Medical CPAs
CPAs whose entire practice is built around doctors and dentists
A medical CPA understands the rules unique to physicians and dentists — SSTB phase-outs, PTET elections, RVU-based comp, cash balance plans, and the HIPAA framework around billing data.
What the specialist does
What a medical cpas specialist actually handles
- Personal and entity tax planning for physicians and dentists
- Practice bookkeeping, billing reconciliation, and overhead analysis
- Provider compensation and partner buy-in modeling
- Retirement plan design and contribution optimization
- Audit defense for medical-specific IRS issues (SSTB, SE tax)
Common tax issues
Tax issues this specialist handles every year
Generic firms miss most of these. A specialist surfaces them in planning conversations, not on the next IRS notice.
SSTB phase-out and QBI planning
Medical is a specified service trade — QBI phases out completely above the threshold. Retirement plan contributions and entity structure can recover much of the lost deduction.
PTET state elections
Most states with income tax allow medical entities to deduct state tax at the entity level — a major SALT-cap workaround.
Self-employment tax planning
S-Corp election or limited-partner structuring can save 2.9–3.8% on a meaningful portion of physician income.
Cash balance and DB plan design
Used to push retirement contributions well past 401(k) limits for older partners.
Locum tenens and side income
Side income needs separate quarterly planning to avoid underpayment penalties.
Bookkeeping requirements
- EHR-to-bank reconciliation and unbilled encounter tracking
- Payer mix dashboards
- Overhead allocation by provider
- MSO / management company books
- Physician owner draws and distributions
Payroll issues
- Physician salary plus bonus and call pay
- Production-based comp (RVU, collections, EWYK)
- Cash balance and 401(k) deferrals
- ACA reporting where applicable
- 1099-NEC for locum and consulting income
Software used
The tools a real specialist works in
Pricing ranges
What you should expect to pay
Real market ranges from active engagements. Fees scale with complexity, location, and firm size.
Solo physician — bookkeeping + tax
$700–$1,800/mo
Monthly close, payroll journal, planning calls.
Group practice — full back office
$2,500–$8,500/mo
Multi-provider comp, MSO accounting, lender packages.
Physician 1040 + entity return
$1,500–$5,500
QBI, PTET, retirement plan modeling included.
Advisory hourly
$300–$550/hr
Practice purchase, partner buy-in, comp redesign.
Featured professionals
CPA medical — vetted pros accepting new clients
Verified specialists appear here as profiles are claimed and reviewed in United States.
Questions to ask
- What percentage of your clients are physicians or dentists?
- How do you model the SSTB phase-out for our income range?
- Have you filed PTET in our state for medical entities?
- Can you coordinate with our retirement plan TPA?
- How will you secure our billing and PHI data?
Red flags
- !Generalist firm that 'has a few doctor clients'
- !Won't sign a HIPAA BAA
- !Doesn't know SSTB or PTET
- !Recommends S-Corp without modeling reasonable comp
- !No retirement plan design experience
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FAQ
About cpa medical
Are medical CPAs more expensive than general CPAs?+
Usually 10–25% more, but the SSTB, PTET, and retirement plan savings almost always exceed the premium.
Can a medical CPA work with my financial advisor?+
Yes. Most medical CPAs collaborate with the practice's wealth advisor, retirement plan TPA, and insurance broker for an integrated plan.
Do dentists need a medical CPA?+
A dental-focused CPA is best, but a medical CPA covers most of the same ground (SSTB rules, PTET, retirement plan design). Many firms serve both.
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