Bookkeeping & Tax for Boston Medical Practices
Bookkeeping, payroll, and tax for Boston physician practices, med spas, and therapy groups. Handled remotely by enrolled agents who learn how your practice runs.
Serving Boston Practices and Physicians
Boston has one of the highest concentrations of doctors in the country. Mass General, Brigham and Women’s, Beth Israel Deaconess, Boston Children’s, and Dana-Farber train and employ thousands of physicians. Many of them eventually open practices of their own or take on paid work outside the hospital. We provide medical practice bookkeeping and tax services for those practices and the people who run them.
We’re based in Lenexa, Kansas, and have handled tax and bookkeeping work since 1995. Boston clients work with us remotely. Your books live in QuickBooks Online, payroll runs through Gusto, and a team of enrolled agents learns how your practice actually operates. You talk to the same people every month, not a call center.
Monthly Bookkeeping
Monthly Bookkeeping
Books closed every month with a one-page summary of where the practice stands. If you bill insurance, we compare what your billing system says was collected against what actually reached the bank. If the books are behind, we bring them current first.
Massachusetts Payroll
Massachusetts Payroll
Front desk staff, clinical staff, and providers paid on time through Gusto. We handle state withholding, Paid Family and Medical Leave contributions, quarterly filings, and multi-state payroll for staff who live in New Hampshire or Rhode Island.
Tax Planning for High Earners
Tax Planning for High Earners
Practice owners in Boston often earn enough to be affected by the state’s 4% surtax on income above roughly $1 million. Each year we review business structure, owner salary, retirement contributions, and equipment purchase timing so the tax bill doesn’t catch you off guard.
Side Income for Hospital Physicians
Side Income for Hospital Physicians
Plenty of Boston doctors are employed by a hospital system and also earn money from locums shifts, expert witness work, or a medical directorship. Our side-income package for employed physicians covers the bookkeeping, quarterly estimates, and returns. Our CIO is a practicing neurosurgeon, so we know this situation firsthand.
Boston Practices We Work With
Outside the large hospital systems, Boston has a deep base of independent practices. Med spas line Newbury Street and continue into the Seaport and the surrounding suburbs. Therapy and psychology groups fill offices in Brookline, Cambridge, and Jamaica Plain. Physicians who trained here often stay and open their own doors.
Each of these practices brings in money differently. Some rely on insurance reimbursements. Others run on cash-pay treatments, prepaid packages, or memberships. Many pay clinicians by the session. We set up the books to match how your practice earns and spends, so the reports you get mean something.
Therapy, Psychology, and Psychiatry Groups
Therapy, Psychology, and Psychiatry Groups
Boston has one of the largest mental health practice communities in the country. For behavioral health group practices, the hardest money problem is usually paying clinicians correctly. We calculate session-based pay from the agreements you already have. Our president holds a master’s in clinical psychology and understands how these practices work.
Med Spas and Aesthetic Clinics
Med Spas and Aesthetic Clinics
Boston is one of the top ten med spa markets in the country, and competition is real. We track profit per treatment after product cost and commissions, record prepaid packages and memberships so revenue isn’t overstated, and file sales tax on retail skincare.
Independent Physician Practices
Independent Physician Practices
Primary care, dermatology, surgical specialties, and pain management groups that have stayed physician-owned in a market full of large systems. We keep separate books for the practice and the building entity when there is one, and calculate provider pay from your production reports.
Direct Care and Concierge Medicine
Direct Care and Concierge Medicine
Doctors leaving hospital employment to open direct primary care, concierge, or integrative practices. We set up the entity, books, payroll, and software before your first patient visit, then track membership revenue and retail sales month to month.
Common Questions About This Area
Do you have an office in Boston?
No. Our home office is in Lenexa, Kansas, and we work with Boston clients remotely. We have clients in nearly every state and handle Massachusetts payroll and tax filings as part of our regular work. Documents come in through a secure portal, and you can reach the same team every month.
I'm employed by a Boston hospital but earn extra income from expert witness work. Can you help?
Yes. This is common in Boston. Side income from expert witness work, locums shifts, consulting, or a medical directorship brings quarterly estimates, deductible expenses, and sometimes a separate entity. We keep the books for that income and prepare your returns so it stays organized and separate from your hospital paycheck.
Can you help with the Massachusetts surtax on high incomes?
Yes. Many practice owners in Boston earn enough to be affected by the state's 4% surtax on income above roughly $1 million. We look at business structure, owner pay, retirement contributions, and the timing of large purchases each year so you can plan around it instead of reacting at filing time.
Our therapy group pays clinicians per session. Can you calculate that?
Yes. We calculate session-based pay every pay run using the compensation agreements your practice already has, then run payroll from those numbers. We don't design or advise on compensation plans because clinician pay is subject to medical compliance rules. Our job is to apply your agreements accurately and on time.
What does monthly bookkeeping cost for a Boston practice?
Monthly bookkeeping runs $500 to $1,500 per month depending on transaction 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 we need to bring current. We give you a flat quote after reviewing your books.
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