How 1099 Per-Visit Pay Works for In-Home Physical Therapists

In a 1099 per-visit arrangement, you are not an employee. You are a Florida-licensed clinician operating as an independent contractor, accepting visits from a platform that handles intake, scheduling, billing, and physician communication. You get paid a defined amount per completed and documented visit. You file taxes as self-employed. You control your schedule, your radius, and how much you work.

That's the whole model. Everything below is the practical detail.

Per-visit pay means the unit of compensation is one completed visit with documentation submitted. It is not hourly. It is not salary. It is not tied to a productivity score. If you complete an eval and submit the note, you're paid for that eval. If you complete a follow-up and submit the note, you're paid for that follow-up.

Different visit types — evaluations, standard follow-ups, re-evaluations — typically carry different rates because they require different time and clinical effort. We don't publish specific rate figures on the public site; those are part of the contracting conversation and they vary by role (PT vs. PTA), region, and visit type.

This is the part contractors most often underestimate. As a 1099 clinician you owe two things on your net earnings: federal income tax (and any state income tax, though Florida has none) and self-employment tax — the combined employer + employee share of Social Security and Medicare, currently 15.3% on net self-employment earnings up to the Social Security wage base, then 2.9% Medicare beyond that.

Most established contractor PTs handle this in a predictable way:

1. Open a separate business checking account. Route 1099 income there.
2. Set aside a percentage of every deposit for taxes. A common starting point is 25–35% depending on income level and deductions — your CPA will give you the right number.
3. Pay quarterly estimated taxes to the IRS (Form 1040-ES) on the IRS deadlines.
4. Track deductible business expenses all year: mileage, equipment, continuing education, professional licensure, liability insurance, phone, home office if applicable.
5. File Schedule C and Schedule SE with your annual return.

As a self-employed clinician, your gross 1099 income is not your taxable income. You deduct legitimate business expenses first. For mobile PTs and PTAs that usually includes:

• Mileage between visits, tracked at the IRS standard business mileage rate (commuting from home to your first patient is typically not deductible — that's the home-office and tax-home conversation to have with your CPA).
• Clinical equipment: goniometers, bands, cuff weights, gait belts, BP cuff, pulse ox, treatment table if you use one.
• Professional licensure, continuing education, board renewal fees.
• Professional liability insurance.
• Phone and data plan (the business-use percentage).
• Health insurance premiums (often deductible as an above-the-line adjustment for self-employed).
• Retirement plan contributions (Solo 401(k) or SEP-IRA).

The 1099 model trades guaranteed structure for guaranteed control. That cuts both ways, and the clinicians who do best in this model are the ones who understand both sides going in.

What you gain: schedule autonomy, route autonomy, treatment autonomy, the ability to scale up or down without asking permission, and a direct line between the work you do and the income you earn.

What you give up: a steady paycheck regardless of caseload, employer-paid health insurance, paid time off, employer 401(k) matching, and the back-office simplicity of "someone else withholds my taxes."

For clinicians coming out of high-volume clinic burnout, the autonomy side usually wins. For clinicians who genuinely want a fixed-hours W-2 role with full benefits, that's a real preference and 1099 isn't going to satisfy it.