Tax Planning and Accounting for Dermatologists

A dermatology practice can be three businesses under one roof: insurance-based medical dermatology, cash-pay cosmetic services, and a retail skincare counter. Add Mohs surgery, a dermatopathology lab, or an affiliated med spa, and the books get complicated fast. Physician Planning Partners is an introduction service. We connect dermatologists with independent, qualified CPAs we select to partner with, professionals who understand mixed medical and aesthetic revenue.

Where dermatology accounting gets tricky

• Retail product sales. Skincare and cosmetic product sales can trigger sales-tax collection and inventory accounting that a purely medical practice never deals with.
• Injectables inventory. Neurotoxin and filler purchases are large, recurring costs. Tracking them properly affects both margins and taxes.
• Med spa and MSO structures. Many states restrict who can own a medical practice. Aesthetic businesses often use a management company or separate entity, and each needs its own books and returns.
• Provider compensation. PAs, NPs, and aestheticians paid on production or commission need clean payroll and accurate reporting.
• Equipment. Lasers and energy devices are expensive, and depreciation timing is worth discussing with your CPA before you buy.

Topics physicians often discuss with a CPA

1. Entity choice and owner compensation for the practice and any aesthetic entity.
2. Sales-tax registration and filing for retail products.
3. Retirement plan design for owners and a staff-heavy practice.
4. Bookkeeping and monthly reporting by service line (medical, cosmetic, retail).
5. Getting financials clean before a partner buy-in or a private-equity conversation.

The CPA you meet is independent. They set their own fees and are solely responsible for their advice.

Why year-round planning matters for derm

Cosmetic revenue swings with the seasons and with promotions. A CPA who reviews your numbers quarterly can spot changes in margin by service line and adjust estimated payments, so you're not surprised in April.

How the introduction works

1. Tell us about your practice mix, entities, and what prompted you to reach out.
2. We suggest an independent CPA we partner with who fits.
3. You meet them directly and decide whether to engage.

Frequently asked questions

Do you provide accounting or tax services?

No. Physician Planning Partners is an introduction service. We connect you with independent, licensed CPAs.

Can one CPA handle both my practice and my med spa?

Often, yes. Ask the CPA how they handle separate entities and any management agreements between them.

Do I need to charge sales tax on skincare products?

It depends on your state and what you sell. A CPA can tell you what applies to you.

What does an introduction cost?

Nothing. If you engage the CPA, you pay them directly. We may receive compensation from partner businesses.

Physician Planning Partners is an introduction service, not a CPA firm, and this page is general information, not tax advice. See our disclaimer.