Med Spas
Bookkeeping, multi-entity accounting, and tax work built for med spas. MSA structures, injectable inventory, provider commissions, prepaid packages, and retail sales tax make med spa books genuinely complicated. Hunter Green CPA already knows this world.
The Owner
Most med spa owners are clinicians first. Nurses, nurse practitioners, physician assistants, physicians. They started the spa as a business venture on top of their clinical career, and many are still working full-time at a hospital or practice while running the med spa on the side. Strong W-2 income. A growing business. And absolutely no time to deal with the books.
The med spa itself is a financially complicated business. MSA structures, injectable inventory, provider commissions, prepaid packages, retail sales tax, equipment financing, marketing spend that is hard to track. Most bookkeepers and accountants do not know how any of this works. Hunter Green CPA does. This is our deepest specialty, and we built our firm around medical business owners just like you.
Who Runs Med Spas
Who Runs Med Spas
Nurses, NPs, PAs, and physicians. Often running the spa alongside a full-time clinical job with significant W-2 income. High earners building a business with no time for the financial back office and no margin for error in the books.
Why the Books Get Messy
Why the Books Get Messy
MSA structures mean multiple entities and effectively two sets of books. Add injectable inventory, provider commissions, prepaid treatment packages, and retail sales, and you have a business that looks nothing like a typical small business. Generic bookkeeping does not fit.
The Financial Complexity
In many states, a med spa operates through a management service agreement with a sponsoring physician or a physician-owned clinical entity. That means two entities, two sets of books, and intercompany transactions that need to be handled correctly. The management entity pays the clinical entity under the MSA, and both sides need clean, separate records that support the structure your attorney set up. We handle the multi-entity and MSA accounting and coordinate with your attorney on the legal side.
Beyond the MSA structure, the spa itself has moving parts. Injectable inventory needs to be tracked so you know what you are using and what it costs. Provider commissions need to be calculated accurately for payroll. Prepaid treatment packages and memberships are liabilities on your books until the services are actually delivered. Retail skincare products require sales tax collection and filing. Equipment purchases often involve financing that needs proper accounting treatment. Each of these creates work that standard bookkeeping ignores.
MSA and Multi-Entity Accounting
MSA and Multi-Entity Accounting
We maintain separate books for each entity, record intercompany transactions correctly, and keep your financial records aligned with your legal structure. The firm provides the accounting. We do not provide legal advice on corporate practice of medicine rules or MSA drafting, and we coordinate with your attorney on the structure itself.
Inventory, Commissions, and Prepaid Revenue
Inventory, Commissions, and Prepaid Revenue
Injectable and supply inventory tracked by product so you can see true cost per treatment. Provider commissions calculated accurately. Prepaid packages and memberships recorded as liabilities and recognized as revenue when services are delivered, not when money hits the bank.
What Goes Wrong
The most common problem we see is books that do not separate the entities properly. The MSA structure exists for a reason, but if the accounting mixes everything together or records intercompany transactions incorrectly, the financial records do not support the structure. That creates risk. We also see prepaid packages recorded as revenue the moment they are sold, which overstates income and creates a tax liability on money that has not been earned yet. Sales tax on retail products gets missed entirely.
Inventory often goes untracked. The owner knows they are spending heavily on injectables and supplies, but has no idea what margin they are actually making on each treatment. Marketing spend is another blind spot. Med spas often spend significantly on digital advertising, influencer partnerships, and promotions. Without proper tracking, there is no way to see which efforts actually bring in business and which ones just burn cash.
Revenue Recognition Errors
Revenue Recognition Errors
A client buys a prepaid package for $2,000. That is not $2,000 of revenue today. It is a liability. Revenue is recognized as sessions are delivered. Recording it wrong overstates your income, creates tax problems, and makes the books unreliable for any real decision making.
No Visibility Into What Works
No Visibility Into What Works
You know you are spending on marketing and paying provider commissions, but do you know the margin on Botox versus filler versus laser treatments? Do you know which marketing channels actually drive appointments? Without proper tracking, you are guessing at the most important questions in your business.
What Changes
You get books that actually reflect how your business operates. The management entity and clinical entity each have clean records that support the MSA structure. Intercompany transactions are documented correctly. Prepaid revenue is handled properly. Inventory is tracked. Sales tax is filed on time. You can see what each treatment line actually costs and earns, and you can tell whether your marketing spend is working.
The tax side gets the attention it deserves. You are a high earner with W-2 income and business income, and the right entity structure and planning approach can make a real difference in what you pay. We handle the ongoing bookkeeping and work proactively on tax strategy throughout the year. When you bundle everything in our Bookkeeping and Tax Package, the same CPA who keeps the books all year prepares the returns. Nothing falls through the cracks.
Records That Support the Structure
Records That Support the Structure
Your attorney set up the MSA and entities for a reason. The accounting needs to match. Clean, separate books for each entity, with intercompany activity documented properly. When anyone looks at your records, they see a business that operates the way the legal structure says it should.
Tax Planning for a High Earner
Tax Planning for a High Earner
Entity structure, timing of income and deductions, retirement contributions. When you are earning well both clinically and through the med spa, proactive tax planning matters more than it does for most small business owners. We handle it year-round, not just at filing time. Reach out for a consultation and let us show you how we work.
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Tell us about your business and what you need help with. We'll ask a few questions, explain how we can help, and tell you exactly what it will cost.