How to Start Your PT/OT/PTA/COTA Home Modification Business

cota home modifications ot pt pta Jun 24, 2024
How to Start Your PT/OT/PTA/COTA Home Modification Business

How to Start Your PT/OT/PTA/COTA Home Modification Business

There are many amazing businesses that Occupational Therapists, Physical Therapists, Physical Therapist Assistants and Occupational Therapy Assistants can start! I’m excited to share that in this article, we will dive into home modifications and how you can use your therapy skills to start a home modification business!

**Looking for a free home modification CEU? Check out our free 1 hour CEU here! 

What you’ll learn:

  • What are home modifications and how OTs, PTs, PTAs and COTAs are uniquely qualified to perform these evaluations and follow ups
  • Business opportunities for PT,s OTs, PTAs and COTAs within home modifications
  • A day in the life of a home modification business
  • Certifications required for home modifications 
  • How to find home modification clients
  • How to find contactors to help you with home modifications


What are home modifications and how OTs, PTs, PTAs and COTAs are uniquely qualified

Home modifications according to is defined as “ Home improvements, modifications, and repairs can help older adults maintain their independence and prevent accidents. Work can range from simple changes, like replacing doorknobs with pull handles, to major structural projects such as installing a wheelchair ramp.”

There are so many areas that home modifications encompasses. Many of us may think of home modifications as only changing doorways or adding a ramp to the entry way, but home modification’s encompasses much more.

What are some billable/chargeable services you could you perform within your home modification business? 

  1. Recommendations of different products to aid in transfers, safety, mobility in the home
  2. Recommendations on adjustments to the universal design (aka the floor plan) of the home
  3. Caregiver, family, and patient training on how to use the new equipment
  4. Recommends on assistive devices and training on these devices
  5. Follows to ensure the modifications were appropriate and overcome any questions or challenges
  6. Project management with interior designers and contractors to ensure the needs of the client are properly conveyed


What is the process of a home modification evaluation and a day in the life of a home modification business?

What is the home modification process?

When you perform home modifications, there are you usually several steps you'll take. First, you’ll interview the patient/client, family, and caregivers to learn about their health history, current activity level, prior level of function, and goals for aging in place. This could take roughly 30 minutes to complete and document. There are several different types of assessments you can use to help guide your home modification evaluation.

A few assessments that are free include:

Second, you’ll walk through the entire home, from the backyard and patio, the front entrance, the living room, dining room, kitchen, garage, basement, bedrooms, stairs, bathrooms and any other areas around the home -even the driveway.  

You’ll measure areas, take pictures, and most importantly – you’ll watch the client perform tasks to see the problems they may be having.

Third, you may suggest some changes or equipment right then, but usually a home modification evaluation may take time to process and write up. You’ll return home to create a write up of your ideas, recommendations with product links if possible, funding ideas, and other tips you may have.

To finalize the evaluation, you may simply provide this paperwork to the client but many times you’ll also perform a in person, phone, or online chat to discuss your findings and answer any last questions.

At this point, your evaluation is complete. You may want to recommend more services that you or others in your network provide. These services could be:

  • Contractor services
  • Purchasing certain equipment and returning for training on items
  • Therapy services
  • Home health aid services
  • Other services


Why are occupational therapists, physical therapists, and assistants uniquely qualified to perform home modifications?

OTs, PTs, PTAs and COTAs are anatomy and physiology experts. You know neurologic and orthopedic diseases and more importantly, you know the progression of these diseases, the prognosis, and the medical care needed to properly care for these diagnoses.

One of the biggest differences often between a contractor and a therapist who performs a home modification evaluation is the medical knowledge and the disease knowledge. You cannot only perform modifications for the needs of the client today. With modifications that may be thousands of dollars, one cannot afford to continue to redo modifications when ever a change happens. As therapists and assistants, you know the outcomes and can predict and make sure these changes to the home are as lifelong as possible.

What type of certifications are required for OTs, COTAs, PTs and PTAs in order to perform home modifications?

Many of us are already performing home modifications in some way in our current roles. So you do not necessarily need a certification in order to perform home modifications. This is already in our practice act. 

However, there are some certifications that are very helpful to ensure you know all the rules and regulations, the business keys, and the key measurements to ensure your modifications are the best as possible for the client.

The 2 best certifications are:

  1.  CAPS – Certified Aging in Place Specialist.

This is a series of three 6 hour online live training sessions. Most CAPS trainers are not approved for AOTA and PT CEUs, but Alternative Healthcare Careers is. And in addition, most CAPS trainers do not provide additional business training, marketing materials and career materials but Alternative Healthcare Careers does.

Within the Alternative Healthcare Careers’ CAPS program, you receive:

  • 3 live training sessions (online via zoom) taught by 2 OT instructors that have full time businesses within home modifications
  • A 4 hour home modification specific business course that walks you through performing evaluations, connecting with contractors and other referral sources, working with clients/patients, billing, pricing, and other business tips specific for home modifications
  • A 4 hour general business course that walks you through EIN, entity set up, liability insurance, organic and paid marketing, social media and more
  • Canva marketing materials you can brand as your own
  • Canva grant template you can brand as your own
  • Website template you can copy, as well as technology tutorials
  • And a free home modification directory you can place your business on
  • Facebook group
  • Price: $760

If you have more questions about this course, please email Alternative Healthcare Careers at [email protected].


USC’s Executive Certificate in Home Modifications (

  • This is a 5 course series that is performed online, through structured exercises, handouts, homework, and 2 online videos to watch per class.  Each course is about 12 hours of class time and can be applied towards AOTA CEUS.
  • Price:  $1125


 **Looking for a free home modification CEU? Check out our free 1 hour CEU here! 


Can therapy assistants perform home modifications?

The answer is yes and no.  Many non licensed clinicals such as realtors and contractors can perform home modifications. However, these are non medical evaluations. If there is a non medical evaluation, for example a evaluation for an Air BNB or a rental in order to prevent falls from a renter then assistants could perform that evaluation.  Let’s say there is a follow up session required, project management, or caregiver training required then these are roles that assistants could perform as well.

However, if it is a Medicare evaluation, such as patient that recently was discharged from the hospital and is under home health care, then these evaluations can only be performed by an OT or a PT.


Business opportunities for OTs, PTs, PTAs and COTAs within home modifications

Occupational and physical therapists and assistants can enter into the home modification business sector from 3 ways:

  1. Contracting with other companies. The best company to contract with is Rosarium Health ( With Rosarium, you can sign up for free and they wil contact you when they have clients in your area. All you have to do is show up and perform the eval :) It's a great side hustle! 
  2. As a side hustle
  3. As your own long term business


The amazing thing is that home modifications blend very well with therapy services.

If you already have therapy business, it's a no brainer to add this into your current practice. You'll get more leads for your therapy services as well as more earnings as you'll add home modifications to your service list. And vice versa, many of those who need therapy may also need home modifications. 

 Now we get the question about if assistants could perform their own business as well? And the answer is yes! Many assistants already run their own therapy business and this is no different. You can do the follows and trainings, work with contractors and do the non medical evaluations. And you can simply hire a therapist for the times you need to do a medical evaluation. 


What could you bill for your OT/PT home modification services?

If you are performing a Medicare evaluation, then you’ll be reimbursed the Medicare rate.

However, there are many instances you could bill cash based and for that, you can change based on hour, based on a package of services, or based on other needs.

Usually around $150-200 per evaluation is a fair stating point. And you can upsell with different services such as equipment training, project management, follow ups, and therapy services.  For example, lets say you did a home modification eval and 2 follow ups, that could be 350 dollars. 


How to find your first home modification clients?

Here are 4 quick ways to find your first client include:

  1. Start as a contractor with Rosarium Health ( They'll find the clients and provide you with the EMR. All you have to do is show up!  This will build your confidence and knowledge, better preparing to go off on your own. 
  2. You can use social media – find groups that are focused on rehabilitation or on certain diagnoses and promote your services there. Finding YouTube channels or other related influencers and collaborate is a great way to spread your voice. 
  3. You can use local SEO through Google My Business and setting up your own website as well. Both are free to very low cost.
  4. Talk to various hospitals, rehabilitation facilities, assisted living centers, adult day centers to share your services. Make sure to bring flyers and business cards. Talking to caregivers and the staff is helpful as well. 
  5. The local police and fire department are a great resource. 
  6. And lastly, there are ads. You can use YouTube, Facebook, Google Ads depending on your comfort level. I usually recommend this as a last resort as I think when first starting, it's best to do the organic routes. 


How to find contactors to help you with the home modification repairs and remodeling?

There are so many contractors out there!

The easiest way is to see if any local family and friends and neighbors have recommendations and give them a call. If you have local Facebook groups, that is another great way to get feedback on good contractors to use.

You can also do a google search and read the reviews and backgrounds of various contractors. Usually those who are CAPS or have worked in home modifications before are a good first start.

Simply hop on a call and introduce yourself and discuss collaborative opportunities. If possible, meet them at a client site or for coffee to talk more. 



We hope this article has helped you discover new ways to use your OT/COTA/PT and PTA skills! Home modifications can be a amazing route to help prevent or reduce your burnout. Home modifications is unique opportunity that should be explored by any therapist or assistant as a way to add more value to their current business, as a great side hustle, or as a great way to be a contactor with companies such as Rosarium Health (  


If you have any questions about home modifications, please email Emma at [email protected].



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