Bookkeeping and Tax for Washington, DC Medical Practices
Bookkeeping, payroll, and tax for concierge, direct primary care, and independent practices in Washington, DC and the surrounding Maryland and Virginia suburbs.
Bookkeeping for Washington, DC Practices
The Washington area is the second-largest market in the country for concierge medicine and direct primary care, and it has more primary care physicians per resident than anywhere else in the US. Many of those doctors spent years inside hospital systems before opening their own practices. Running a concierge or direct care practice means learning payroll, taxes, and membership revenue on top of seeing patients.
The metro adds a complication most markets don’t have. A practice on Connecticut Avenue might employ a nurse who lives in Silver Spring and a practice manager who commutes from Arlington, while the owner lives in Bethesda. That is three tax jurisdictions before the first patient walks in. We’re a family-run bookkeeping and tax firm based in Lenexa, Kansas, and our remote team handles this for practices across the District, Maryland, and Northern Virginia.
Payroll Across DC, Maryland, and Virginia
Payroll Across DC, Maryland, and Virginia
Withholding follows where each employee lives, unemployment follows where they work, and DC adds its own paid family leave tax. We run staff and provider payroll through Gusto so every person is set up correctly from the first pay run.
Monthly Bookkeeping
Monthly Bookkeeping
Books closed every month with a one-page summary. Concierge retainers paid up front are spread across the months they cover, so a strong January doesn’t make the rest of the year look thin. For hybrid practices that still bill insurance, we check that collections actually reached the bank.
Tax Returns and Planning
Tax Returns and Planning
Returns for the practice and the owner, including nonresident and part-year filings. DC doesn’t follow the federal S-corp election the way Maryland and Virginia do, so business structure and owner pay need a closer look here. Enrolled agents handle the work and any notices that arrive.
New Practice Setup
New Practice Setup
Leaving a health system to open your own practice? We set up the entity, books, payroll, and software before you open. Your first month runs on a real system instead of a spreadsheet you meant to fix later.
Washington Practices We Work With
Our focus is independent medical and healthcare practices, which fits the Washington area well. Between the District, Montgomery County, Fairfax, and Arlington, there are hundreds of small practices owned by the physicians and clinicians who work in them. Most have between one and ten providers and nobody on staff whose job is the finances.
Our Chief Information Officer, Marc Eastin, is a practicing neurosurgeon who also owns a business. Our President, Marcella Nichols, holds a master’s in clinical psychology. We offer healthcare bookkeeping services shaped by people who understand the clinical side and still treat the numbers carefully.
Concierge Medicine
Concierge Medicine
Annual retainers, hybrid billing, and patient panels kept small on purpose. With fewer patients, each one carries more weight in revenue. We track membership income and renewals so you know where the practice stands each month.
Direct Primary Care
Direct Primary Care
Monthly memberships, in-house labs, and medications dispensed at cost. Many DPC owners also sell supplements, which can bring sales tax filings. We keep memberships, product sales, and supply costs separate so the margins are easy to see.
Independent Physician and Specialty Practices
Independent Physician and Specialty Practices
Insurance-based primary care, pediatrics, dermatology, and surgical groups. We check billing reports against deposits, calculate provider pay from your existing compensation agreements, and keep separate books for a building entity if you own your space.
Behavioral Health Groups
Behavioral Health Groups
Therapy and psychiatry groups across the District and the suburbs. Clinicians paid by the session need accurate pay every run. We calculate it from the terms your agreements already set and run payroll from there.
Common Questions About This Area
You're based in Kansas. Why would a Washington practice work with you?
Our remote services division was built for practices outside Kansas City, and we have clients in nearly every state. Bookkeeping, payroll, and tax work happen in QuickBooks Online and Gusto no matter where we sit. A DC practice needs a team that knows how the District, Maryland, and Virginia rules fit together, and we do that work every month.
Our office is in DC, but our staff live in Maryland and Virginia. Can you handle that?
Yes. This is one of the most common setups in the metro. We register the practice where it needs to be registered, withhold the right state tax for each employee based on where they live, and handle Maryland county tax for staff who live there. DC paid family leave contributions are included.
I'm leaving a hospital job to open a concierge or DPC practice. When should I reach out?
Before you open, ideally a few months ahead. New practice setup covers the entity, books, payroll, and software, and it costs $500 to $5,000 one time depending on how much is involved. Getting the structure right early matters more in DC than in most places because of how the District taxes businesses.
What does monthly bookkeeping cost?
Between $500 and $1,500 per month depending on the size and complexity of the practice. If your books are behind when we start, each month of catch-up is billed at 75% of the monthly fee.
Do you prepare DC, Maryland, and Virginia tax returns?
Yes. We prepare returns for the practice and the owner, including nonresident and part-year returns when you live in one jurisdiction and work in another. Enrolled agents handle the work and respond to any IRS or state notices. Baker's is a bookkeeping and tax practice, and we've been preparing returns since 1995.
A Family-Run Firm Since 1995
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