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Productivity targets by setting: what is normal and what is not
The figures here are ASHA’s, for US speech-language pathologists in health care. Employers set the rest, so the method matters more than the number.
The median therapy productivity target was 80% in ASHA's 2023 survey of US speech-language pathologists (SLPs) in health care, which reports targets by setting. In that survey, therapy productivity targets by setting ran from 69% in pediatric hospitals to 85% in SNFs.
Employers set these targets. Use the survey as a reference point for SLPs in the US. For physical therapists, occupational therapists, assistants, school settings and countries outside the US, targets vary from employer to employer.
The published figures: US SLPs in health care, 2023
The survey had 1,422 respondents. The mean requirement across all settings was 79%, and the median was 80%. In SNFs, 94% of clinical service providers had a productivity requirement.
| Setting (US SLPs, 2023) | Median requirement | Mean requirement |
|---|---|---|
| Skilled nursing facility (SNF) or subacute | 85% | 84.8% |
| Outpatient clinic | 80% | 77.4% |
| Home health | 80% | 79.6% |
| Rehabilitation hospital | 75% | 77.6% |
| General medical, VA, long-term acute care or university hospital | 75% | 75.8% |
| Pediatric hospital | 69% | 69.1% |
| All health care settings | 80% | 79% |
The setting presets in the home page calculator use these medians: SNF 85%, outpatient 80%, home health 80%, and acute or rehabilitation hospital 75%. There is no school preset, because there is no published school figure. Your employer's target always replaces the preset.
SNF productivity target
The SNF median of 85% was the highest of the settings in the survey. Treatment is scheduled in blocks, residents are in the building, and there is little travel between patients. Time is lost to residents who decline, medical holds, coordination across disciplines, and the documentation for each session.
Group and concurrent treatment also affect the number in US SNFs. PDPM is the US Medicare payment model for SNF Part A stays. Under PDPM, group and concurrent minutes together are limited to 25% of each resident's therapy minutes in each discipline. How your employer credits those minutes can move your percentage by a long way. The guide to group and concurrent therapy under PDPM works through it.
The old US Medicare therapy caps do not affect an SNF target. They applied to outpatient services, never to SNF residents in a covered Part A stay, and the Bipartisan Budget Act of 2018 repealed them.
Outpatient productivity targets
The outpatient median for US SLPs was 80%, below the SNF median. Back-to-back scheduling and no travel make a high number possible on paper. The pressure comes from cancellations and no-shows, which some employers count against the clinician, and from evaluation-heavy days.
For US Medicare Part B outpatients, the 2018 repeal replaced the caps with the KX modifier threshold. For 2026 it is $2,480 for physical therapy and speech-language pathology combined, and $2,480 for occupational therapy. The threshold is a billing rule, and it does not set a productivity target.
The guide to cancellations and no-shows shows how a missed slot changes the day's percentage.
Home health productivity targets
The home health median for US SLPs was also 80%. Travel between patients is part of every day, and some employers do not count it as productive time. Home health also carries care coordination with families, nursing and physicians, much of which sits outside the productive column.
Some home health agencies measure output in visits or points instead of a percentage. Each agency sets its own point values, so a points target from one agency cannot be compared with another's. The guide to home health productivity points and the home health points calculator cover that system. The guide to productivity with travel time covers the driving.
Hospitals: acute, rehabilitation and pediatric
The hospital medians for US SLPs were lower. Rehabilitation hospitals and general medical, VA, long-term acute care and university hospitals had 75%, and pediatric hospitals had 69%. Chart review, screening and team rounds all take time that is not treatment. So does waiting for a patient to come back from imaging, or a session stopped because the patient is unwell.
School-based settings
There is no published productivity figure for school-based therapists. Many schools do not measure a percentage at all. In US public schools, the work is driven by the service minutes in each student's IEP, which is reviewed at least once a year. Where a school does set a target, the employer sets it and the figure varies. The guide to school-based therapy productivity covers service minutes and workload.
Physical therapists, occupational therapists and assistants
Employers set these targets, and they vary. Some employers give assistants a higher target than therapists. The guide to COTA and PTA productivity targets covers when that gap is fair.
Outside the US
In the UK and Australia, the same idea has other names. In the UK, some NHS services use "clinical hours to contact". It divides the total hours clinical staff work by the number of direct contacts with patients. This site found no national target for it. In Australia, the equivalent measure is the "clinical care ratio". A 2024 study found it a useful tool for workload management and for setting staffing levels.
How to judge whether your target is reasonable
Three follow-up questions tell you more about a target than its headline percentage.
What is in the denominator? An 85% target on paid time minus an unpaid break is easier than 85% on the whole shift. Example: an 8-hour shift of 480 minutes with a 30-minute unpaid lunch. At 85% of 480 minutes you need 408 productive minutes. Measured against the 450 minutes you are available, that is 408 ÷ 450 = 90.7%. The guide to lunch breaks and productivity explains the difference.
What counts as productive? If evaluations, care coordination and family education count, a high target is reachable. If only direct treatment counts, the same number is much harder in a setting with complex patients.
Over what period? A daily target with no averaging is harsher than a weekly one. It leaves no way to recover from a day when three patients decline. The weekly productivity calculator shows the average.
Example: a department asks for 90% of paid time, with evaluations counted and a weekly average. That is a different job from 85% of the whole shift, measured daily, with only direct treatment counted. The second is the harder job, despite the lower number.
Why two departments with the same target ask for different things
Two SNFs can both advertise an 85% target. One removes unpaid breaks, counts evaluations in full, averages weekly and excludes documented cancellations. The other measures the whole shift, counts only direct treatment, measures daily and counts no-shows against the clinician. The second asks for far more at the same headline number.
What to do if your target is above the median
A target above the published median for your setting needs a stated reason. An outpatient clinic with a full-time scheduler, a short-notice waiting list and documentation time built into the day may support a target above 80%.
Ask what the department's actual average is. Example: if the target is 90% and the department averages 82%, the target is one that most people miss. Raise that gap with your manager. The guide to setting a productivity target shows how a target can be built from the day.
Questions to ask at interview
Ask the three questions above at interview, before the first week. Listen for a rehab director who can explain the calculation and knows what is in the denominator. A director who also knows the department's actual average has checked how close staff come to the target. A vague answer can mean the target was inherited.
Comparing offers
If you are weighing two roles, convert both targets to the same basis first. Adjust for whether the break is in the denominator, whether documentation happens on the clock, and the measurement period. The role with the higher headline number can be the easier job once those adjustments are made. The therapist productivity calculator lets you run both offers against the same day.
Comparing your percentage with a colleague in another setting tells you little unless you also compare methods.