Bookkeeping and Tax for Las Vegas Med Spas and Clinics
Bookkeeping, payroll, and tax for Las Vegas med spas, IV therapy lounges, and hormone and weight-loss clinics, with profit tracked for every treatment.
Bookkeeping for Las Vegas Med Spas
Las Vegas is one of the top three cities in the country for med spa providers, and new clinics keep opening in Summerlin, Henderson, Spring Valley, and all along the 215. Most are owned by nurse injectors, nurse practitioners, and entrepreneurs who know aesthetics inside and out but never had a reason to learn accounting. The work is cash-pay, product-heavy, and busy, which makes it easy to bring in strong revenue and still wonder where the profit went.
Baker’s Bookkeeping & Tax Services is a family firm that has handled tax and bookkeeping since 1995. Our home office is in Lenexa, Kansas, and we work with Las Vegas owners remotely. Independent healthcare practices are our focus, and med spa and aesthetic clinic bookkeeping is a large share of that work.
Treatment Profitability
Treatment Profitability
Treatment profitability reports show what you keep from each service after product cost and provider commission. Neurotoxin, filler, laser, and microneedling all carry different margins, and a full schedule doesn’t always mean the right mix.
Packages and Memberships
Packages and Memberships
Prepaid packages and monthly memberships are money collected for treatments you still owe. We track them separately and count the revenue as clients come in, so your income isn’t overstated and you always know what’s still owed on the schedule.
Monthly Bookkeeping
Monthly Bookkeeping
Books closed every month in QuickBooks Online with a one-page summary you can read in a few minutes. If you’re months behind, we bring everything current first and then keep it there.
Retail Sales Tax
Retail Sales Tax
Skincare, supplements, and other retail products are taxable in Nevada. We track those sales apart from your services and file the returns on time, including in other states if you ship products to customers outside Nevada.
Las Vegas Practices We Work With
Med spas get most of the attention, but the Las Vegas aesthetics and wellness market is wider than that. IV therapy lounges and mobile IV services that deliver to hotel rooms on the Strip. Hormone and weight-loss clinics that have grown quickly with demand for GLP-1 programs. Cosmetic surgery practices, functional medicine clinics, and longevity clinics. Most of these are cash-pay businesses with memberships, retail products, and staff who are paid in different ways.
Nevada has no state personal income tax, and that draws a lot of practice owners here, many of them from California. It doesn’t mean taxes take care of themselves. The federal return is still the big one, and Nevada has its own business taxes, including the Modified Business Tax on payroll and the Commerce Tax for businesses with more than $4 million in Nevada gross revenue. Our enrolled agents plan for all of it ahead of time so April holds no surprises.
Med Spas and Injector Clinics
Med Spas and Injector Clinics
Single-location clinics and owners with two or three locations across the valley. If your med spa is set up as a management company and a separate medical entity, we keep separate books for each one as part of our medical practice bookkeeping and tax services.
IV Therapy and Mobile IV
IV Therapy and Mobile IV
Bags, vitamins, and supplies add up fast, and mobile services carry vehicle, mileage, and booking platform costs on top of that. We track cost per drip, run nurse payroll through Gusto, and point out worker classification questions early so they don’t turn into problems later.
Hormone and Weight-Loss Clinics
Hormone and Weight-Loss Clinics
Membership revenue, pharmacy and medication invoices, lab fees, and supplement sales. We match program revenue against what it costs to deliver, so you can see which programs actually make money and how your margins shift when medication prices change.
New and Relocating Owners
New and Relocating Owners
Opening a clinic in Las Vegas or moving one here from out of state. We set up the business structure, books, and payroll before your first patient. If you moved from California, we also prepare the part-year return so you pay California only what it’s owed.
Common Questions About This Area
Do you work with Las Vegas med spas even though you're based in Kansas?
Yes. All of our work is done remotely through QuickBooks Online, Gusto, and a secure portal for documents. We have clients in nearly every state, and your practice is handled by an enrolled agent who learns how your clinic runs, not a call center. Our CIO, Marc Eastin, is a practicing neurosurgeon and business owner, so our systems are built around how busy owners actually work.
Nevada has no state income tax. Do I still need tax planning?
Yes. Without a state income tax, the federal return carries all the weight, and aesthetics owners often earn enough for planning to make a real difference. We look at your entity structure, whether an S corporation makes sense, a reasonable owner salary, retirement contributions, and when to buy equipment like lasers. We also keep track of Nevada's Modified Business Tax and Commerce Tax so nothing gets missed.
I moved my practice here from California. Does that affect my taxes?
It can. In the year you moved, you will likely need a California part-year resident return for income earned before you left. We prepare multi-state returns regularly and can sort out what California is owed and what it isn't, then set you up cleanly as a Nevada resident going forward.
How do you handle prepaid packages and memberships?
We track them as money collected for treatments you still owe and count the revenue as clients come in for their appointments. That keeps your income from looking higher than it really is and gives you a clear view of how many prepaid treatments are still on the books.
What does it cost?
Monthly bookkeeping runs $500 to $1,500 a month depending on transaction volume. Treatment profitability reporting is $300 to $600 a month. Each additional entity, such as a separate medical entity, adds $300 to $800 a month. If your books are behind, catch-up is billed at 75% of the monthly fee for each month we bring current.
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