How to Sell a Medical Practice in Florida: 2026 Multiples Guide

Florida is one of the most active markets in the country for medical practice acquisitions, and 2026 is proving to be a seller's market for physicians who have built something worth buying. Private equity-backed management services organizations (MSOs), regional health systems, and independent strategic buyers are all competing for profitable Florida practices right now. If you are a physician over 55 thinking about your exit timeline, the window is open — but how you structure the deal, present your payer mix, and choose your transaction partner will determine whether you walk away satisfied or leave a significant amount of money on the table. ## Why Medical Practice M&A in Florida Is Heating Up Florida's demographics make it a near-perfect healthcare M&A environment. The state added over 400,000 residents in 2024 alone, the bulk of them retirees and working professionals — high utilizers of primary care, specialty care, and outpatient services. At the same time, independent physicians are dealing with escalating administrative burdens, labor costs, and the reimbursement pressure of a post-COVID insurance landscape. The math increasingly favors exiting to a well-capitalized partner rather than grinding it out solo. PE-backed platforms are particularly aggressive. In Central Florida, Tampa Bay, and South Florida, consolidation plays across primary care, dermatology, orthopedics, pain management, ophthalmology, and behavioral health are closing at a pace that has not been seen since the mid-2010s. Buyers have capital to deploy and they are competing for quality practices. The seller's advantage right now is simple: good practices sell. The challenge is getting in front of the right buyers, properly packaging your financials, and navigating the regulatory and licensing complexity unique to Florida. ## What Determines Value in a Florida Medical Practice Sale Valuation for a medical practice is more nuanced than most other businesses. Revenue and EBITDA still anchor the number, but buyers will adjust sharply based on several factors specific to healthcare. - **Payer mix** — A practice with 60% or more Medicare and Medicaid revenue will be discounted compared to one with commercial insurance or fee-for-service dominance. Buyers see government payer concentration as reimbursement risk. If you are heavy on government payers, be prepared for a lower multiple or to negotiate on deal structure. - **Provider dependency** — How much revenue walks out the door if you leave? A practice generating $3M in revenue where 90% is physician-generated faces a steep valuation haircut versus one with a team of employed mid-levels and diversified production across providers. - **EBITDA margins** — Healthcare M&A buyers care about EBITDA, not just revenue. Practices running 15 to 25 percent EBITDA margins are in the sweet spot. Below 10 percent, you may only attract asset buyers — equipment, patient charts — rather than going-concern acquirers willing to pay a meaningful multiple. - **EHR and billing systems** — Modern, clean systems such as Epic, Athena, and DrChrono signal operational readiness. Outdated systems mean integration cost, which buyers price into the offer. - **Payor contracts** — Owned or assignable payor contracts that transfer with the practice are valuable. If your contracts terminate upon change of ownership, flag this early and work with counsel on novation or re-credentialing timelines. This is one of the most common deal-killers in Florida medical transactions. - **Restrictive covenant landscape** — Florida recently updated its non-compete statute. Your ability to execute a valid, enforceable covenant not to compete post-sale now has more nuance, particularly for physician sellers. Buyers price in transition risk heavily if non-competes are uncertain. ## 2026 Deal Multiples for Florida Medical Practices Multiples vary significantly by specialty, practice size, and buyer type. Here is what CBH Business Group is seeing in the Florida market as of 2026:

Specialty	EBITDA Multiple Range	Revenue Multiple Range	Typical Buyer
Primary Care (Family / Internal Med)	4x – 7x EBITDA	0.5x – 1.0x	PE-backed MSO, health system
Dermatology	6x – 10x EBITDA	1.2x – 2.0x	PE platform (specialty roll-up)
Orthopedics / Spine	5x – 8x EBITDA	0.8x – 1.5x	PE-backed group, health system
Pain Management	4x – 7x EBITDA	0.6x – 1.2x	PE MSO, private buyer
Behavioral Health	5x – 9x EBITDA	0.8x – 1.5x	PE roll-up, regional operators
Ophthalmology	7x – 12x EBITDA	1.5x – 2.5x	PE-backed ophthalmic platforms
Urgent Care (multi-site)	6x – 10x EBITDA	1.0x – 1.8x	PE, regional health systems

These are going-concern multiples for practices with $500K or more in normalized EBITDA. Sub-scale practices under $300K EBITDA tend to trade at the lower end of these ranges or on an asset basis. ## The PE Roll-Up Buyer: What They Actually Want Private equity-backed MSOs and roll-up platforms are the most active buyer category in Florida's medical M&A market, and understanding what they want puts you in a stronger negotiating position. PE buyers are acquiring practices as platforms — they want scale, geography, and margin. They are not buying a job; they are buying cash flow they can leverage and grow. Here is what matters to them: - Multiple locations or the realistic ability to add locations quickly - Employed or contracted clinical staff, not just the founding physician - Clean, auditable financials — three years of P&Ls, clean books, documented add-backs - A management structure that does not collapse when you exit - Non-compete agreements that hold up and actually protect the transition period PE buyers often offer a mix of cash at close, an equity roll where you retain a minority stake in the platform, and an employment agreement that keeps you in the practice for two to five years. If a PE buyer offers you a 6x EBITDA multiple with a 20 percent equity roll into a platform they expect to sell in five years at 10x to 12x, your total value could be materially higher than the upfront number — or not, depending on platform performance. Understand what you are rolling into before you commit. Strategic buyers — health systems, larger physician groups — tend to offer lower multiples but more stability and no equity roll requirement. For physicians who want a clean exit and no ongoing financial exposure to a PE outcome, a strategic buyer can actually be the better fit. ## The Florida-Specific Process: Licensing, AHCA, and Billing Compliance Florida has regulatory nuances that affect healthcare M&A deals specifically, and ignoring them causes delays and deal failures. - **AHCA facility licenses** — If your practice operates under an AHCA clinic license, the license is typically non-transferable. The buyer must apply for a new license before or concurrent with closing. This adds 30 to 90 days to deal timelines if not planned for early. - **Corporate Practice of Medicine** — Florida is not a strict CPOM state, which means PE funds and MSOs can structure management agreements rather than outright ownership of the clinical entity. This is the standard structure in Florida PE healthcare deals. Your transaction attorney should be familiar with it. - **Medicaid participation agreements** — If you bill Medicaid, the buyer must obtain their own Medicaid provider number. The transition period, during which you may still be billing under your number while ownership has effectively changed, requires careful structuring to avoid billing compliance issues and potential False Claims Act exposure. - **DEA registration** — Prescribers who handle Schedule II through V substances need to ensure the buyer has DEA registration at the practice location before close. This is frequently overlooked and creates closing delays. Work with a healthcare transaction attorney, not a general business attorney. The difference in outcomes is material, and the compliance landscape in Florida healthcare M&A has enough landmines that generalist counsel frequently misses. ## Timing, Tax Strategy, and Getting Ready to Sell Florida has no state income tax, which means the federal long-term capital gains rate — currently 20 percent for most physician sellers, plus 3.8 percent net investment income tax — is your primary tax exposure. If the sale is structured as an asset sale, which most buyers prefer, a portion of the proceeds will be taxed as ordinary income (receivables, equipment, non-compete payments) and a portion at capital gains rates (goodwill). Strategies worth discussing with your CPA before signing a letter of intent: - Allocate purchase price to maximize goodwill (capital gains) versus receivables (ordinary income) - Qualified Opportunity Zone investment to defer capital gains if the timing aligns - Installment sale structuring if you are willing to carry a seller note from a creditworthy buyer - Charitable Remainder Trust for high-value sellers with philanthropic intent On timing: start preparing 12 to 24 months before your target close date. Clean up your financials, reduce owner-specific add-backs where possible, document your operations so the business runs without you, and start thinking about succession at the clinical level. Practices that go to market prepared sell faster and at higher multiples than practices that go to market raw. ## Frequently Asked Questions ### How long does it take to sell a medical practice in Florida? Plan for six to twelve months from the decision to go to market through closing. That typically includes four to six weeks to prepare your marketing package and normalized financials, four to eight weeks of buyer outreach and letter of intent negotiation, and 60 to 120 days for due diligence, regulatory approvals, and closing paperwork. PE-backed platforms tend to move faster on due diligence but slower on regulatory compliance. Health system deals often move slower overall due to internal approval chains and board-level requirements. ### Do I need a healthcare M&A advisor, or can I sell directly to a PE platform that contacts me? You can sell directly, but unsolicited offers from PE platforms are almost never the best offer available. PE buyers who approach you are working in their interest — their LOI is a starting point calibrated to their model, not your market value. An advisor who runs a competitive process and brings five to ten qualified buyers to the table typically delivers 15 to 30 percent higher valuations than uncontested offers. On a $5M practice, that gap is $750K to $1.5M. Hire representation. ### Will I have to stay on after the sale? Almost always, for a defined period. PE buyers typically require a two to five year employment agreement post-close. Health systems often require two to three years. The employment terms matter enormously — negotiate your base salary, productivity bonus structure, and the consequences of early termination before you sign the LOI. Do not treat the employment agreement as a formality; it is the second most important document in the transaction. ### What financial documents do I need to prepare? Three years of profit and loss statements and tax returns, a current balance sheet, and a trailing 12-month revenue breakdown by payer and by provider. Buyers will also request your billing and collections data, staff roster and compensation detail, and a summary of your payor contracts. Start gathering this before you engage an advisor — it accelerates the timeline and signals preparedness to buyers. ### What is an LOI and should I sign one before negotiating hard? A letter of intent sets out the key economic terms — purchase price, deal structure, any earnout, employment terms, exclusivity period, and timeline to close. Most LOIs are non-binding on price but binding on exclusivity, meaning you agree not to talk to other buyers for 60 to 90 days while the buyer conducts due diligence. Sign one carefully. Material deal terms negotiated after LOI rarely improve for the seller. Negotiate purchase price, earnout structure, and employment compensation hard before you sign, not after. CBH Business Group works with medical practice sellers across Florida — Central Florida, Tampa, Miami, Fort Lauderdale, Jacksonville, and throughout the state. Jesse Hastings has been named a Top 50 Business Broker in Florida for 2024 and 2025, a Million Dollar Producer both years, and the Number One Top Dollar Producer in Central Florida for 2025. If you are thinking about selling your practice in the next 12 to 24 months, start with a free, confidential Business Opinion of Value at https://cbhbusinessgroup.com/valuation-calculator, or schedule a 20-minute call with Jesse directly at https://calendly.com/jesse-cbhadvisory. You can also reach Jesse at (407) 908-3845.