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Accounting for Growing Group Practices
Hiring clinicians changes everything about your finances: payroll, classification, multi-state filings, and knowing whether each new hire is actually profitable. We handle the numbers so you can focus on leading your team.
What Changes When You Grow
- Clinician classification. Choosing between W-2 employees and 1099 contractors affects payroll taxes, benefits, and your risk if the IRS or your state disagrees. We help you get it right and document why.
- Payroll in more than one state. Telehealth clinicians in other states can create payroll registration and withholding obligations there. We track where your people work.
- 1099 filing. Contract clinicians need W-9s on file and 1099-NEC forms by January 31. We handle both.
Reports That Show How the Practice Is Doing
Summit includes monthly management reports built for therapy practices: revenue by clinician, clinician pay as a share of revenue, profit after payroll, and trends over time. You'll know whether a new hire is paying off, and when you can afford the next one.
Multi-State and Pass-Through Entity Tax Planning
Owners of growing practices often pay more state tax than they need to. We review your state filing obligations and analyze whether your state's pass-through entity tax election would lower your federal tax.
Group Practice Questions
Should My Clinicians Be W-2 Employees or 1099 Contractors?
It depends on how much control the practice has over how, when, and where your clinicians work. The IRS looks at behavioral control, financial control, and the overall relationship, and some states, including California, apply a stricter test. Misclassification can lead to back payroll taxes and penalties, so we review your arrangements and help you structure them correctly.
What Is the Pass-Through Entity Tax?
Many states let S corporations and partnerships pay state income tax at the business level instead of on the owners' personal returns. Because that tax is deductible to the business, it can lower your federal tax (IRS Notice 2020-75). Whether it helps depends on your state and your income, so we analyze it each year.
When Are 1099s Due for Contract Clinicians?
Form 1099-NEC is due to both your contractors and the IRS by January 31. We track contractor payments throughout the year, collect W-9s up front, and file on time.
Build a Practice That Can Grow Without the Guesswork
Book a free 20-minute discovery call. You'll talk with a CPA, get straight answers, and leave knowing where you stand.