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

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A client prepaid for a package of sessions. Is that income now?

The money in your bank account is not automatically income on your books. When a client pays upfront for a package of sessions, that payment is a liability until you deliver the sessions.

Think about what you owe the client. If they paid $1,200 for six sessions and you’ve delivered zero, you owe them six sessions or a refund. That obligation shows up in your books as deferred revenue or unearned revenue. It sits as a liability on your balance sheet, not revenue on your income statement.

As you deliver each session, you recognize a portion as income. After the first session, you move $200 from the liability to revenue. After the second, another $200. This continues until all sessions are delivered and the full amount has moved from liability to income.

This isn’t an optional accounting choice. It’s how accurate books work. Booking the entire $1,200 as income on day one creates several problems. Your profit looks higher than it actually is. You’ll pay taxes on money you haven’t really earned yet. Your books hide the fact that you still owe services to that client. If the client asks for a refund, your financials will show a loss when really you’re just returning unearned money.

This issue shows up constantly in medical businesses. Med spas sell treatment packages and monthly memberships. Therapy practices bundle sessions at a discount. Home care agencies collect deposits for care hours. A CPA who works with medical businesses sees this situation regularly and knows how to set up your chart of accounts correctly from the start.

Your books should always show the outstanding balance you owe to clients in prepaid services. This gives you an accurate picture of what you’ve actually earned versus what you still need to deliver. It also keeps your tax liability aligned with income you’ve genuinely recognized.

If your current bookkeeping dumps prepaid packages straight into revenue, that’s a problem worth fixing. Monthly full-service bookkeeping ensures deferred revenue is tracked properly and income gets recognized correctly as sessions are delivered.

If you’re not sure how prepaid packages are flowing through your books, let’s take a look together. Book a consultation and we can review how your revenue is being recorded.

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More Questions

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 can I tell which of my services earn money and which just stay busy?

Track the direct costs that go into each service and compare them to what you charge. Many owners find that their busiest services aren't their most profitable, and without cost tracking there's no way to know which is which.

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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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How much can my business put into retirement for me in 2026?

For 2026, a solo 401(k) allows contributions up to $72,000 if you're under 50, $80,000 if you're 50 or older, and $83,250 for ages 60 to 63. A SEP IRA caps at $72,000 but requires much higher income to reach that level.

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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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Can one person handle both my business return and my personal return?

Yes, and for pass-through owners it's practically necessary. Your business return generates a K-1 that flows directly onto your personal return. Having one CPA see both sides means better coordination of salary, distributions, and deductions.

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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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