How to Open a New Optometry Practice

Ready to launch your practice? This 2025 guide covers financing, location, credentialing, compliance, equipment, marketing, and a new practice checklist with insights from Dr. Courtney Dryer, founder of Autarchic Spec Shop in Charlotte, NC.

Financing Your Startup

Choosing how you’ll fund your eyecare business is one of the first irreversible decisions you’ll make.

Start by mapping your total startup budget (build-out, equipment, inventory, marketing, working capital) and then select a financing mix that fits your cash flow.

Disclaimer: This blog is for informational purposes only and does not constitute legal, financial, tax, medical, or compliance advice. Laws, regulations, and payer policies vary by state and are subject to frequent changes. Please consult qualified professionals before making decisions.

Compare Common Financing Options

• SBA 7(a) term loan: SBA’s primary program: funds working capital, equipment, build-out, and more (maximum loan amount $5M, apply through a lender).
• Bank term loan or line of credit: Useful for build-out and early cash-flow gaps.
• Equipment financing: Spreads device costs across useful life.
• Owner equity: Lowers monthly payments and strengthens your application.

Lender-readiness Checklist

• Business plan and 24–36-month financial projections
• Personal financial statement and credit history
• Entity documents (EIN, operating agreement), lease LOI/lease
• Use-of-funds breakdown and quotes for major purchases
• Choose lenders familiar with healthcare; you can also use SBA’s Lender Match to connect with participating lenders.

Tip: Underwrite your own plan first, including a cash flow stress-test for a slower ramp and higher-than-expected build-out costs.

Credentialing and Enrollment

Getting paid on time starts with clean IDs and enrollments. Complete these tasks in order before opening your doors.

1) Get your NPIs

• Type 1 (you, the clinician). Apply online via NPPES.
• Type 2 (your organization), if you’ll bill as a group. Manage NPIs through NPPES with CMS Identity & Access (I&A) credentials.

2) Enroll in Medicare (if applicable)

• Use PECOS to submit your enrollment, upload documents, and e-sign—paperless end-to-end.

3) Panel with commercial payers

• Create/attest a profile in CAQH, and authorize health plans to pull your data, streamlining credentialing across multiple payers.

4) Keep a shared tracker

• Columns to track: payer, submission date, status, effective date, remit info, and follow-up cadence.

Tip: Verify payer EFT/ERA enrollment and place test claims one month before launch.

Compliance Basics

Every new practice needs a lightweight compliance program you can actually run.

HIPAA Security

• The HIPAA Security Rule requires administrative, physical, and technical safeguards to protect electronic protected health information (ePHI). Do a written risk analysis, assign a security officer, and document policies, training, and incident response.
• What’s changing: HHS has proposed updates to strengthen cybersecurity (e.g., MFA, encryption, enhanced risk assessments). Treat these as best practices while the rule-making proceeds.

Workplace Safety

• OSHA Bloodborne Pathogens Standard requires an Exposure Control Plan, engineering/work-practice controls, PPE, Hep B vaccinations, and training/records for at-risk staff.

Licensure and Scope

• State boards govern licensure, scope (diagnostic/therapeutic authority), and CE. Check your state board’s requirements during planning and before offering new services.

CLIA Certificate (if doing waived tests)

If you plan to perform CLIA-waived in-office tests, you must obtain a CLIA Certificate of Waiver by submitting the CMS-116 application to your state agency; some states have additional steps.

Certificates are generally valid for two years. (Note: New York and Washington operate their own programs, so check your state's guidance.)

Quick steps:

1. Confirm your test menu is “waived.”
2. Complete CMS-116 and submit it to your state agency, along with the required fee.
3. Receive your certificate before patient testing begins.
4. Maintain manufacturer's instructions, quality control records, and staff training files.

Equipment and Build-out Checklist

Plan rooms around patient flow first, then power and network requirements.

First-year KPIs

Track a focused set of metrics on a monthly basis and review trends quarterly.

New patient volume:

• Definition: Count of first-time patients.
• Why it matters: Drives growth and word-of-mouth.
• How to track: Referral source + campaign tags in your optometry EHR.

Optical capture rate:

• Formula: (# patients who fill eyewear at your practice ÷ # Rx-eligible patients) × 100.
• Action levers: Doctor-to-optician handoff, assortment, pricing, bundles, benefits education.

Days in A/R:

• Formula: (A/R balance ÷ average daily charges).
• Action levers: Same-day claim submission, ERA/EFT, rework queue, denial prevention.

No-show rate:

• Formula: (Missed appointments ÷ total scheduled) × 100.
• Action levers: Text/email reminders, deposits for long visits, waitlist, tight recall cadence.

Return/recall effectiveness

• Formula: % of patients with a scheduled next exam within the recommended interval.
• Action levers: At-checkout scheduling, automated recalls, targeted outreach.

Tip: Build one dashboard, assign owners per metric, and run a 30-minute monthly KPI huddle to pick two improvements to test.

Why Open a Private Optometry Practice?

Dr. Dryer decided to open her own private practice for the freedom it provided. After working in various settings, she realized she wanted more control over day-to-day decisions, from staff to products. The autonomy allowed her to implement changes and improvements without waiting for approval from others.

Owning your practice means you can enjoy pride in your services, fulfill your vision, and have the flexibility to balance work and personal life.

Choosing a Location

Location is crucial.

Start by researching lease rates in different areas and comparing them to find the best deal. Then, meet with landlords to gauge potential relationships and consider the type of patient base you want to serve.

Check the demographics of your chosen area to ensure it aligns with your target patient base.

Talk to existing tenants and ask four important questions:

• Are they happy with the landlord?
• How is the business in their area?
• Would they do anything different?
• Anything they wished had been a part of their lease?

And a final note – very important! — before signing your lease, have a lawyer review it to ensure it complies with industry standards.

Also, the number of existing optometry practices in the area should be considered to assess competition. Conducting a competitive analysis can help you identify areas with high demand and limited competition.

"I always suggest that people find out if they qualify for any of the Small Business Association loans. In particular, check interest rates and see how they compare to standard bank loans." – Dr. Dryer

Keep in mind that there are benefits to working with a small, local bank versus a large bank. Each bank has its own loan requirements, such as a necessary number of years out of school or the mandatory hiring of a consultant.

Larger banks may have other special requirements you might find onerous.

"Small banks can be easier to work with, according to colleagues who’ve gotten loans from those institutions." – Dr. Dryer

Loans will be given based on financial status, how much debt is tied up in student loans, and the amount of living expenses. The bank will ask for tax documents and proof of income from an outside employer.

Keep in mind that most loans require a business owner to work at least three days outside of their optometry practice so that there is some cash flow and working capital.

Creating Your To-Do List

Opening an optometry practice involves a lot of paperwork.

You can begin by registering for NPI numbers and a business tax ID. Fortunately, it’s a pretty easy process.

A National Provider Identifier is a unique, 10-digit identification number issued to healthcare providers in the U.S. by the Centers for Medicare and Medicaid Services.

Next, register for a business tax ID, then file your business entity with both the state and your state’s board of optometry. This process may vary depending on the state where you plan to operate.

Find out how optical goods are taxed in your state. Can you get an exemption certificate?

Set up your business on social media platforms like Instagram, Facebook, and Yelp, and consider using Google paid ads to drive traffic to your site.

Start the process of getting approved for Medicare early, as it can take several months.

If your bank loans require that you have disability, malpractice, life, and business insurance, then line those up as soon as possible.

Also, line up the necessary insurance plans and begin the credentialing process.

Branding and Marketing

Branding is essential to stand out in a competitive market.

Branding is really the fun stuff, where you get to tell the community who you are and what you’re about.

Develop a clear mission statement and articulate your values.

• What makes your practice different?
• Do you have a niche?  
• Do you have a mission statement?
• Are you able to clearly articulate your values?

Communicating these aspects will help brand your practice and attract your target audience.

If you’re thinking about establishing a niche practice, then be sure to include it in your name — for example, vision therapy or sports therapy. Your name should clearly convey that focus.

Dr. Dryer’s practice, for example, caters to a clientele looking for unique fashion eyewear and positions itself as a high-end luxury boutique.

Marketing your practice effectively is critical.

Utilize social media to build a following and engage with potential patients. Referral networking can also be an effective strategy.

Connect with other local private practices, such as physicians, specialists, dentists, and therapists, to build a referral network. Additionally, consider offering incentives like discounts on glasses or contact lenses to encourage patient referrals.

Managing the Build-Out

The build-out phase involves construction, layout, and design.

Consult with several construction companies to get quotes. Visit your space regularly during construction to catch any mistakes early. Choose flooring and colors that create a welcoming environment.

Your office should be redecorated or remodeled every seven years to keep it fresh and inviting.

Choosing an EHR

Selecting the right Electronic Health Record (EHR) system is important to your daily business operations.

Research different options and choose one that fits your practice's needs. The right optometry EHR software system can streamline your operations and improve patient care.

There are some very important considerations when choosing an EHR:

• Is the company innovating and changing to meet the demands of healthcare?
• Does the EHR allow for customization?

"Personally, I love the way RevolutionEHR allows me to lay everything out the way I want to." – Dr. Dryer

• Will it save you time and money and reduce your risk of errors?
• What about integration with other equipment and business solutions?
• Is the software intuitive to learn?

"Staff turnover is very high within optometry. It’s important to me that every staff member I’ve had come on board has learned to use Rev within a week." – Dr. Dryer

• How simple is the optical ordering process? For example, RevolutionEHR’s vision web integration makes sending glasses from the system to the lab very easy.
• Is it easy to manage/input inventory? RevolutionEHR allows you to import certain frames from Frame Data, but it’s also easy to manually input data if you have something unique.
• Are you able to run reports and track KPIs?

"I worked for a doctor once and managed his AR and saw that no one knew where the money was. I really love how easy it is to track the accounts receivable that are out there. You can see all the claims that have been accepted, denied, and why." – Dr. Dryer

• Is the software cloud-based or tied to a server? This is a huge consideration, especially if you plan on working patient files while offsite.
• What about the security systems in place to protect patient privacy?

Look for features that enhance patient interaction, such as online appointment scheduling and online patient portals.

Product Research

Finally, research the products you want to offer.

Ensure they align with your brand and meet the needs of your patient base. Dr. Dryer’s practice, for instance, focuses on high-quality, fashionable eyewear that appeals to her target market.

Meet with lab reps to determine which relationship works best for you. Schedule meetings with all the major frame manufacturers and ask them if they can work with you on pricing.

Develop a working knowledge of lens options, treatments, and technology for yourself. Some may rely on an optician to handle most of this, but nowadays, there is a significant emphasis on doctor-driven dispensing.

Patients buy more when their doctor recommends them.

It’s very important to be able to explain to the patient why you’re recommending the treatment or the lens options.

Clarify extras like shipping and handling with vendors. Certain types of frames may have additional edging charges.

What are their redo policies? The base price can be different, and that affects your cash flow.

Investigating popular buying groups can help you get an idea of fair pricing and rebates. This will give you a good starting point, and you’ll know what you should charge and pay.

Consider labs that are insurance plan-approved for consolidation and simplification. Simplifying the process and consolidating most of your jobs into one or two labs will make your staff's lives easier.

As far as frames go, ask about the company's trade-out policies, shipping costs, and buy-in policies—do you need to carry a certain number of frames? You want to clarify this upfront so there are no surprises later.

Consider the latest trends in eyewear and stay updated with new products to keep your inventory fresh and appealing. But, most importantly, you want to choose companies that are easy to do business with!

Assembling Your Team

Building a strong team is essential for the success of your practice. Hire staff who share your vision and values.

Consider hiring an accountant, bookkeeper, and attorney to handle the business side of your practice. You might also want to hire a virtual assistant to help with administrative tasks.

Training your staff thoroughly ensures they provide excellent service and contribute positively to your practice’s growth.

Opening Your Practice

Once everything is in place, it’s time to open your doors.

Plan a grand opening event to attract attention and introduce your practice to the community. Offer special promotions and invite local businesses and potential patients to attend. This can help create a buzz and start building your patient base from day one.

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Disclaimer: The information in this article is provided “as is” for U.S. optometry practices. It does not constitute legal, financial, tax, medical, or compliance advice, and no professional–client relationship is created by reading it. We make no representations or warranties regarding the completeness, accuracy, or timeliness of this information. You are responsible for verifying requirements with the appropriate authorities and payers (e.g., NPI/NPPES, PECOS/Medicare, CLIA, HIPAA/HHS, OSHA, state boards). References to financing (including SBA programs) are illustrative only and not an offer, solicitation, or commitment to lend. External links are provided for convenience and do not imply endorsement of the linked content. For guidance specific to your situation, consult an attorney, CPA, and/or compliance specialist.