How much does bookkeeping cost for a medical practice?

Most independent medical practices pay between $500 and $1,500 a month for bookkeeping. Where you land in that range depends on several factors.

• How many providers you have
• How many entities the books cover
• How many transactions run through your accounts each month
• Whether the books are current when you start

Payroll and tax returns are priced separately, though most practices end up bundling all three.

Here is how bundled bookkeeping, payroll, and tax pricing usually breaks down at Baker’s. A solo provider practice typically runs $750 to $1,200 a month. A practice with two to six providers runs $1,500 to $2,750 a month. Larger groups and practices with more than one entity generally run $3,000 to $5,000 or more. A common example is a practice that also owns its building through a separate LLC.

If you want the pieces individually, payroll through Gusto is $150 to $400 a month plus $10 to $15 per employee beyond ten. Tax returns for the practice and its owner run $2,500 to $6,000 a year. That includes quarterly estimates and any IRS or state notices, which our enrolled agents handle.

Healthcare bookkeeping costs more than bookkeeping for a typical small business, and the reasons are specific. Insurance payments arrive in batches from multiple payers, often weeks after the visit. A single deposit rarely lines up neatly with what was billed. Good monthly bookkeeping for a practice includes checking that what your billing system says was collected actually reached the bank. That gap is where money quietly goes missing in a lot of practices. Provider pay adds another layer when partners or associates are paid from production. Multi-entity structures mean separate sets of books that still have to tie together. A med spa split into a management company and a physician-owned medical entity is one example.

If your books are behind, expect a one-time catch-up charge. We bill 75% of the monthly fee for each month that needs to be brought current. Take a practice quoted at $1,000 a month that is six months behind. It would pay $4,500 to catch up, then the regular monthly fee going forward. The cost grows with every month the books sit, so it is worth fixing sooner rather than later.

You will find bookkeepers who charge $300 a month. For a small retail shop that may be enough. For a practice billing insurance, a low-cost service usually means someone categorizes your bank feed and stops there. Nobody compares collections to deposits, so a missing payer deposit or a misapplied payment goes unnoticed until your tax preparer inherits the mess.

To get an accurate quote, have a few details ready.

• Your number of providers and staff
• How many bank and credit card accounts you use
• How many entities you operate
• The last month your books were fully reconciled

With that information, we can usually give you a monthly price you can plan around in a single conversation. Baker’s has offered medical practice bookkeeping and tax services to independent practices nationwide, and we would rather you know the real number up front than be surprised later.