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UNAUDITED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Dec. 31, 2024
OPERATING ACTIVITIES      
Net income including non-controlling interest $ 13,468 $ 11,617  
Adjustments to reconcile net income including non-controlling interest to net cash provided by operating activities:      
Depreciation and amortization 5,867 4,095  
Provision for credit losses 1,848 1,627  
Equity-based awards compensation expense 1,771 1,997  
Amortization of debt issue costs 106 106  
Change in deferred income taxes 5,242 1,943  
Change in revaluation of put-right liability 404 80  
Gain on change in fair value of contingent earn-out consideration (4,822) (612)  
Equity of earnings in unconsolidated affiliate (393) (271)  
Loss on sale of fixed assets 0 5  
Loss on sale of a partnership 123 0  
Changes in operating assets and liabilities:      
Increase in patient accounts receivable (7,341) (5,124)  
Decrease (increase) in accounts receivable - other 774 (3,985)  
Increase in other current and long term assets (6,209) (433)  
Decrease in accounts payable and accrued expenses (14,229) (6,678)  
(Decrease) increase in long term liabilities (1,284) 52  
Net cash (used in) provided by operating activities (4,675) 4,419  
INVESTING ACTIVITIES      
Purchase of fixed assets (2,579) (1,838)  
Purchase of majority interest in businesses, net of cash acquired (4,211) (15,971)  
Purchase of redeemable non-controlling interest, temporary equity (907) (2,702)  
Purchase of non controlling interest, permanent equity 0 (498)  
Proceeds from the sale of partnership interest - redeemable non-controlling interest, temporary equity 15 67  
Proceeds from the sale of non-controlling interest, permanent equity 0 23  
Proceeds from sale of partnership 700 0  
Distributions from unconsolidated affiliate 310 367  
Other 44 88  
Net cash (used in) investing activities (6,628) (20,464)  
FINANCING ACTIVITIES      
Proceeds from revolving facility 17,000 0  
Distributions to non-controlling interest, permanent and temporary equity (3,653) (3,160)  
Payments on term loan (3,750) (938)  
Principal payments on notes payable (473) (392)  
Net cash provided by (used in) financing activities 9,124 (4,490)  
Net (decrease) in cash and cash equivalents (2,179) (20,535)  
Cash and cash equivalents - beginning of period 41,362 152,825 $ 152,825
Cash and cash equivalents - end of period 39,183 132,290 $ 41,362
Cash paid during the period for:      
Income taxes 7,359 367  
Interest paid 2,205 1,844  
Non-cash investing and financing transactions during the period:      
Purchase of businesses - seller financing portion 0 500  
Purchase of redeemable non-controlling interest, temporary equity, recorded in accrued liabilities 6,672 0  
Fair market value of initial contingent consideration related to purchase of businesses 1,259 0  
Notes payable related to purchase of redeemable non-controlling interest, temporary equity 89 0  
Notes receivable related to sale of redeemable non-controlling interest 646 315  
Notes receivable related to the sale of non-controlling interest, permanent equity 0 243  
Offset to notes receivable associated with purchase of redeemable non-controlling interest 180 75  
Dividends payable to USPH shareholders $ 6,836 $ 6,630