Medical Spas & Aesthetic Clinics
We show you what each treatment earns after product and commissions, and keep package money from inflating your numbers.
The Business You Built
Most med spas are started by people who are very good at the work. They are nurse injectors, aestheticians, physicians who wanted something different, and entrepreneurs who saw the demand. The clinical skills came from years of training. The finance side usually came from figuring it out along the way.
The industry has grown fast. There are about 10,500 med spas in the US. Most are a single location bringing in around $1.4 million a year. With no insurance to bill, it can look like the simplest kind of healthcare business to keep books for. Clients pay and the money lands in the bank. In practice, that money arrives in ways that make your reports harder to trust than they appear.
Who This Covers
Who This Covers
Med spas, aesthetic and laser clinics, cosmetic dermatology, plastic and cosmetic surgery practices, and hair restoration clinics. We work with owners who are nurses, physicians, or business partners running a cash-pay practice anywhere in the country.
What Makes It Different
What Makes It Different
Clients prepay for packages and memberships long before their treatments happen. Product like neurotoxin and filler is expensive and gets used by the unit or the syringe. Injectors and aestheticians often earn commissions. Many spas run two separate legal entities, and most sell retail skincare that carries sales tax.
What We Handle
We close your books every month in QuickBooks Online and send a one-page summary you can read in a few minutes. If your books are behind, we bring them current first. From there we build the reporting a med spa actually needs, starting with what each treatment earns once product and commissions come out.
Money collected for packages and memberships is recorded as service you still owe until the client comes in. It moves to revenue as treatments are delivered. If your spa is set up as a management company plus a physician-owned medical entity, each one gets its own books. Payroll runs through Gusto, and sales tax on retail products is filed on time in every state where you sell.
Profit per Treatment
Profit per Treatment
For neurotoxin, filler, laser, microneedling, and the rest of your menu, we track revenue against the product used, the provider’s commission, and card fees. You see which services carry the business and which ones keep your schedule full without leaving much behind.
Packages and Memberships
Packages and Memberships
Prepaid packages, membership dues, banked credits, and gift cards are tracked as a balance you owe clients in treatments. Revenue shows up when the work is done. You always know how many prepaid sessions are still waiting to be used.
Where It Goes Wrong
The most common problem is counting package money as income the day it is collected. Say a client buys six laser sessions for $1,800 in January. If the full amount is booked as January revenue, that month looks strong and the following months look weak, even though you are doing the same work. Add a big holiday promotion and your reports can show a profitable year while hundreds of prepaid treatments are still on the calendar.
Treatment pricing is the second blind spot. A $260 neurotoxin appointment might use $120 in product, pay a 20% commission, and lose a few dollars to card fees. That leaves about $80 to cover rent, the front desk, marketing, and equipment. Discounts shrink that number quickly, because the vial costs the same whether the treatment was on sale or not. Without treatment-level numbers, most owners do not see this until cash gets tight.
Two Entities, One Bank Account
Two Entities, One Bank Account
Rules in many states about who can own a medical practice lead med spas to split into a management company and a physician-owned medical entity. When both run through one account or the management fee never gets recorded, the separation only exists on paper. That creates tax problems and makes it hard to show the structure is actually being followed.
Sales Tax on the Retail Shelf
Sales Tax on the Retail Shelf
Skincare, sunscreen, and take-home products are usually taxable even when treatments are not. Spas that ring up product sales without collecting and filing sales tax can end up owing years of back tax plus penalties once a state takes notice.
What Changes
You make menu and pricing decisions from real margins. You know which treatments earn the most for each hour of provider time, which promotions brought in clients worth keeping, and which ones moved product at a loss. Commission costs make sense when you can see them next to the revenue they produce.
Your reports tell the truth about each month. Revenue reflects treatments delivered, the prepaid balance is always visible, and each entity’s books stand on their own. Our enrolled agents prepare your returns and quarterly estimates. Tax planning looks at owner pay, retirement contributions, and the timing of your next laser or device purchase.
Confidence to Grow
Confidence to Grow
Most med spas are a single location. If you are thinking about a second one, a new device, or another injector, you have numbers that show whether the business can support it and what it will take to get there.
Time Back for Your Clients
Time Back for Your Clients
Bills, payroll, sales tax, and the month-end close stop following you home. Your evenings are no longer spent in spreadsheets, and your days go back to the work that built the spa in the first place.
A Family-Run Firm Since 1995
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