Ask a PT Response: "Yes, that is a big problem. Reducing expenses and maximizing return on investment is the best way to make it in private practice. I know alot of private practices are diversifying there payer mix as well. ie. work comp, personal injury, community programs -  ie. Healthy steps, etc. When seeing Medicare patients the PT will have no choice to accomplish as much as possible in less time given reimbursement rates. Checking out the APTA Private Practice Setion may give you some more insight as well: http://www.ppsapta.org/ I hope this helps."