Bookkeeping and Tax for Austin Medical Practices
Bookkeeping, payroll, and tax for Austin's direct primary care, concierge, and integrative medicine practices. Built for doctors running a business for the first time.
Bookkeeping for Austin Practices
Austin has become one of the leading cities in Texas for direct primary care. Many of the physicians opening these practices spent years inside a hospital system or a large medical group before deciding to work for themselves. They know medicine. Most have never had to run payroll, close a month, or figure out how a membership fee belongs on the books. That is the work we do for direct primary care and integrative medicine practices across the city.
Baker’s Bookkeeping & Tax Services has handled tax, bookkeeping, and payroll since 1995. We are based in Lenexa, Kansas, and work with Austin practices remotely through QuickBooks Online and Gusto. Tax returns and IRS notices are handled by enrolled agents who get to know your practice. Our Chief Information Officer is a practicing neurosurgeon who also owns a business, so we understand what it is like to be the doctor on the other side of the table.
Opening Your Practice
Opening Your Practice
Leaving employment means making decisions about entity type, bank accounts, payroll, and software before the first patient walks in. Our new practice setup service puts all of it in place before you open, so you are not untangling it six months later.
Monthly Bookkeeping
Monthly Bookkeeping
Books closed every month with a one-page summary you can read in a few minutes. Membership fees, retail sales, and any insurance or lab revenue recorded correctly. If you have fallen behind, we bring the books current first.
Tax Planning in a No Income Tax State
Tax Planning in a No Income Tax State
Texas does not tax personal income, so the federal return is where your money goes. That makes S-corp status, how much you pay yourself, retirement contributions, and when you buy equipment matter even more. We build a plan each year instead of waiting for April.
Payroll
Payroll
Medical assistants, nurses, front desk staff, and providers paid on time through Gusto. Federal deposits, Texas unemployment tax, and year-end W-2s handled. If you hire a provider or remote staff in another state, we cover that too.
Austin Practices We Work With
Austin’s growth has brought a lot of people with good incomes and high expectations for their care. Concierge practices in Westlake, functional medicine clinics in central Austin, med spas around the Domain, and DPC practices spreading out to Round Rock, Cedar Park, and Dripping Springs. Patients here are willing to pay directly for more time with a doctor, and a whole set of practices has grown up around that.
Most of these practices are cash-pay or membership-based, which changes how the books work. Money often comes in before care is delivered, retail products carry sales tax, and the owner is usually running a business for the first time. We provide healthcare bookkeeping services built around those differences rather than borrowed from a general small business template.
Direct Primary Care and Concierge
Direct Primary Care and Concierge
Monthly and annual memberships, a small staff, and a doctor who wants to know whether the panel actually covers the overhead. We record annual fees paid upfront over the months they cover, so your numbers show what you earned and not just what you collected.
Functional and Integrative Medicine
Functional and Integrative Medicine
Hormone therapy, weight-loss programs, IV clinics, and practices that sell supplements at the front desk. Many of those products are taxable in Texas. We file sales tax on time and keep product costs separate so you can see what each program earns.
Med Spas and Aesthetic Clinics
Med Spas and Aesthetic Clinics
Texas is strict about who can own a medical practice, so many med spas run as a management company alongside a physician-owned medical entity. We keep separate books for each, track profit per treatment after product cost and commissions, and record prepaid packages so revenue isn’t overstated.
Behavioral Health Groups
Behavioral Health Groups
Therapy and psychiatry groups with clinicians paid by the session. We calculate clinician pay each pay run from the compensation agreements you already have and run payroll from there. Marcella Nichols, our President, holds a master’s in clinical psychology and spent years in HR, so this work is familiar ground.
Common Questions About This Area
You're based in Kansas. Can you really serve an Austin practice?
Yes. Our remote division was built to serve practices across the country, and we already work with clients in nearly every state, Texas included. Everything runs through QuickBooks Online, Gusto, and a secure portal. Your work is handled by enrolled agents who learn your practice, and you can reach them by phone, email, or video.
Texas has no state income tax. Do I still need tax planning?
Probably more than you would somewhere else. Without a state return, nearly all of your income tax goes to the IRS, so federal planning is where the savings are. Entity choice, owner salary, retirement contributions, and the timing of equipment purchases can make a real difference for a high-earning practice owner.
I'm leaving a health system to start a direct primary care practice. When should I reach out?
Before you open, ideally a few months ahead. Choosing the right structure and setting up the books, payroll, and software from day one is much easier than fixing them after a year of seeing patients. New practice setup runs $500 to $5,000 one time depending on what you need.
What does monthly bookkeeping cost?
Monthly bookkeeping runs $500 to $1,500 a month depending on volume and complexity. If your books are behind when we start, catch-up work is billed at 75% of the monthly fee for each month behind. We quote a set price after we look at your practice.
Do you file Texas sales tax on supplements and skincare?
Yes. If your practice sells supplements, skincare, or other retail products, we track what is taxable and file returns on time with the Texas Comptroller and in any other state where you sell. This comes up often for integrative medicine clinics and med spas in Austin.
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