook without a coordinated nexus and registration review, and correcting it later can be costly.

Annual-only tax surprises

If tax planning happens once a year in March, you’re not planning. You’re reporting. Quarterly tax-strategy review tied to actual P&L is what turns S-corp comp, accountable plans, and PTET elections into real money rather than missed opportunities.

A clinician sitting on the floor of a pediatric clinic playroom, working with a young child using sensory and play-based materials

Reporting

Reporting shaped around your clinic, not a template.

The right reporting depends on the clinic’s size, operating model, systems, and decisions. Strategic and Transformative engagements may include reporting such as:

Center-level P&L

Revenue and costs organized by location, with an agreed approach to shared leadership, billing, and overhead allocation.

Payor-mix reporting

Revenue and available collection data organized by payor to support concentration and profitability analysis.

Authorization and utilization reporting

Operational and financial data connected where the clinic’s systems capture consistent authorization, billable-hour, and clinician-utilization information.

Cash forecasting

Rolling forecasts built from the financial records and the receivables, payroll, authorization, or operating data available within the engagement.

Service-line reporting

Revenue and costs organized by discipline or service line when the underlying data support that level of analysis.

The Financial Clarity Assessment confirms which reports will be useful, what the available data can support, and whether cleanup, reporting configuration, or additional integration is needed before the reporting can be built.

Our services, shaped for this industry

Services that meet the clinic where it is.

Pediatric and behavioral therapy clinics in the $1M–$25M revenue band are at very different stages. A two-BCBA clinic just past $1M needs different help than a four-center group preparing for a PE conversation. We meet the clinic where it is, with the same firm, same team, and the same standard of work across the engagement spectrum:

Foundation: Cleanup & Setup

For clinics whose books are behind, payor revenue is undifferentiated, and the chart of accounts was set up by the original CPA. A defined-scope project to get the financial foundation in place before ongoing work begins.

Monthly Accounting & Advisory

Full monthly accounting and advisory, with specialty reporting added at the Strategic and Transformative tiers based on the clinic’s needs and available data. Available across three tiers — Fundamental, Strategic, and Transformative — depending on whether you have internal billing or admin support and how much oversight you want.

Tax Planning & Preparation

Quarterly tax strategy tied to actual P&L, S-corp compensation review, PTET election analysis, multi-state payroll registrations, and return preparation. Designed for clinics whose tax exposure changes meaningfully with payor mix shifts, multi-state expansion, or owner compensation decisions.

Financial Advisory Projects

Single-decision engagements with a defined scope and fixed fee. Useful when the clinic needs a specific question answered — a hire, a pricing change, an entity restructure, a payor renegotiation — without committing to ongoing work.

Exit Planning

For multi-center operators considering a sale, succession, or strategic transition in the next three to five years. Learn more below.

Exit planning for therapy operators

The work that influences your sale price starts years before you sell.

ABA and pediatric therapy continue to attract interest from PE platforms and strategic buyers, and some multi-center operators are receiving outreach well before they expect to sell. The owners who are ready for those conversations got that way deliberately, by strengthening the business years before an offer arrived. Owners who are not prepared often discover that the number on the term sheet is lower than expected—and that the reasons trace back to decisions made years earlier.

Exit planning at EO is led by a CEPA®-certified advisor, with CPA support for the tax and financial components of the engagement. The work typically includes:

A baseline business value estimate for planning purposes, informed by the clinic’s financials and operating characteristics
Identification of the value drivers and gaps most likely to affect a future transaction
Sell-side readiness work, including financial cleanup, owner add-back normalization, EBITDA bridge preparation, and payor-mix documentation
A phased roadmap for the years between now and the transition
Coordination with M&A advisors, attorneys, and wealth planners as the timeline approaches

Formal appraisals, quality-of-earnings work, and other transaction-reliance reports are separately scoped with the appropriate specialist when required.

Most operators we talk to are three to five years from the conversation. That’s the right window to start.

Learn more about Exit Planning

Advisory projects we scope most often

When a specific decision calls for focused work.

Not every question needs an ongoing engagement. For pediatric and behavioral therapy operators, the advisory projects below come up most often. Each is scoped on its own terms with a defined deliverable and fixed fee.

$3M–$5M plateau modeling

Three-statement model with scenarios for the next growth move: a second center, a clinical director hire, an RBT retention bonus pool. Payback period and cash impact for each option, using your unit economics, not industry averages.

Sell-side financial preparation

Financial cleanup, owner add-back normalization, payor-mix documentation, and EBITDA bridge preparation. Scope and timing depend on the condition of the records and the buyer’s diligence requirements. Formal quality-of-earnings and other reliance reports are completed by the appropriate independent provider.

Multi-state nexus and PTET review

For clinics with telehealth across state lines, in-home work, or recent acquisitions: state-by-state nexus analysis, payroll registrations, and PTET election review. Annual scope.

BCBA and clinician comp model

Compensation modeling tied to billable hour expectations, caseload targets, and clinic margin. Base, productivity bonus, retention structure, benchmarked and grounded in the unit economics of your specific clinic.

Ready to run your clinic on numbers that match how it actually operates?

Start with a complimentary Discovery Call. If the Financial Clarity Assessment is the right next step, we’ll confirm that on the call.

Prefer to start on your own? Complete the five-minute Financial Health Questionnaire to identify potential gaps in your clinic’s reporting, cash flow, and financial processes.

Book a Discovery Call Take the Financial Health Questionnaire