Tax and bookkeeping built for healthcare practitioners

Entity structure for licensed professionals

New York has specific rules for professional corporations (PCs) and professional LLCs (PLLCs) for licensed healthcare providers. The wrong entity type creates legal exposure; the right one can reduce your tax bill significantly.

Owner compensation and S-corp strategy

Healthcare practitioners often take all income as distributions. An S-corp election with a reasonable salary can reduce self-employment tax — but the salary must be defensible to the IRS and appropriate for your specialty.

Insurance reimbursement reconciliation

Insurance payments arrive weeks or months after services are rendered, often at different rates than billed. Reconciling insurance receivables against actual collections is a bookkeeping challenge most general accountants underestimate.

High-cost equipment and depreciation

Dental chairs, imaging equipment, lasers, and medical devices are expensive. Timing purchases around Section 179 and bonus depreciation — and tracking depreciation correctly — directly affects your tax liability.

Payroll for clinical and administrative staff

Practices with both clinical and administrative employees face complex payroll — different pay structures, overtime rules, and benefits. Payroll errors in a medical practice are expensive to fix and create IRS exposure.

Retirement planning for high earners

Physicians and dentists are often high earners with limited time to plan. Defined benefit plans, solo 401(k)s, and SEP-IRAs can shelter significant income — but only if set up and funded correctly before year-end.

Sales tax on med spa and aesthetic services

In New York, some aesthetic and cosmetic services are subject to sales tax while medical services are exempt. The line is not always obvious, and misclassification creates audit exposure.

Associate vs. employee classification

Many practices bring in associate physicians or dentists. Whether they are employees or independent contractors has significant payroll tax and liability implications — and the IRS scrutinizes this classification in healthcare.

When:

Net income exceeds $80,000

Evaluate S-corp or PC election to reduce self-employment tax

When:

Planning a major equipment purchase

Time the purchase to maximize Section 179 or bonus depreciation

When:

Bringing on an associate

Determine employee vs. contractor status before the first payment

When:

Profitable year with cash available

Maximize retirement contributions — defined benefit plan may shelter $100K+

When:

Offering cosmetic or aesthetic services

Review New York sales tax applicability before billing

When:

Opening a second location

Review entity structure — separate entities vs. one practice with multiple locations