Plenty of experienced BMETs eventually consider going independent. The demand is real: smaller hospitals, surgery centers, clinics, dental practices, and veterinary offices all need equipment service and few can justify a full-time in-house tech.
This is what actually goes into starting, without the small-business-blog optimism. The technical part is the part you already have; almost everything else is new.
Credentials and standing
There is no single national license to repair medical equipment in the US, but credibility is gated by credentials and manufacturer training, and your customers' compliance programs will ask.
Pick two or three device families to be genuinely excellent at before broadening. "We service everything" from a one-person shop reads as "we service nothing well."
- CBET certification — the recognized baseline; strongly worth having before you go independent
- OEM training on the specific platforms you intend to service — this is what unlocks parts, documentation, and service software on many lines
- Documented technical experience — most customers want years in the field, not a certificate alone
- Check state and local business licensing, plus any state-level requirements for servicing specific device categories
Test equipment: the real startup cost
Your tooling is the capital cost, and it has to be calibrated and stay calibrated. Buying used is normal; skipping calibration is not — uncalibrated test equipment invalidates every report you write.
- Electrical safety analyzer — non-negotiable, first purchase
- Patient simulator appropriate to your device families (ECG/NIBP/SpO2 for general biomed)
- Defibrillator analyzer, infusion pump analyzer, or gas flow analyzer depending on specialization
- Standard hand tools, ESD protection, and a laptop with service software access
- Annual calibration budget for every piece of test equipment — plan for it as a recurring line item
Insurance and legal
You are working on devices used on patients. Coverage is not optional, and hospital vendor credentialing programs will require proof before you set foot on site.
- General liability and professional liability (errors and omissions)
- Business entity formation — an LLC is the common structure for liability separation
- A written service agreement template covering scope, turnaround, parts warranty, and limitation of liability
- Vendor credentialing — hospitals typically require background checks, immunization records, and training modules before site access
- Consult an attorney and an insurance broker who know healthcare vendors specifically
Pricing your work
The three common models, and when each fits:
Price against the local OEM rate, not against what feels comfortable — meaningfully below OEM, well above hobby pricing. Charge travel and minimum call-out separately, and build calibration and insurance costs into your rate.
- Hourly time-and-materials — simplest to start, but income is lumpy and every hour must be sold again
- Per-device PM contracts — annual per-asset pricing; this is the model that creates predictable revenue and is worth building toward
- Full-coverage service contracts — highest value per account, but you carry parts risk and need enough scale to absorb a bad month
Finding the first customers
Almost every successful independent starts with relationships from their previous role. Cold outreach into hospitals is slow; the referral path is much faster.
- Former colleagues and the facilities you already know
- Surgery centers, urgent care, dental, and veterinary practices — underserved and far shorter sales cycles than hospitals
- Overflow work subcontracted from larger ISOs — steady, lower-margin, but it fills the calendar early
- Local AAMI chapters and biomed associations
- Existing in-house departments that need coverage for device families they cannot support
Documentation is your product
This is the point independents underestimate most. Your customer is not buying a repair — they are buying a repair plus a record that satisfies their accreditation program. A great repair with a two-line report is a failed deliverable for a hospital customer.
Consistent, complete, professional service reports are also your main competitive lever against the OEM. You cannot beat them on parts access, but you can absolutely beat them on documentation quality and turnaround.
TESSA Field Notes was built for exactly this — branded, structured service reports written at the device in a couple of minutes. It is free to use, which makes it a reasonable first tool when you are watching every startup dollar.
- Every report: device identity, complaint, findings with measured values, actions, parts, labor, outcome, next due date
- Standard formatting across every job, ideally with your own branding on it
- Same-day delivery to the customer — turnaround is a differentiator
- Your own searchable copy of every report; it is your service history, your billing backup, and your evidence if a job is ever questioned
A realistic first year
Expect the technical work to be the easy part. The hard parts are cash flow while accounts ramp, vendor credentialing timelines that run weeks, parts sourcing without OEM standing, and the administrative load of being the technician, the salesperson, and the bookkeeper simultaneously.
Most people who make it do two things: they start part-time or with one anchor account before leaving a salaried role, and they keep their overhead low enough that a slow quarter is survivable.