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

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Memberships and packages bring cash in early. Where is the catch?

The catch is that the cash is not income yet. When a client buys a package of six facials or signs up for a monthly membership, that payment lands in your bank account but it does not belong on your income statement until you deliver the treatments. Until then, that money represents services you still owe. In accounting terms, it is a liability.

Spending prepaid cash as if it were income is one of the most common ways med spas and aesthetic clinics get into trouble. You sell a lot of packages. The bank balance looks great. You buy new equipment, hire another provider, or take a distribution. A few months later, clients show up to redeem their prepaid treatments and there is no cash left to cover the cost of delivering them. You owe the services but the money is gone.

The fix is to record the sale correctly from the start. When a client pays $600 for a package of six treatments, the books should show a liability called deferred revenue or unearned revenue. As the client uses each treatment, you move $100 from the liability to income. Medical practice accounting that handles this correctly means your books always show what you have actually earned versus what you still owe in services.

Your monthly financial reports should include the outstanding prepaid balance. If you sold $20,000 in packages this month and clients redeemed $8,000 worth of prepaid services, the liability grew by $12,000. That is fine if you planned for it. It is a problem if you thought you had $20,000 to spend.

Many spa owners check the bank balance and assume things are fine. The real picture only shows up when the books track prepaid obligations correctly. This is exactly the kind of detail that full-service bookkeeping should handle each month. If your current bookkeeping treats package sales as immediate income, those financial statements are misleading you.

If your books do not currently track prepaid packages and memberships as liabilities, it is worth getting that fixed. Reach out to book a consultation and we can talk through how to set this up correctly.

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We serve school districts on contract. What does that mean for our books?

School district contracts mean your books should track earned, invoiced, and paid revenue separately for each contract. The school-year rhythm creates summer cash gaps that require planning, and prompt invoicing is the biggest lever you control.

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What is a medical director fee and how should it be recorded?

A medical director fee is compensation paid to a supervising or sponsoring physician for clinical oversight. It should be recorded in the correct entity, match the documented agreement, and stay consistent month to month.

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I have a feeling my old returns left money on the table. Is it recoverable?

A prior-return review sometimes finds missed deductions, credits, or elections that can be recovered through amended returns filed within about three years of the original deadline. Beyond that window, any findings become forward-looking fixes rather than refunds.

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

You can often deduct most or all of the equipment cost in the first year using Section 179 or bonus depreciation. This applies even if you financed the purchase with a loan.

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How should injectables be handled in my books?

Injectables are inventory, not an expense at purchase. Record them as an asset when they arrive, then move cost to expense as units are used on clients. This approach shows you true cost per treatment and surfaces waste.

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My business now operates in two states. What did I just get myself into?

Operating in two states means you now have filing obligations in both. You'll likely need to register with the second state, file income tax returns there, and if you have employees or taxable sales in that state, handle payroll withholding and sales tax too.

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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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