Medical Billing Service
The back office every doctor's office quietly relies on
Medical billing companies handle claims submission, insurance follow-up, denial management, and payment posting for physician practices, clinics, and hospitals. Clients pay 4–8% of collections as a monthly retainer — and they almost never leave. Switching billing companies is painful, and a good one that gets claims paid is worth its weight in reimbursements. Fully remote-capable with high recurring revenue.
Avg Revenue
$800K
Profit Margin
30%
Acquisition Multiple
2.5x - 4x
Startup Cost
$10K - $50K
Difficulty
3/5
How It Works
Billers submit insurance claims on behalf of medical providers, follow up on unpaid or denied claims, and reconcile payments. Revenue is typically a percentage of collections (4–8%) or a flat fee per claim. A company with 10 physician clients billing $2M/year in collections generates $80K–$160K/month in revenue. The key moat: HIPAA compliance, deep payer relationships, and the sheer pain of switching providers.
Revenue Range
Real Acquisitions in This Category
SBA 7(a) change-of-ownership loans · NAICS 541214 · Payroll Services
Deal Size Distribution
Deal Flow Over Time
Financing Profile
Recent Comparable Deals
| Closed | State | Loan | Implied deal | Jobs | Franchise |
|---|---|---|---|---|---|
| Nov 2025 | TX | $805K | $947K | 6 | — |
| Aug 2025 | AK | $345K | $406K | 5 | — |
| Jul 2025 | CA | $882K | $1.0M | 8 | — |
| Jun 2025 | NY | $298K | $350K | 4 | — |
| May 2025 | OH | $1.6M | $1.8M | 9 | — |
| Aug 2024 | IN | $5.0M | $5.9M | 98 | — |
| Mar 2024 | OK | $2.0M | $2.3M | 23 | — |
| Jun 2021 | UT | $900K | $1.1M | 3 | — |
| Sep 2020 | NV | $218K | $256K | 4 | — |
Source: SBA 7(a) FOIA dataset, filtered to acquisitions (loans where business age is "Change of Ownership"). Implied deal size assumes an 85% loan-to-purchase ratio, a common SBA change-of-ownership structure. Charge-off rate shown only when 10+ loans have resolved (paid in full or charged off). Interest rates reflect last 24 months only. Actual deal values vary with equity injections, seller financing, and working capital terms.
Pros
- +Extremely sticky clients — switching billing companies is rare
- +Recurring percentage-of-collections model scales with client growth
- +Fully remote — no physical location required
- +Acquisition multiples of 3–4x SDE for established books
- +Healthcare billing demand grows with aging US population
Cons
- -Requires HIPAA compliance and ongoing staff training
- -Highly competitive — many offshore providers undercut on price
- -Losing one large client can hurt revenue significantly
- -Complex insurance and coding regulations require expertise
Best For
Operators with healthcare admin experience or who can hire a strong billing team
Operating Costs
Main costs: billing software ($500–$2K/mo), staff wages (coders and AR specialists), HIPAA compliance tools, and client management. Remote-first model keeps overhead lean.
SBA Financing Estimator
Adjust the deal — see if it cash flows after debt service
Estimates only. Excludes owner compensation, capex, working capital draws, and taxes. Margin assumes average occupancy and volume. Actual SBA terms vary by lender and borrower profile.
Where to Buy
Search medical billing and healthcare admin businesses for sale
Healthcare service business listings including billing
Specialty brokers focused on healthcare business acquisitions
Acquisition Score
Scores margin (30), entry multiple (25), SBA market depth (20), category risk (15), and deal momentum (10). Higher = better acquisition candidate.
Quick Facts
- Category
- service
- Difficulty
- 3/5
- Buy price
- $2.0M–$3.2M
Buyer's Toolkit
Essential tools to get started
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Largest business-for-sale marketplace in the US
SBA loans and business acquisition financing — get funded fast
ROBS financing — use retirement funds to buy a business tax-free
Bookkeeping for small business owners — hands-off financials
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