Accounting for Medical & Dental Practices
Specialized CPA, tax, and financial guidance for physicians, dentists, and group practices in Garden City, across Long Island, and beyond. We help providers keep more of what they earn while staying fully compliant.
Reviewed by James R. Hurley, CPA · June 2026
Your practice is a business. We treat it like one.
Running a medical or dental practice means carrying two jobs at once: caring for patients and operating a small business with payroll, expensive equipment, and a tax profile that grows more complicated every year you succeed. Generic accounting software does not understand the difference between a professional corporation and a sole proprietorship, or why an associate dentist might be a contractor in one arrangement and an employee in another. We do.
JRH & Associates works with solo practitioners, multi-physician groups, and dental partnerships throughout Long Island and the tri-state area. We combine entity structuring, retirement-plan design, and proactive tax planning into a single relationship, so the decisions you make about your corporation, your staff, and your equipment all work together rather than against each other. The result is a practice that is easier to run and a tax bill that reflects real planning.
Practice entity structure and the S-corp election
Most practices operate through a professional corporation (PC) or professional limited liability company (PLLC) because state law requires a licensed structure. The bigger lever is the tax election layered on top. For an established practice with healthy net income, electing S-corporation treatment can split earnings between a reasonable salary and distributions, reducing the self-employment tax that would otherwise apply to every dollar. We model your actual numbers, factor in the number of owners and your retirement-plan goals, and recommend the structure that fits, not a one-size template.
Equipment purchases and depreciation
Imaging systems, chairs, lasers, and operatory build-outs are major investments, and how you write them off changes your taxable income for years. Section 179 expensing and bonus depreciation can accelerate deductions in the year you place equipment in service, while a measured approach can preserve deductions for higher-income years ahead. We coordinate the timing of large purchases with your overall tax picture so the deduction lands where it does the most good.
Retirement plans for high earners
Physicians and dentists are often in the highest tax brackets and need to shelter more than a standard 401(k) allows. After maximizing a 401(k) with profit sharing, an owner can layer on a defined benefit or cash balance plan that permits substantial additional contributions, fully deductible to the practice. These plans require actuarial design and careful coordination with associate and staff coverage rules, which is exactly the kind of work we handle alongside your tax and accounting services.
Payroll, associates, and accountable plans
Adding associates, hygienists, and administrative staff brings payroll tax filings, benefits questions, and worker-classification decisions that carry real penalties when handled incorrectly. We set up compliant payroll and put an accountable plan in place so the practice can reimburse owners and associates for home-office use, vehicle expenses, and continuing education on a tax-free basis, with the documentation to support every dollar.
Buying or selling a practice
Whether you are acquiring a retiring colleague's practice or planning your own exit, the structure of the deal drives the after-tax result. Purchase-price allocation across equipment, goodwill, and restrictive covenants matters to both buyer and seller, and the entity you sell from affects whether gain is taxed as ordinary income or at capital-gain rates. We help structure the transaction, model the tax consequences, and coordinate financing so the numbers work for the life stage you are in.
"The mistake I see most often with practices is treating the corporation, the retirement plan, and the equipment decisions as three separate conversations. They are one conversation. When you plan them together, a successful physician or dentist can legally save a remarkable amount, year after year."
James R. Hurley, CPA Founder & President, JRH & Associates Built for healthcare providers
Entity structure & S-corp election
PC and PLLC setup with the tax election that fits your income and ownership.
Equipment depreciation planning
Section 179 and bonus depreciation timed to your overall tax picture.
Defined benefit & cash balance plans
High-contribution retirement plans designed for owner physicians and dentists.
Payroll for associates & staff
Compliant payroll, classification guidance, and quarterly filings.
Accountable plans
Tax-free reimbursement of home-office, auto, and CE expenses, fully documented.
Practice purchase & sale
Deal structuring and purchase-price allocation for buying or exiting a practice.
Medical & dental practice accounting FAQs
For many established practices, electing S-corporation status (often through a professional corporation or professional limited liability company) can reduce self-employment tax by splitting income between reasonable W-2 salary and distributions. The right answer depends on your net income, the number of owners, your state professional-entity rules, and your retirement plan goals. We model the actual numbers for your practice before recommending an election, because a structure that helps a solo dentist may not fit a multi-physician group.
High earners often max out a 401(k) and profit-sharing plan and still have room to shelter more income. A defined benefit or cash balance plan layered on top can allow six-figure annual contributions for an owner who is closer to retirement, with the contribution deductible to the practice. These plans require an actuary and careful coordination with associate and staff coverage, so we design them alongside your payroll and entity structure rather than in isolation.
Most practice transactions are asset sales, and how the purchase price is allocated across equipment, goodwill, a restrictive covenant, and supplies drives the tax result for both sides. Buyers generally want faster write-offs, while sellers often prefer capital-gain treatment on goodwill. We help structure the allocation, advise on financing the equipment purchase, and coordinate the entity setup so the transaction is efficient on both ends.
Yes, through a properly documented accountable plan. When the practice reimburses an owner or associate for legitimate business use of a home office, vehicle, or continuing-education travel under an accountable plan, the reimbursement is deductible to the practice and tax-free to the recipient. Without a written plan and substantiation, those same payments can become taxable wages, so the documentation matters.
It depends on whether the associate is an employee or an independent contractor, which is a fact-specific determination that affects payroll tax, benefits eligibility, and malpractice arrangements. Misclassifying an associate is a common and costly error. We set up compliant payroll, handle the quarterly and annual filings, and make sure associate compensation is documented in a way that supports your entity and retirement-plan strategy.
Talk to a CPA who understands your practice.
Your first consultation is free. We will review your entity, your retirement plan, and your tax position, then show you exactly where the opportunities are.