Bookkeeping and tax for medical businesses • Personal tax returns for individuals

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I bought an expensive laser or piece of equipment. How does the write-off work?

The good news is you can likely deduct most or all of that equipment cost in the first year, even if you financed the purchase.

Two provisions in the tax code make this possible. Section 179 allows businesses to deduct the full purchase price of qualifying equipment in the year you place it in service. Bonus depreciation works similarly, allowing a large percentage of the cost as a first-year deduction. The exact bonus depreciation percentage has been phasing down from 100% in recent years, so current rules should be verified for the year you place the equipment in service. For most medical business equipment purchases, one or both of these provisions will let you write off the full amount right away rather than spreading it over five or seven years through regular depreciation.

The part that surprises many owners is how financed purchases work. The deduction happens when you put the equipment in service, not when you pay for it. If you finance a $150,000 laser with a loan, you still get to deduct $150,000 in year one. The loan shows up as a liability on your books and you make payments over time, but the tax benefit happens upfront.

This is where tax strategy matters. A $150,000 deduction does more for you in a year when you have $200,000 in profit than in a year when you have $50,000. If you are considering a major equipment purchase, think about your expected income for the year before you buy. Purchasing in December of a strong year versus January of the next year can change your tax outcome significantly.

The equipment that qualifies includes most tangible property used in your business. Lasers, treatment devices, therapy equipment, and vehicles used for mobile patient care all generally fit. There are dollar limits and income requirements that apply, but most medical business purchases fall well within them.

One more thing to know. If you use equipment for both business and personal purposes, only the business-use percentage qualifies. A vehicle used 80% for mobile patient visits and 20% for personal errands would have 80% of its cost eligible for the deduction.

Working with a CPA for medical businesses before you buy lets you time the purchase and structure things correctly. If you recently bought equipment or are planning a purchase and want to make sure you get the full tax benefit, book a consultation and we can walk through your situation.

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More Questions

Cash basis or accrual: which fits a medical business?

Cash basis is simpler and works for many small practices, but insurance reimbursement lag and prepaid packages mean medical businesses often need accrual-style visibility. Many owners start with cash-basis books while tracking receivables and package liabilities separately.

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How long do I need to keep receipts and financial records?

Keep most business financial records for seven years to cover the IRS's standard audit window and extended periods for income understatement. Payroll records need at least four years. Cloud bookkeeping with digital receipt storage makes retention automatic rather than a filing cabinet project.

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What does a properly built chart of accounts do for a medical business?

A properly built chart of accounts separates revenue by service line, splits direct delivery costs from overhead, and tracks prepaid package liabilities. Without this structure, your books show totals but cannot answer margin questions.

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Does the QBI deduction still exist, and do I qualify?

Yes, the 20 percent qualified business income deduction is now permanent. But healthcare businesses are classified as specified service trades, which means income thresholds determine whether you can claim it.

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How do quarterly estimated payments actually work?

The IRS requires self-employed individuals to pay taxes throughout the year via four quarterly payments. Missing these payments triggers penalties even if you pay the full balance in April. Safe harbor rules based on last year's tax make the amounts predictable, and clinicians with W-2 jobs can sometimes increase withholding instead.

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What changed with 1099 rules, and what do I file this January?

The $2,000 reporting threshold applies to payments made in 2026, not 2025. This January, you still file 1099s for contractors who received $600 or more. The first filings under the new threshold happen in January 2027.

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Hunter Green CPA provides bookkeeping, tax preparation, and tax strategy for medical business owners across the United States. Alongside its business services, the firm prepares personal tax returns for individuals and families. Based in Oak Park, Illinois and led by Mason Hunter, a CPA with 10 years of tax experience and a background in corporate tax management.

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