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

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Am I supposed to collect sales tax at my spa?

The short answer is probably yes, at least on part of what you sell. Most spa owners have sales tax obligations even when many of their services are exempt.

In most states, injectable treatments and other services performed on the body are not subject to sales tax. Botox, fillers, facials, and similar treatments typically fall outside the sales tax base. But retail products sold at the front desk are almost always taxable. Skincare products, supplements, devices, and anything a client takes home and uses on their own will usually trigger a sales tax obligation.

The line between taxable and exempt can get blurry. A facial might be exempt, but take-home skincare bundled with that facial might not be. Some states tax certain spa services that don’t qualify as medical. The rules vary state by state, and borderline items create real complexity for owners trying to figure this out on their own.

The failure mode here is quiet. If you should be collecting sales tax and you aren’t, the liability is building up month after month without any warning. The state doesn’t send a notice until an auditor finds the problem. When that happens, you owe the back taxes plus penalties and interest, and you can’t go back to clients to collect retroactively. That liability sits with you as the owner. Bookkeeping for medical businesses should catch this before it becomes a problem.

Many med spa owners run the business alongside a clinical job and reasonably assume that since most of their revenue comes from services, sales tax isn’t their concern. But one wall of retail skincare at the front desk changes everything.

Hunter Green CPA provides sales tax management for med spas and aesthetic businesses across the country. The firm determines which of your sales require tax collection in your state and handles filings at $100 per filing.

If you’re not sure whether you’re collecting what you should be, book a consultation and let’s get it right before an auditor finds the gap.

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More Questions

Gift cards, series discounts, GLP-1 program fees: how does all this get booked?

Gift cards, prepaid packages, and recurring program fees are all recorded as liabilities when cash is received, not as revenue. Revenue is recognized when services are actually delivered, keeping your books accurate and your margins visible.

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Where do caregiver overtime rules stand right now?

The federal rules are in flux. The DOL has proposed reinstating the companionship exemption for agencies, but the change is not final and many states require overtime regardless. The safe approach is to budget and pay as if overtime applies.

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What financial red flags should make a med spa owner stop and fix things now?

Six warning signs that are cheap to fix now and expensive to fix later: prepaid package cash spent with services untracked, inventory not counted against sales, uncollected retail sales tax, intercompany fees on paper only, no tax reserve set aside, and books falling behind during growth.

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Plenty of bookkeepers are cheaper. What am I paying for with a specialist?

A specialist already understands your industry's accounting and doesn't learn on your dime. Add CPA-level tax work in the same seat and the price difference often returns itself in avoided mistakes and tax savings.

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My spa revenue doubled but my stress doubled too. What should the finances look like at this stage?

At doubled revenue, your books should show treatment-level margins, monthly inventory reconciliation, provider pay per provider, package liabilities, and tax reserves. If you have an MSA structure, both entities need clean books.

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Everyone in home care argues about 1099 versus W-2 caregivers. What is the truth right now?

Hourly caregivers whose schedules and work an agency controls generally look like employees under the classification tests that matter. The cost of misclassification is severe, including back wages, penalties, and potential personal liability for agency owners.

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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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