BH Practice Real Estate — 2026 Decision Framework

Buy vs Lease vs Telehealth-Only

Telehealth-Only (Lowest Overhead)

• Zero real estate cost
• Providers work from home
• Not all patients want telehealth
• Some states require in-person for initial evaluation
• SUD residential impossible without physical space

Lease (Most Common)

• Typically $20-40/sq ft/year urban
• 500-1500 sq ft for solo/small
• 3-5 year lease terms typical
• Broker fees + tenant improvement negotiable
• Flexibility to scale up or exit

Buy (Long-Term Investment)

• Building equity vs paying rent
• Locked-in cost (property tax + maintenance)
• Illiquid + tied to location
• SBA 504 loans available for owner-occupied medical
• Best after practice stabilizes (5+ years)

Space Requirements per Provider

• Solo therapist: 500-800 sq ft (office + waiting)
• Multi-provider therapy: 200-300 sq ft per provider
• Psychiatric med management: 150-250 sq ft per provider
• ABA in-clinic: 400-600 sq ft per BCBA + treatment rooms
• PHP/IOP: 60-100 sq ft per client capacity
• Residential SUD: 200-400 sq ft per bed

Location Factors

• Insurance panel density
• Public transit access (patient access)
• Parking availability
• Neighborhood safety perception
• Zoning (mental health services + parking requirements)
• Complementary services proximity (PCPs, pharmacies)

Revenant Care Real Estate Advisory

– KD, Revenant Care