A 13-Week Cash Flow Forecast for a Med Spa: Template Logic and Worked Example

A med spa's bank balance is a poor guide to its health because money arrives out of order. A patient pays $2,400 for a six-treatment laser package in November and comes in through April. The neurotoxin used this week was ordered three weeks ago and will be paid for in three more. The injector's commission on today's filler appointment lands in next month's payroll. Owners who manage from the balance see a flush December and a frightening January.

A 13-week cash flow forecast puts those timing differences on one page: a weekly sheet that starts from the reconciled bank balance and shows what will be in the account on each payday, distributor due date and tax date through the end of the quarter. This guide gives the row logic for a med spa, the dates that belong on it, and a worked example with round numbers.

Why thirteen weeks, and why weekly

Thirteen weeks is one quarter: long enough to hold six biweekly payrolls, three rent payments, three retail sales tax remittances, a quarterly payroll filing and one owner estimated-tax date, and short enough to build from the appointment book and the POS outstanding-balance report rather than a budget. A twelve-month projection says whether the practice model works; the 13-week forecast says whether the January 8 payroll clears. The mismatches are measured in days, so the sheet is weekly.

The layout: rows that follow how money moves through a med spa

One column per week, starting with the current week, and these rows in order:

• Opening cash: the reconciled operating balance, not the bank app.
• Receipts, on four lines: card settlements for treatments and retail; membership autopay; package and gift card presales, which are cash that is not yet revenue; and payouts from patient financing partners.
• Payroll, all-in: net pay, employer taxes, the federal deposit and the commission run, in the week each leaves.
• Injectables, consumables and retail: distributor invoices on their due dates, not ship dates.
• Fixed obligations and taxes: rent, device loans, the medical director fee, subscriptions, insurance, retail sales tax, quarterly filings and the owner's estimated payments.
• Owner items: draws and distributions on their own line, so you see what the practice generates before you take money out.
• Ending cash, which becomes next week's opening, with the cash floor underneath; we set the floor at one commission-inclusive payroll plus a week of vendor payments.

Receipts: cash arrives before, during and after the treatment

Settlement lag. Card sales settle a business day or more after the batch closes, net of processing fees, and the last days of each month land in the next. Build this line from the processor's deposit history, not the POS sales report, and forecast it net of fees. Patient financing partners pay on their own schedule, also net of a fee, so give them their own line.

Prepayments. When a patient buys a package, a membership or a gift card, the cash arrives now and the revenue is earned later: good news this week, a liability every week after, because the patient will come in for treatments that produce payroll and product cost and no new cash. A Black Friday event that presells $38,000 of packages is a wonderful week on the forecast and a quieter January. The accounting is in memberships, packages and gift cards; for the forecast, presale cash is not yours to spend on anything except delivering those treatments.

Redemptions. The mirror image: a January full of gift card and package visits has full chairs and thin receipts. Pull the outstanding-balance report from your POS (Aesthetic Record, Boulevard, Zenoti and the others all produce one) and estimate what share of next month's visits are redemptions. That share produces no cash.

Memberships and everything else. Autopay is the most forecastable receipt a med spa has: members times fee on a known day, less a declined-card allowance. For visits not yet booked, use the trailing three months by week of the month, adjusted for events and holidays; for presales, use what the same promotion did last year, discounted.

Disbursements: the five that decide the quarter

Payroll and commissions. Payroll is the largest and most rigid outflow. Show each payday all-in and mark the runs that carry commissions, which can be 40% larger. Commissions should be calculated on delivered services, not package sales, and paid in the first payroll after month-end; if your plan pays at the sale, cash leaves months before the treatments and the forecast has to show it. Plan design is in injector compensation and commission payroll.

The federal deposit has its own calendar. Under IRS Topic 757, an employer that reported $50,000 or less of employment tax in the lookback period deposits monthly, by the 15th of the following month; above that, semiweekly, by the following Wednesday for a Friday payday. A practice with two injectors and support staff is usually semiweekly. We show the deposit with the payroll, which is conservative by a few days.

Injectables and retail. Distributor invoices for neurotoxin, filler and biostimulators are the second-largest outflow and the lumpiest. Put each open invoice on its due date under the terms you actually have, and planned orders in the week they will be paid. If a year-end volume tier makes a large December order attractive, the forecast shows whether January can pay for it. Product in the refrigerator is cash that has already left.

Fixed obligations. Rent, the device loan, the medical director's fee, software, and the annual items: malpractice and liability renewals, the device service contract, the facility license. Anything on two of the last three bank statements goes on the sheet on its usual day; the same quarter last year supplies the annual ones.

Taxes. A med spa collects sales tax on retail skincare and devices in essentially every state with a sales tax, while most states do not tax the treatments; the tax collected is the state's money and leaves on a fixed date. The owner's estimated taxes are the line most often missing, and the January installment lands in the worst week of the year. For a Florida practice:

Sources: the IRS employment tax due dates, Form 1040-ES and the Florida DR-15 instructions. Sizing the installments is covered in quarterly estimated taxes for med spa owners.

Owner items. Draws on their own line, on the dates you take them, so that "can the practice afford my January draw" has an answer on the page.

Worked example: a Tampa practice, November 9, 2026 to February 7, 2027 (illustrative)

Take an illustrative single-location practice in Tampa, Florida doing about $1.5 million a year: a nurse practitioner owner who injects three days a week, an RN injector, a laser technician, an aesthetician and two front desk staff, paid every other Friday with commissions in the first payroll after month-end. Rent is $9,500 on the first, the laser loan $3,200 on the 15th, the medical director $2,000 on the first, and the owner draws $8,000 on the 15th and the last business day. Retail sales tax is remitted before the 20th at Hillsborough County's 7.5% (6% state plus 1.5% surtax). The reconciled opening balance on Monday, November 9 is $62,000 and the floor is $35,000. Receipts are settlements net of fees, $9,000 of membership autopay on the first, and presales; "Other" holds rent, the loan, the director, marketing, software, insurance, sales tax, draws and the owner's $14,000 estimated tax on January 15. Figures are rounded and illustrative.

Read the shape first. A Black Friday event on November 27 presells $38,000 of packages, settling across weeks 3 and 4, and about $18,000 of December's receipts are gift cards. Cash peaks at $88,700 on December 6. Then the week of December 28 carries rent, the director, a draw and the $7,200 malpractice renewal; the January 8 payroll carries December's commissions, the largest run of the year; and the week of January 11 carries a $31,000 year-end tier order from the injectables distributor, the loan, a draw and the $14,000 estimated tax. Receipts in weeks 9 through 11 are thin because the chairs are full of patients redeeming gift cards and packages they paid for before Christmas. Cash falls to $9,200 after week 10 and $3,500 after week 11, a payroll week. The P&L never warned: with package revenue recognized on delivery, December and January both show profits, the gap explained in why your med spa shows a profit but has no cash.

The number that explains the quarter: of the $88,700 peak, about $56,000 was presold packages and gift cards for treatments the practice still owed, so free cash at the peak was closer to $33,000. The fixes, in the order we apply them:

1. Treat presale cash as spoken for. When the Black Friday money settled, the owner moved $38,000 to a separate savings account and released it weekly as treatments were delivered, and did the same with gift card sales. Operating cash never showed $88,700.
2. Split the year-end order. Buy January's product ($16,000) in December and the rest in February, or ask the distributor for extended dating. This moved $15,000 out of week 10.
3. Skip the January 15 draw. The estimated tax is the IRS's money and stays; the draw is the owner's choice.
4. Fill January with paying visits. A December campaign for new-patient consults and neurotoxin maintenance, with card-on-file deposits, added about $3,000 a week in weeks 10 and 11.
5. Leave the government's money alone. The federal deposit stayed inside the payroll figure and the sales tax left on the 19th. The IRS can assess a responsible owner personally for unpaid withholding under the Trust Fund Recovery Penalty.

The revised forecast ends week 10 at $35,200 and week 11 at $32,500, still a touch under the floor, which is why the owner confirmed a $40,000 line of credit in week 5 as a backstop and never drew it; week 13 ends at $50,500, part of which is the deferred $15,000 order due in February. The structural lesson sits under the timing fix: over the quarter the practice generated about $21,500 of cash before owner items, and the owner planned to take $62,000 in draws and estimated taxes. That is not a timing problem; it is a conversation about pricing, provider cost and how the owner pays herself.

The Monday routine

Thirty minutes every Monday. Replace last week's column with actuals from the reconciled bank feed and ask why for any line that missed by more than $3,000 or 10%. Receipts misses are usually a redemption share you underestimated; disbursement misses are usually a distributor invoice with shorter terms than you assumed or a forgotten annual item.

Then roll the window: drop week 1, add week 13, and refresh the first four weeks from the POS outstanding-balance report, the distributor statement, the payroll calendar and the production report that drives next month's commissions. When the month closes, replace the estimated commission, sales tax and inventory figures with the numbers from the med spa monthly close checklist.

What usually goes wrong

Building receipts from the POS sales report instead of the processor's settlement history, so cash is gross of fees and early. Counting presale cash as available and learning in January that it belonged to patients. Forgetting that redemptions fill the schedule without filling the account. Entering distributor orders on the ship date. Leaving the owner's estimated taxes off the sheet and meeting January 15 with a credit card.

Paying commission on package sales without forecasting the cash that leaves before the treatments do. Treating collected sales tax or the payroll deposit as a cushion. And building the forecast once, during a scare, then never updating it, so the next scare arrives on schedule.

When to get help

If your books are closed monthly and your POS produces a reliable outstanding-balance report, you can build and maintain this forecast yourself with the layout above. The practices that struggle are the ones whose bookkeeping is weeks behind, because the opening balance, the deferred revenue figure and the commission accrual are all guesses, and a forecast built on guesses is a mood. In our practice the 13-week sheet is part of med spa cash flow and bill pay: we maintain it from the closed books, schedule distributor payments against it and flag the week a decision is needed, as the cash flow and bill pay scope added to a Med Spa Core engagement (Core starts at $1,500 a month), or as part of a fractional CFO engagement.

If you are looking at a January like the one above, request a 20-minute fit call and bring your last bank statement, the POS outstanding-balance report and your payroll calendar. That is enough to build the first four weeks on the call.

Jenny Gao, CPA, EA

Founder of Balance Partners, a CPA-led accounting, tax and fractional CFO practice for med spas. Florida-licensed CPA and IRS Enrolled Agent with more than 13 years of accounting and tax experience. Jenny writes and reviews every guide on this site. About Jenny

This guide is general educational information for owners of med spas and aesthetics practices in the United States and is not accounting, tax, legal, medical, payroll or financial advice for your situation. Rules change and vary by entity, state and facts. Balance Partners, LLC does not provide audit, review, compilation or other attest services. Last reviewed November 8, 2026.