Industry Expertise
Medical Practices
Specialized tax and accounting for healthcare providers across NYC & NJ.
Medical practices run on a financial model most accountants never see: a mix of insurance reimbursements and cash-pay revenue, expensive equipment, strict professional entity rules, and owners with high incomes that deserve high-level planning. OnPoint Business Tax & Accounting works with physicians, chiropractors, med spas, mental health practitioners, and cosmetic surgeons across NYC and NJ — reducing tax liability, keeping the books clean, and building long-term wealth behind the practice.
Common Tax Challenges for Medical Practices
We understand the unique financial pressures your industry faces — and we know how to solve them.
Insurance vs. Cash-Pay Revenue Mix
Tracking reimbursements, superbills, and cash-pay services in one clean picture of practice profitability.
High-Income Tax Exposure
Setting a defensible reasonable salary, timing bonuses, and structuring distributions to lower your effective rate.
PC/PLLC & Professional Entity Rules
New York and New Jersey restrict which entity types licensed practitioners can use — we structure it right the first time.
Equipment & Technology Depreciation
Section 179 and bonus depreciation on lasers, exam tables, adjusting tables, imaging, and practice software.
Associates, Locums & Injectors
Correctly classifying 1099 contractors vs. W-2 employees — and avoiding IRS reclassification penalties.
Retirement & Wealth Planning
Cash balance and defined benefit plans that shelter six- and seven-figure practice incomes.
Which Practice Do You Run?
Every type of practice has its own numbers. Here's how we approach yours.
Chiropractors
Cash-heavy practices with equipment-heavy deductions.
- Section 179 on adjusting tables, X-ray, and therapy equipment
- Cash-pay vs. insurance billing reconciliation
- Multi-doctor and multi-clinic profit splitting
Med Spas & Aesthetics
Retail, cash-pay, and equipment under one roof.
- Sales tax on retail product lines (skincare, injectables-adjacent)
- Laser and aesthetic device depreciation schedules
- W-2 vs. 1099 classification for injectors and aestheticians
Mental Health Practitioners
Simplified books for therapists, psychologists & LCSWs.
- Insurance panel payments vs. private-pay session tracking
- Solo practice entity setup and reasonable salary
- Home office, CE, and supervision expense deductions
Cosmetic Surgeons
High-income planning for surgical practices.
- Cash balance plans that shelter seven-figure incomes
- OR build-out and surgical equipment cost recovery
- Practice overhead, staffing, and anesthesia contractor reporting
Physicians & Medical Groups
From solo practice to multi-partner groups.
- S-Corp salary benchmarking for physician-owners
- 1099 locum tenens and coverage reporting
- Partner allocations and buy-in/buy-out tax planning
Frequently Asked Questions
Should a physician practice be an LLC, PLLC, or PC?
Most states, including New York and New Jersey, require licensed physicians to form a professional entity — a PC or PLLC — rather than a standard LLC. We help you choose the structure that fits your practice and then layer on S-Corp or partnership tax planning.
What salary should I take from my medical S-Corp?
The IRS requires a reasonable salary before distributions, and for physicians that number is benchmarked against specialty, hours, and revenue. We document a defensible salary and structure distributions to keep your effective tax rate down.
Can I deduct medical equipment and build-outs?
Yes. Exam tables, imaging, lasers, and practice build-outs generally qualify for Section 179 expensing or bonus depreciation when placed in service. We time purchases and elections to your income each year.
How do I handle 1099 locum tenens and per-diem providers?
Contractor payments require correct 1099 reporting and a genuine independent-contractor relationship. We review classification, handle reporting, and flag arrangements that put you at risk of reclassification penalties.
What retirement plan works best for a physician owner?
Cash balance and defined benefit plans can shelter six-figure contributions for high-income practice owners, often combined with a 401(k). We design and administer the right plan for your age, income, and goals.
Services We Provide for Medical Practices
OnPoint Business Tax & Accounting delivers tailored tax and accounting services designed specifically for your industry's needs.
- Medical practice tax preparation and filing
- Professional corporation (PC/PLLC) tax returns
- S-Corp salary and distribution planning
- Payroll, benefits, and contractor payments
- Monthly bookkeeping and practice P&L reporting
- Equipment purchase and depreciation planning
- Retirement plan design and contribution planning
- Practice acquisition, sale, and IRS audit support
Why OnPoint?
NYC & NJ's Trusted Business Tax Experts
- Circle of Excellence 2025 Award Recipient
- 5-star rated on Google Reviews
- Serving NYC & NJ businesses for over a decade
- Flat-fee pricing — you know the cost upfront, always
- 100% in-house — your work is never outsourced or offshored
- Bilingual staff — English & Spanish
- In-person, virtual, and drop-off options
Keep More of What Your Practice Earns
Whether you're a solo therapist or a multi-provider group, we handle the numbers so you can stay focused on patients. Book a free consultation today.