For Therapy & Healthcare Practices

An accountant who actually understands your practice.

Most accountants treat a therapy clinic like any other small business. They miss the things that matter — the insurance reimbursement timing, the W-2 vs. 1099 clinician classification, the S-corp planning, the property strategy as you build wealth. We don’t. This is the work the firm is built around.

$15K22K
Typical annual SE tax savings from a properly executed S-corp election for a $750K therapy practice.
$20K75K
First-year tax deduction acceleration potential when buying commercial real estate, with a properly structured cost segregation study.
More year-end tax planning interactions in a Practice Growth engagement than typical reactive tax-prep relationships.
If any of this sounds familiar

The questions therapy practice owners actually have.

These are the conversations that come up over and over with practice owners I work with. They’re also the conversations most generalist accountants struggle with — because the answers depend on understanding how a clinical practice actually operates.

“Should I make the S-corp election? When?”
Most therapy practices benefit from S-corp status once they’re consistently above $75K–$100K in net profit. The election needs to be timed correctly, paired with proper reasonable comp analysis, and supported by payroll that runs cleanly. Done right, this saves $10K–$25K per year. Done wrong, it creates tax problems that take years to undo.
“Are my clinicians W-2 or 1099?”
If you control how, when, and where your clinicians work, they’re almost certainly W-2 employees — even if you’ve been paying them as 1099 contractors. Misclassification is one of the most common audit triggers in this industry. We help you get the classification right and stay out of trouble.
“What’s reasonable compensation for me as the owner?”
There’s a defensible range based on your role, hours, and industry comp surveys. Set it too high and you overpay payroll taxes. Too low and the IRS challenges your distributions. We document this annually so you can sleep at night and your tax savings actually hold up under scrutiny.
“Should I buy the building I practice in?”
Sometimes — with the right structure. The building goes in a separate LLC that rents to your practice. The structure has to be set up properly before closing, with a documented arm’s-length lease, a §469 grouping election, and depreciation strategy. We do this work specifically and frequently.
“Why is my A/R so confusing?”
Therapy practices have multiple revenue streams — insurance EOBs, patient copays, deductibles, sliding-scale fees, sometimes private-pay. Without a clean workflow, A/R becomes meaningless. We set up your books to reflect what’s actually happening in your practice and tie it back to your EHR.
“How do I plan for taxes throughout the year?”
Quarterly. We meet four times a year to look at distributions, retirement contributions, equipment purchases, and any major business decisions. We project your tax liability mid-year so April becomes a confirmation, not a surprise. This is what proactive planning actually looks like.
Why a specialty firm

The difference between a generalist and a specialist.

Most accountants are perfectly competent at general small business work. The reason therapy practices need a specialist isn’t that the work is harder — it’s that the patterns are specific. A firm that sees one therapy practice every few years can’t recognize what a firm that works with these practices every day will spot in 30 seconds.

01

We know what good looks like.

I’ve seen what a healthy $500K solo practice looks like. I’ve seen what a healthy $2M group practice looks like. I’ve seen the financial profile of a clinic that’s about to fall apart and the one that’s about to scale beautifully. When something’s off in your numbers, I notice — not in March, but as it’s happening.

In practice
Caught a clinician misclassification at onboarding that would have triggered a penalty within 18 months.
02

We speak the language.

You don’t have to explain that EOBs come in batches, that some sessions get billed but never collected, that 1099 supervisees are different from employees, that group practices have a specific compensation rhythm. The vocabulary is shared, which means our calls go faster and our work goes deeper.

In practice
Don’t spend 20 minutes explaining your business model on every call.
03

The packages match the work.

Our service tiers were built specifically around what therapy practices need at each stage. Solo practitioner who just needs clean books and accurate taxes? That’s a tier. Established practice with multiple clinicians and an S-corp? That’s a tier. Multi-location group practice planning a sale? That’s a tier. No square pegs in round holes.

In practice
Engagement scope matches what your practice actually requires — nothing missing, nothing wasted.
04

The strategic moves get caught.

S-corp election timing. Real estate purchase structuring. Cost segregation. Reasonable compensation analysis. Retirement plan optimization. §469 grouping elections for related-party rentals. These are the strategies that compound over years — and they’re the ones a generalist firm tends to miss because they’re not in the standard playbook.

In practice
Multi-year tax savings from strategies most firms wouldn’t bring up unprompted.
Where you are right now

Practice owners we work with at every stage.

Stage 01

The solo practitioner getting set up

You’re a year or two into your practice. Bookkeeping has been DIY or chaotic. Tax season is stressful. You’re wondering whether you should be an LLC, an S-corp, or something else.

Where we focus: Clean books, entity structure decisions, tax planning, and stable monthly rhythm.
Stage 02

The growing group practice

You have multiple clinicians now. You’ve made the S-corp election or are considering it. Your books are mostly fine but tax time still surprises you. You want strategy, not just compliance.

Where we focus: Quarterly planning, reasonable comp documentation, clinician classification, growth modeling.
Stage 03

The established practice owner

Your practice is doing well. You’re thinking about buying the building, opening another location, bringing in a partner, or eventually selling. The financial decisions are getting bigger and more permanent.

Where we focus: Real estate structuring, succession planning, multi-entity strategy, CFO-level partnership.
What to expect

How we go from strangers to working partners.

01

Submit a brief intake form

A short questionnaire about your practice, what you’re looking for, and where things stand right now. Takes about 5 minutes. This lets me come prepared to our conversation rather than asking the same questions on the call.

02

20-minute consultation

We talk through your practice, your current setup, and what you’re actually trying to solve. I’ll ask follow-up questions about the things that matter and identify any immediate opportunities or red flags. No pressure, no pitch.

03

Clear, upfront pricing

By the end of the consultation, you’ll know exactly what working together would cost, what tier fits your practice, and what the engagement would include. No mystery, no “I’ll send a quote later.”

04

Engagement letter & onboarding

If we’re a fit, I send a clear engagement letter. Once signed, we set up access to your books, gather the documents needed, and book the first monthly meeting. Most engagements onboard in 2–3 weeks.

05

Working together — on a real rhythm

Monthly bookkeeping, monthly review calls, quarterly planning (Growth tier and up), proactive communication, and a relationship that compounds in value over years. Not a vendor. A partner.

Ready to talk about your practice?

Start with a 20-minute consultation. No pressure, no pitch — just a conversation about what you’re building and how we might be able to help.

Schedule a Consultation