How to calculate therapy caseload capacity
Capacity is your available minutes divided by what each patient takes from them.
Therapy caseload capacity is the number of patients your available treatment minutes can hold at their visit frequency. You work it out as available minutes per week divided by the minutes each patient takes per week.
The caseload calculator does the sum. This guide shows the steps, so you can check the result and adjust it for evaluations, travel and a mixed caseload. Working in minutes lets your manager check each step of a caseload argument.
How to calculate therapy caseload capacity in three steps
Step one: available treatment minutes per week
Start with paid minutes per week. Take away documentation, then meetings and admin, then the minutes you expect to lose to cancellations and no-shows.
Step two: minutes each patient takes per week
Multiply visit length by visits per week. If you count documentation per patient rather than as a daily block, add that patient's share of notes here instead of in step one.
Step three: capacity = available minutes ÷ minutes per patient
Round down, because part patients don't exist.
Worked example: outpatient
This example uses the caseload calculator's default inputs. They are example values, not norms. The paid day is 450 minutes, five days a week, so 2,250 paid minutes.
- Documentation: 60 minutes a day, or 300 a week
- Meetings and admin: 90 minutes a week
- Attendance loss: 12% of the 1,860 minutes left, or 223 minutes
- Available treatment minutes: 2,250 − 300 − 90 − 223 = 1,637
The 12% is an example rate. Use your own, worked out as lost slots divided by booked slots over a month or two.
Now the cost of each patient. Patients in this example are seen twice a week for 45 minutes.
- Per patient per week: 45 × 2 = 90 minutes
- Capacity: 1,637 ÷ 90 = 18.2, so 18 patients
If you are carrying 24, the schedule needs 24 × 90 = 2,160 treatment minutes against 1,637 available. The gap is 523 minutes a week, or about 105 minutes a day (1 h 45 m) over five days. That is the number to take into the conversation, in place of "my caseload is too big".
Adjusting for evaluations
Evaluations take more time than follow-ups, in the session and in the write-up. In this example, an evaluation runs 60 minutes with 30 minutes of write-up. That is 90 minutes, against 45 for a follow-up.
Count evaluations separately rather than averaging them in. Four evaluations a week at 90 minutes is 360 minutes off your available total before any follow-up is booked. In the example, that leaves 1,277 minutes. That holds 14 follow-up patients on top of the four evaluations, against 18 with no evaluations.
Case mix changes capacity even when the caseload number stays the same. Swapping five follow-ups for five evaluations takes 5 × (90 − 45) = 225 more minutes that week, by the figures above. A conversation about caseload numbers alone misses that.
Visit frequency changes capacity
The same 1,637 available minutes hold very different caseloads at different visit frequencies. All rows use 45-minute visits.
| Visit frequency | Minutes per patient per week | Capacity from 1,637 minutes |
|---|---|---|
| 3 times a week | 135 | 12 patients |
| Twice a week | 90 | 18 patients |
| Weekly | 45 | 36 patients |
| Every two weeks | 22.5 | 72 patients |
| Monthly (12 visits a year) | 10.4 | 157 patients |
The monthly row spreads 12 visits across the 52 calendar weeks of the year: 45 × 12 ÷ 52 = 10.4 minutes a week.
The caseload calculator takes visits per week in steps of 0.25. Entering 0.25 (one visit every four weeks) gives 11.25 minutes per patient and a capacity of 145.
A caseload of 40 is over capacity at weekly visits (36) and more than three times capacity at three visits a week (12). Any caseload figure needs its visit frequency stated next to it.
The version for home health
Add travel to the visit length. A 45-minute visit with 25 minutes of driving takes 70 minutes. The same 1,637 available minutes then hold 23 visits a week, against 36 visits of 45 minutes with no travel.
In that example, travel is 25 of every 70 minutes, or 35.7% of the time each visit takes. In the US, travel between patients during the workday counts as hours worked, so it sits inside your paid minutes. For more on this, see productivity with travel time.
Checking the result against your real week
If the calculation says 18 and you carry 24 while finishing on time, one of your inputs is off. Check three: your documentation estimate, your attendance loss, and whether some visits run shorter than the standard slot.
If the calculation says 18 and you carry 24 while finishing about 105 minutes late every day, the calculation holds. Those late minutes are the daily gap worked out above.
Give capacity as a range rather than one figure. Run the example with attendance loss at 8% and at 15%, both example values, and capacity comes out at 19 and 17 patients.
Capacity for a mixed caseload
Real caseloads mix visit frequencies. Work each group out separately and add them.
Say you carry 8 patients at three visits a week, 12 at twice a week and 10 weekly, all in 45-minute slots. That is (8 × 135) + (12 × 90) + (10 × 45) = 1,080 + 1,080 + 450 = 2,610 minutes against 1,637 available.
You are 973 minutes over each week. Over five days that is about 195 minutes a day, or 3 h 15 m.
Capacity and discharge
Some capacity problems are partly discharge problems. Patients who stay on the list at the same frequency take the same minutes every week, whatever stage they have reached.
Running the capacity figure alongside a review of who is on your list shows where the minutes go. Whether a patient's frequency changes or they are discharged is a clinical decision, made by the clinician and the team.
Recalculating when things change
Re-run the calculation when visit frequency changes or evaluation volume rises. Re-run it too when your documentation load changes after a new EMR or a new note requirement. For the week-by-week view of whether you are hitting your target, use the weekly productivity calculator. For a single day, use the therapist productivity calculator.
If you work in counseling or mental health and your requirement is counted in sessions, use the counselor productivity calculator. It works out the sessions to book after no-shows.