Industries We Serve • Medical Practices

Tax planning built for physician income and practice complexity.

High-contribution retirement strategy, entity structuring for PCs and PLLCs, and payer reimbursement bookkeeping for physicians and practice owners.

Practice & Payer Mix
Industries We Serve

Tax, payroll & bookkeeping built for medical practices

Medical practices deal with a specific mix of complex payer reimbursement, retirement plan opportunities that most other small businesses do not have access to, and entity structures that vary meaningfully by state and specialty. Hasco Tax Advisors works with physicians, specialists, and practice owners on the bookkeeping and tax planning that fits how a medical practice actually generates revenue and pays its people.

Medical Practice Tax Issues

The tax questions specific to running a medical practice

Retirement plan strategy at physician income levels

Physician-level income typically justifies retirement plan strategies beyond a standard SEP-IRA. A Solo 401(k) or a defined benefit/cash balance plan can allow six-figure annual contributions for high-earning owners, meaningfully reducing current taxable income while building substantial retirement savings. We model out which plan structure actually fits your income and practice structure.

Entity structure: PC, PLLC, or S-Corp election

Many states require physicians to operate through a Professional Corporation (PC) or Professional Limited Liability Company (PLLC) rather than a standard LLC. Layering an S-Corp election on top of that structure, where permitted, allows splitting income into reasonable salary and distributions, the same mechanism that drives S-Corp tax savings in other industries, but with state-specific rules that need to be confirmed first.

Locum tenens and 1099 income alongside W-2 employment

Many physicians earn 1099 income from locum tenens work or moonlighting shifts alongside W-2 employment at a hospital or group practice. This creates a Schedule C filing with its own deductions, quarterly estimated tax obligations, and potential retirement plan opportunities separate from an employer plan.

Practice buy-ins and buy-outs

Buying into a practice or being bought out has tax consequences that depend heavily on how the transaction is structured, asset purchase versus stock purchase, and whether goodwill is involved. These transactions are worth modeling out with a tax professional before terms are finalized, not after.

Bookkeeping & Payroll

Books built around payer mix and provider payroll

Payer Reimbursement Tracking

Insurance and Medicare/Medicaid reimbursements are tracked from claim to payment, giving you a real accounts receivable picture across a complex payer mix.

Physician & Staff Payroll

Payroll processed for a full range of roles, physicians, nurse practitioners, administrative staff, each classified and compensated correctly.

Retirement Plan Coordination

Books are structured to support high-contribution retirement strategies, tracking employer and employee contributions accurately against plan limits.

Multi-Entity Coordination

Practices structured across a PC and a separate real estate holding entity for the office building are reconciled together, correctly handling intercompany rent and management fees.

Flat-rate pricing for practice bookkeeping and tax
Pricing is based on practice size, payer complexity, and payroll headcount, quoted clearly during your free consultation.
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Frequently Asked Questions

Medical practice tax and bookkeeping, answered directly

It depends on your income level and practice structure. A Solo 401(k) allows meaningful contributions for a solo practitioner, while a defined benefit or cash balance plan can allow six-figure annual contributions for established, high-earning owners. We model your specific numbers before recommending a plan.
In many states, yes, typically through a Professional Corporation or PLLC structure with an S-Corp election layered on top. State-specific rules for professional entities vary, so this needs to be confirmed for your specific state and specialty before assuming it applies.
Locum tenens and moonlighting income is typically reported on Schedule C as self-employment income, separate from your W-2 wages. This creates its own deductions, quarterly estimated tax obligations, and potential retirement plan opportunities beyond what your employer offers.
Reimbursements should be tracked as accounts receivable from the point services are rendered, not recorded as revenue only once cash arrives. This gives an accurate picture of practice profitability rather than one distorted by payer processing delays.
The tax outcome depends heavily on how the transaction is structured, particularly whether it is an asset or stock purchase and how goodwill is treated. These details should be modeled with a tax professional before terms are finalized, since the structure meaningfully changes the tax result for both parties.
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