Med Spa & Aesthetics

Med spa accounting, bookkeeping and tax — explained by a CPA.

20 guides on the questions aesthetics-practice owners actually ask: how to account for packages and memberships, injectables inventory, injector commissions, retail sales tax, MSO / professional-entity books, deductions, margins and the monthly close. Written and reviewed by Jenny Gao, CPA, EA, with sources and a review date on every guide.

Med spa accounting & tax services →Request a 20-minute fit call

Start here 3

The three guides to read first.

Med Spa Accounting: A Complete Financial Guide for OwnersLearn how med spa accounting handles memberships, packages, inventory, provider pay, monthly close, taxes, and treatment-level profitability.Med Spa & Aesthetics How to Choose an Accountant for Your Med Spa: 9 Questions to AskHow to choose an accountant for your med spa: why generalists miss deferred revenue, injectable inventory and commissions, 9 questions to ask, and red flags.Med Spa & Aesthetics What Does Med Spa Accounting Cost? Bookkeeping, Tax and Controller FeesWhat med spa accounting costs: the seven factors that drive the fee, what a $1,500-a-month engagement includes, cleanup pricing, and in-house vs outsourced.Med Spa & Aesthetics

Running the books 8

Revenue, inventory, the monthly close and what the numbers should look like.

How Should a Med Spa Account for Memberships, Packages, and Gift Cards?Learn how med spas should track cash, earned revenue, unused treatments, membership credits, gift cards, refunds, and book-to-tax differences.Med Spa & Aesthetics Med Spa Inventory Accounting for Injectables, Supplies, and Retail ProductsLearn how to track med spa injectables, treatment supplies, retail products, waste, expiration, counts, and cost of goods sold without distorting profit.Med Spa & Aesthetics Med Spa Chart of Accounts: A Practical QuickBooks Setup GuideBuild a med spa chart of accounts that tracks earned revenue, packages, memberships, inventory, provider costs, equipment, taxes, and profit.Med Spa & Aesthetics The Med Spa Monthly Close: A 12-Step Bookkeeping ChecklistA 12-step med spa month-end close: POS to deposits, revenue by line, deferred revenue rollforward, sales tax, inventory and COGS, commissions and payroll.Med Spa & Aesthetics 15 Med Spa KPIs Every Owner Should Review MonthlyTrack the 15 med spa KPIs that connect revenue, treatment margin, provider productivity, memberships, cash flow, retention, and marketing performance.Med Spa & Aesthetics Med Spa Profit Margins and Benchmarks: What a Healthy P&L Looks LikeWhat is known about med spa revenue and margins, why published average margins mislead, the P&L structure to use, and the targets we use in a med spa's books.Med Spa & Aesthetics Med Spa Gift Cards, Deposits and No-Show Fees: Accounting and the RulesHow a med spa books gift cards, deposits and no-show fees: liability vs. revenue, ASC 606 breakage, the federal five-year rule, Florida law and tax timing.Med Spa & Aesthetics Best Accounting Setup for a Med Spa: QuickBooks Online Plus Your POSWhich QuickBooks Online plan a med spa needs, what Boulevard, Vagaro, Mangomint, Aesthetic Record and Zenoti sync, and a worked daily sales entry.Med Spa & Aesthetics

Tax 3

Deductions, sales tax and equipment write-offs for aesthetics practices.

Med Spa Tax Deductions: What Aesthetics Practices Can Write Off in 2026What a med spa can deduct in 2026: injectables and inventory timing, Section 179 and bonus depreciation on devices, provider pay, and the QBI health limit.Med Spa & Aesthetics Sales Tax for Med Spas: Which Services and Products Are Taxable, State by StateWhich med spa services and products are subject to sales tax, with Florida rates and rules for Botox, skincare, packages, gift cards, supplies and web sales.Med Spa & Aesthetics Section 179 vs. Bonus Depreciation for Med Spa Equipment in 2026Compare Section 179, 100% bonus depreciation, and regular depreciation for med spa lasers, devices, furniture, software, and other equipment in 2026.Med Spa & Aesthetics

People and structure 5

Paying providers, classifying workers, and the MSO / professional-entity setup.

How to Pay Injectors and Providers: Commissions, Payroll and AccountingHow to pay injectors and providers: commission structures, what counts as commissionable revenue, package timing, payroll taxes and the month-end accrual.Med Spa & Aesthetics Med Spa Employee vs. Independent Contractor: Payroll and 1099 RulesLearn how control, tools, pricing, schedule, benefits, risk, and the full working relationship affect med spa employee and contractor classification.Med Spa & Aesthetics MSO and Professional-Entity Accounting for Med Spas: Management Fees, Intercompany and Clean BooksHow a med spa accounts for an MSO and professional entity: which books hold what, booking the management fee, the monthly intercompany reconciliation and tax.Med Spa & Aesthetics Paying a Med Spa Medical Director: Fees, 1099 vs. W-2 and BookingHow to pay a med spa medical director: retainer, per-exam or hourly fees, fee-splitting risk, 1099-MISC box 6 vs. 1099-NEC for 2026, and the month-end entry.Med Spa & Aesthetics Opening a Med Spa: Entity Choice, Tax Registrations and Accounting Setup ChecklistA med spa launch checklist: LLC vs S-corp vs MSO structure, EIN and Florida registrations, banking, chart of accounts, payroll, insurance and start-up costs.Med Spa & Aesthetics

Growing, financing and selling 1

Leadership-level questions: margins, equipment, and what a buyer will look for.

Selling a Med Spa: What Buyers Look for in the Books and How the Sale Is TaxedWhat a buyer's quality-of-earnings review checks in med spa books, asset vs. stock deals, Form 8594 allocation and how each piece of the price is taxed.Med Spa & Aesthetics

Working with us

Would you rather have it handled?

Balance Partners is a CPA-led accounting and tax practice in Tampa, Florida, working with med spas and aesthetics practices across the United States: monthly close with a deferred-revenue rollforward, injectables inventory, provider payroll and commission accruals, sales tax by state, MSO / professional-entity books and year-round tax planning. Monthly engagements start at $1,500 under a written scope.

See how a med spa engagement works → Fractional CFO, controller and tax director →

Questions

Common questions from med spa owners.

Do I need an accountant who specializes in med spas?

Usually, once the practice sells packages or memberships, carries injectables inventory, pays providers on commission or runs an MSO alongside a professional entity. Each of those is handled wrong by default in generalist books. The guide on choosing a med spa accountant lists the questions to ask.

How is a med spa's bookkeeping different from a normal service business?

Prepaid packages and memberships are liabilities until treatments are delivered, injectables are inventory until injected, provider commissions must be accrued against the revenue they produced, retail products carry sales tax while treatments usually do not, and many practices keep two sets of books (MSO and professional entity) with a management fee between them.

What does Balance Partners charge for med spa accounting?

Monthly engagements start at $1,500 for a single-location, single-entity practice with clean books, under a written scope and a flat fee. Cleanup and catch-up work is quoted as a separate fixed project after a diagnostic. See the med spa accounting and tax services page.

Not a med spa? The full resource library covers bookkeeping, tax, payroll and QuickBooks for owner-led businesses generally.

Request a med spa fit call

Twenty minutes on your systems, your close and your reporting gaps. No obligation — if we are not the right fit, we will say so.

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