Every package includes monthly bookkeeping, payroll oversight, the business tax return, and personal tax return for the owner. The difference is how proactive the strategy and advisory get as your practice scales. Pricing is transparent and discussed upfront on our consultation call — no surprises, no hourly billing for ongoing work.
For solo practitioners and small practices that need everything covered without the bells and whistles. You get accurate monthly bookkeeping, payroll oversight, and both your business and personal tax returns — all under one engagement, with one person who knows your practice.
Essentials is built for practice owners who want the operational basics handled with care, but aren’t yet at the size or complexity where year-round strategic planning is essential. Most clients in this tier are solo therapists or small practices in their first 1–2 years of structured operations.
Solo practitioners, small group practices under $500K revenue, owners who want clean books and accurate taxes without ongoing strategic work.
For practice owners who want tax strategy built into the rhythm of the year, not just rushed in March. Everything in Essentials, plus the proactive planning that pays for itself many times over — quarterly tax meetings, reasonable compensation analysis, mid-year projections, and ad-hoc advisory calls included as part of the relationship.
Growth is where most practices land once they’ve passed the early stage. The S-corp election has been made (or is on the table), there’s real revenue at stake, and the value of getting things right strategically — not just accurately — is meaningful.
Established practices with revenue between $500K and $1.5M, S-corp owners, practices with multiple clinicians or multiple income streams, owners who want strategic tax planning year-round.
For larger practices, multi-location operations, and owners actively planning major moves — a sale, an acquisition, an expansion, or a transition. Strategic is the full-fractional-CFO experience: monthly advisory, budget and cash flow forecasting, KPI dashboards, and modeling for the decisions that move the business forward.
At this tier, our work is genuinely operational. We’re looking at clinician utilization, revenue per visit, lease economics, succession scenarios, and capital allocation decisions. The accounting and tax work is handled completely — that’s table stakes — and the focus moves to strategic partnership.
Multi-location group practices, practices over $1.5M in revenue, owners planning a sale or acquisition, practices with significant real estate holdings, owners who want a true CFO-level partner without hiring one full-time.
For individuals who just need a personal return done right — no monthly relationship required. Particularly common for clinicians and other healthcare professionals with W-2 income, 1099 work, K-1 income from a practice, or rental properties on the side.
W-2 income, standard deduction, no significant complications. Single state. Pricing starts at the low end of the range.
Itemized deduction, investment income, one rental or one K-1, possibly multiple states. Most clinician returns land here.
Multiple K-1s, multiple states, equity compensation, foreign income, multiple rentals, or other meaningful complexity.
Most practices fit neatly into one of the three tiers above. But sometimes there’s additional scope — a property entity, a special tax election, an additional business activity. These are priced separately so you only pay for what applies to you.
Monthly oversight for a separate LLC that owns the building you practice in. Includes self-rental compliance, related-party tracking, and Schedule E preparation.
If you’d rather not run payroll yourself, we’ll handle it. Includes employee onboarding, regular pay runs, tax filings coordination, and direct approval workflow. Tiered pricing based on employee count.
One-time engagement when you’re purchasing commercial real estate. Entity setup, lease guidance, depreciation, tax elections, and bookkeeping setup. Done before closing, not after.
Form 2553 preparation, IRS coordination, reasonable compensation analysis, and the planning conversation that should accompany every S-corp election. One-time engagement.
Behind on books? Multiple workflows colliding? One-time cleanup engagement with a written workflow document so it doesn’t happen again. Priced based on scope after a brief diagnostic.
Formal grouping election for practice owners with related-party rentals. Analysis, documentation, and election statement filed properly per Rev. Proc. 2010-13.
Practices operating in multiple states or with multiple business entities require additional scope built into the engagement. Discussed and quoted during onboarding.
Most CPAs serve every kind of small business, so a practice like yours is just one of dozens of industries they touch. I work only with therapy and healthcare practices — which means I already know the patterns: reasonable compensation for clinician-owners, S-corp timing, self-rental rules when you own your building, multi-clinician comp. You also get proactive, year-round contact instead of someone who goes quiet until tax season — and because I handle your work directly, you’re never re-explaining your practice to a rotating cast.
Platforms scale by standardizing everything and assigning you to whoever’s available — which works until your situation needs judgment. With me, you work directly with a named Enrolled Agent who knows your practice, can represent you before the IRS, and handles the strategy a software workflow can’t: S-corp distribution planning, real estate decisions, acquisition modeling. You get the focus of a niche platform with the accountability of a real person who picks up the phone.
Pricing depends on the size of your practice, your entity structure, the number of clinicians, whether you have related real estate, and a few other factors. Listing one number on the website would either be misleading or so vague it wouldn’t help. After a 20-minute consultation, you’ll get a specific price quoted upfront before any work begins.
Yes. The tiers are designed to grow with your practice. Most clients start in Essentials or Growth and move up as their needs change. We review fit annually, and you can request a tier change anytime — we’ll talk through whether it makes sense based on what’s actually changed in your business.
Engagements are month-to-month, but with a strong preference for at least a year of working together because tax work has an annual cycle. There are no long-term contracts. If something isn’t working, we talk about it.
Most practices fit one of the three tiers, sometimes with add-ons. If your situation is genuinely unique — multiple practices, complex international issues, an unusual entity structure — we’ll talk through what makes sense and design an engagement that fits. It’ll still be transparent and flat-fee, just calibrated to your work.
Payroll oversight is included in every package. We reconcile your payroll transactions monthly, verify taxes are being withheld and remitted correctly, review quarterly and annual filings, and coordinate W-2s and 1099s at year-end. You (or someone on your team) runs the actual pay runs in your payroll system.
Payroll processing is an optional add-on where we run payroll for you. You send us hours and any changes, we handle pay runs, and you simply approve before each pay date. Pricing is tiered by employee count and the OnPay subscription is billed directly to you.
After our consultation, I send a clear engagement letter with the tier, scope, and price. Once that’s signed, we set up access to QuickBooks (or get you onto it if needed), gather historical documents, and book the first monthly meeting. The first month is mostly about establishing the relationship and getting clean books in place. By month two, the rhythm is set.
That’s exactly what the consultation is for. We’ll talk through your practice, identify what level of support actually makes sense, and you’ll get a clear up-front price before signing anything.
Book a 20-minute consult