Key points

  • A full-time allied health therapist typically has 25-30 billable hours per week out of a 38-hour week
  • Healthy billable utilisation sits between 65% and 75%; above 85% signals the need to hire
  • Start recruiting when your waitlist exceeds 4 to 6 weeks or utilisation is consistently above 85%
  • Geographic scheduling for mobile therapists can increase capacity by 20-30%
  • Practice management software pays for itself through automated NDIS claiming and scheduling efficiency

Why capacity planning matters

Running an allied health practice without capacity planning is like driving without a fuel gauge. Everything feels fine until it suddenly isn’t. You are either turning away clients because you are full, or your therapists are burning out because you took on too many.

Good capacity planning means knowing, at any point in time, how many clients you can serve, when you will need to hire, and where your bottleneck is. For NDIS providers, it also means understanding the relationship between plan cycles, service bookings, and your available hours.

This guide walks through the numbers, systems, and decisions involved in managing therapy capacity for a small to mid-sized allied health practice.

Understanding billable time

The 38-hour week breakdown

A full-time therapist works 38 hours per week. Not all of those hours are billable. Here is a realistic breakdown:

ActivityHours per weekPercentage
Direct client sessions25-3066-79%
Report writing and documentation3-58-13%
Travel (mobile/home visit)2-45-11%
Team meetings and supervision1-23-5%
Administration (emails, phone calls)1-23-5%
Professional development13%

The “25-30 billable hours” figure is the realistic target for most allied health professionals. New graduates tend to be at the lower end (more supervision, slower report writing), while experienced therapists sit at the higher end.

Utilisation rate

Your utilisation rate is the percentage of total working hours spent on billable work:

Utilisation rate = (Billable hours / Total working hours) x 100

Utilisation rangeWhat it means
Below 60%Underutilised. Check referral pipeline and scheduling.
60-65%Acceptable for new therapists or complex caseloads
65-75%Healthy target range for most practices
75-85%Getting busy. Monitor for signs of strain.
Above 85%Unsustainable. Hire or reduce intake.

Calculating your caseload capacity

Clinic-based therapists

For therapists working from a clinic with minimal travel:

Maximum active clients = Billable hours per week / Average hours per client per week

Example: A therapist with 28 billable hours per week seeing clients fortnightly for 1-hour sessions:

  • Each client uses 0.5 hours per week on average (1 hour every 2 weeks)
  • Maximum clients = 28 / 0.5 = 56 active clients

In practice, you would cap this lower (around 45-50) to allow for cancellations, assessments (which take longer), and complex cases.

Mobile and home-visit therapists

Mobile therapists lose billable time to travel. A therapist covering a suburban area might spend 30-45 minutes travelling between appointments.

Adjusted capacity = (Billable hours - Travel hours) / Average session time

Example: 28 billable hours, 6 hours travel per week, 1-hour sessions:

  • Available for sessions = 28 - 6 = 22 hours
  • Maximum sessions per week = 22
  • If clients are seen fortnightly: 44 active clients

Group therapy

Group sessions improve your capacity metrics because you bill per participant. A group of 4 participants in a 1-hour session generates 4 billable hours from 1 hour of therapist time.

However, group sessions require:

  • Preparation time
  • Suitable space
  • Clients with compatible goals
  • Clinical justification under NDIS guidelines

Use groups strategically to free up individual session slots for clients who genuinely need one-on-one support.

Waitlist management

When to start a waitlist

Start a waitlist when your therapists are at or above 80% utilisation and you cannot fit new referrals within 2 weeks. Do not wait until you are completely full. Having a structured waitlist is better than ad-hoc “we’ll call you when something opens up” approaches.

Running an effective waitlist

A well-managed waitlist includes:

  1. Prioritisation criteria: Urgent cases (risk of harm, plan reviews imminent, children under 7) should be prioritised
  2. Regular contact: Call or email waitlisted clients monthly to confirm they still want to be seen
  3. Estimated wait time: Give people a realistic timeframe. Vague promises erode trust.
  4. Alternative support: Where clinically appropriate, offer interim group sessions, resources, or referral to other providers
  5. Tracking: Record date added, priority level, contact attempts, and outcome

Waitlist as a hiring trigger

Waitlist lengthAction
0-2 weeksNormal. Monitor.
2-4 weeksWatch utilisation rates. Plan for hiring if trend continues.
4-6 weeksBegin recruitment. Post job ads.
6+ weeksUrgent hire needed. Consider subcontracting or locum cover.

Hiring decisions

When to hire

The worst time to hire is when you are already overwhelmed. Recruitment in allied health typically takes 2 to 3 months (advertising, interviews, credential checks, onboarding). Start the process before you are at breaking point.

Triggers for hiring:

  • Utilisation above 85% for 4+ consecutive weeks
  • Waitlist exceeding 4 weeks
  • Turning away 3+ referrals per week
  • Therapist overtime becoming regular
  • Client outcome measures declining

Financial viability of a new hire

Before hiring, run the numbers:

ItemAmount
Therapist salary (mid-level OT/physio)$75,000-$95,000/year
Superannuation (11.5%)$8,625-$10,925/year
Leave provisions (annual + sick + PD)~6 weeks lost billable time
Equipment and software$2,000-$5,000 one-off
Vehicle costs (mobile)$8,000-$12,000/year
Total annual cost$95,000-$125,000

Revenue needed to cover this cost at NDIS rates ($214.41/hour):

  • $95,000 / $214.41 = 443 billable hours per year minimum
  • That is roughly 9 billable hours per week (well below the 25-30 target)

A new therapist typically reaches full caseload within 3 to 6 months. Budget for reduced revenue in that ramp-up period.

Scheduling strategies

Time blocking

Divide each therapist’s week into blocks:

  • Morning blocks (8am-12pm): Client sessions
  • Lunch (12-1pm): Admin catch-up
  • Afternoon blocks (1-4pm): Client sessions
  • Late afternoon (4-5pm): Reports and documentation
  • One half-day per week: Team meeting, supervision, professional development

Geographic scheduling (mobile therapists)

Group home visits by geographic area on specific days. For example:

  • Monday: Northern suburbs
  • Tuesday: Eastern suburbs
  • Wednesday: Clinic day (assessments, groups, reports)
  • Thursday: Southern suburbs
  • Friday: Western suburbs + admin

This approach can reduce travel time by 20-30% compared to random geographic scheduling.

Buffer slots

Leave 1-2 open slots per week for urgent assessments, catch-up sessions, or cancellation reallocation. Do not book to 100% capacity. Empty slots are not wasted if they prevent burnout and allow flexibility.

NDIS-specific capacity considerations

Plan cycles and seasonal patterns

NDIS participant plans typically run for 12 months. Plan reviews and reassessments tend to cluster around certain times. Watch for:

  • July-September: High demand as new financial year plans are activated
  • January-February: Lower demand during school holidays
  • Plan review periods: Participants often increase therapy frequency before reviews to demonstrate progress

Service booking management

For agency-managed participants, ensure service bookings are in place and have sufficient funds before scheduling appointments. Running out of service booking funds mid-plan means you either stop seeing the client or provide unpaid sessions while waiting for a plan amendment.

Track service booking balances monthly and flag any bookings with less than 4 weeks of funding remaining.

Report writing capacity

NDIS therapy reports (progress reports for plan reviews, functional capacity assessments) take 2 to 6 hours each to write, depending on complexity. If you have 30 clients due for plan review in the same quarter, that is 60 to 180 hours of report writing on top of regular sessions.

Factor report writing into your capacity calculations. Some practices dedicate specific non-client days to report writing during peak periods.

Practice management software

A good practice management system is not optional for NDIS allied health providers. The administrative burden of NDIS claiming, service bookings, and reporting is too high to manage manually.

What to look for

  • NDIS line item integration (auto-populates support items and rates)
  • Bulk NDIS claiming (submit multiple claims at once)
  • Calendar and scheduling with reminders
  • Client record management
  • Invoicing for private and plan-managed clients
  • Reporting (utilisation, revenue, caseload)
  • Medicare integration (for non-NDIS clients)
SoftwareBest forNDIS claimingPrice (approx.)
ClinikoSmall to mid practicesVia integration$45-$99/month
HalaxySolo to mid practicesBuilt-inFree to $79/month
iinsightNDIS-focused practicesBuilt-in$60-$120/month
SpidertracksMobile and home-visitBuilt-inContact for pricing

How Carevo can help

If your practice is at capacity and you need to refer clients to other providers, or if you are growing and want to attract more referrals, listing your allied health practice on Carevo connects you with NDIS participants and families searching for therapists in your area.

For participants looking for occupational therapists, physiotherapists, or other allied health providers, browse providers on Carevo or call 1800 953 253.

FAQ

How many clients can one therapist manage?

A full-time therapist with 25-30 billable hours per week can typically manage 40-60 active clients on a fortnightly schedule, or 25-35 clients weekly. Numbers vary with session length, travel, and caseload complexity.

What is a healthy utilisation rate?

65-75% is the target range. Below 60% suggests underutilisation. Above 85% for extended periods signals the need to hire.

When should I hire another therapist?

When utilisation is consistently above 85%, your waitlist exceeds 4-6 weeks, you are turning away referrals, or therapists are regularly working overtime. Start recruiting before you hit breaking point.

How do I manage an NDIS therapy waitlist?

Prioritise by urgency, contact clients monthly, give realistic wait times, offer interim group sessions where appropriate, and track waitlist length as a key metric.

What is the NDIS billable rate for allied health?

The 2024-25 NDIS Price Guide sets maximum rates at $214.41/hour for standard weekday sessions. Rates are indexed annually. Check the current NDIS Pricing Arrangements for the latest figures.

Should I use practice management software?

Yes. Automated NDIS claiming, scheduling, and reporting save significant admin time. Popular options include Cliniko, Halaxy, and iinsight.

How do I plan capacity for mobile therapists?

Factor in 30-60 minutes travel between appointments. Use geographic scheduling to group visits by area on specific days. A mobile therapist might manage 4-5 sessions per day versus 6-8 in a clinic.

What are the signs my practice is at capacity?

Growing waitlist, therapists working overtime, declining cancellation rates, inability to accept referrals, and declining client outcomes.

Resources