The Med Spa Monthly Close: A 12-Step Bookkeeping Checklist

A med spa's books are harder to close than a typical service business's because money arrives before, during and after the treatment. A package is paid in March and delivered through July. The neurotoxin was bought in bulk last month, used this month and paid for next month. A generic checklist that stops at "reconcile the bank account" leaves all of that unresolved and produces a P&L that follows your promotions calendar instead of your treatments.

This is the close we run for medical aesthetics practices: twelve steps, in order, each tied to a report outside the accounting system so the numbers are checked rather than assumed. The first ten days of the month are enough if the data arrives on day one.

The 12 steps at a glance

Steps 1 to 4: revenue, deferred revenue and sales tax

Step 1. Export the POS or EMR sales summary for the month: gross sales by category, discounts, tax collected, tips and payment types. Card sales tie to the processor's batch report; deposits arrive net of fees and a day or more later, so the last days of the month sit in next month's bank statement and are booked as in transit. Record gross sales and merchant fees separately. Tips collected for staff are a liability, never revenue.

Step 2. Every POS item maps to an income account: injectables, energy devices, skincare services, retail, membership fees. The POS sales-by-category report should equal income by account to the dollar. Discounts the patient did not pay are contra-revenue, not expense, and a new item added mid-month is the usual reason the two reports disagree.

Step 3. Money collected for treatments not yet delivered is a liability. For packages, memberships and gift cards, the rollforward is opening balance plus sales, less redemptions, less expirations or forfeitures under your written policy, equals closing balance, which ties to the POS outstanding-balances report. Redemptions are the month's revenue from these programs. Florida gift certificates may not carry an expiration date under section 501.95, so gift card balances stay on the books until used; package and membership forfeitures follow the terms the patient signed. Policy questions are in the memberships, packages and gift cards guide.

Step 4. Taxable sales per the POS tax report times the rate should equal tax collected, and sales tax payable should equal that figure less what was remitted. In Florida the rate is 6% state plus county surtax (1.5% in Hillsborough, 1% in Pinellas and Pasco for 2026), with the surtax applying to the first $5,000 of an item. Cosmetic and medical services are not taxed; retail product is. Add use tax on supplies bought without tax, since under Rule 12A-1.020 the practitioner is the consumer of those items. Per the DR-15 instructions, the return and payment are due on the 1st and late after the 20th of the following month, and an e-filed, e-paid return earns a collection allowance of 2.5% of the first $1,200 of tax, at most $30.

Steps 5 to 8: inventory, providers, payroll and intercompany

Step 5. Count injectables by unit or syringe and retail by piece on the last day of the month, value at cost, and book cost of goods sold as opening inventory plus purchases less closing inventory. Compare units relieved with units billed in the POS treatment log; the gap is waste, samples, staff treatments or shrink, and it should be small and explained. The inventory accounting guide covers valuation.

Step 6. Run the production report by provider on recognized service revenue, net of discounts and excluding tax, tips and gift card sales, with package treatments counted when delivered. Apply the written commission plan, accrue commissions payable in the month earned, and reverse the accrual when the payroll run pays them. Provider cost then lands in the same month as the revenue it produced.

Step 7. Book the payroll register: gross wages, employer taxes, withholdings and net pay. Employer taxes are 6.2% Social Security up to the 2026 wage base of $184,500 and 1.45% Medicare with no limit, FUTA at a net 0.6% of the first $7,000 per employee, and Florida reemployment tax at 2.7% of the first $7,000 for a new employer. Tie each liability account to the deposits made; monthly depositors pay by the 15th, Form 941 is due at the end of the month after each quarter, Florida RT-6 is quarterly and Form 940 is due January 31, per the IRS employment tax due dates.

Step 8. If the practice runs an MSO and a professional entity, confirm the management fee was invoiced and paid as the agreement states, and that Due to MSO in one file equals Due from PC in the other. MSO and professional-entity accounting covers the mechanics.

Steps 9 to 12: debt, accruals, owner items and the review package

Step 9. Reconcile every credit card to its statement. Split each loan and equipment-financing payment into interest and principal from the lender's amortization schedule, and tie the remaining balance to the lender's statement. Lease payments go to rent or the lease liability, never to equipment expense.

Step 10. Annual insurance and software payments are prepaid and amortized monthly. Bills received after month-end for services used in the month are accrued. A device bought this month goes on the fixed asset register and is depreciated monthly in the books; the tax decision between Section 179 (a $2,560,000 limit for 2026) and 100% bonus depreciation is made at year-end.

Step 11. Personal charges on the business card are owner draws or distributions, not marketing or meals; the owner's own treatments and product are personal use. In an S corporation, confirm the owner's salary ran through payroll before distributions were taken.

Step 12. The package is the P&L by service line with each line as a percentage of revenue and the trailing three months beside it, a balance sheet on which every account is reconciled, the deferred revenue schedule, the KPI sheet described in 15 med spa KPIs, and an open-items list of questions for the owner. After the owner's review, set the closing date in QuickBooks so the period cannot be edited by accident.

A worked example: the step 3 rollforward

An illustrative single-location practice closes October. The POS reports $22,000 of package sales, $9,600 of membership billings and $4,200 of gift card sales; redemptions were $19,500, $8,900 and $3,600. Under the signed terms, $1,500 of package value and $700 of membership credits expired in the month.

The $450 was a package upgrade sold late on the 31st, after the export was pulled; once added, the books show $116,750 and the two agree. The month's entries move $32,000 from the liability to the service lines where the treatments were delivered and $2,200 to forfeited package and membership revenue. Revenue for the month is $34,200 from these programs, not the $35,800 collected, and the practice carries a $116,750 obligation into November that its cash balance must respect.

The close calendar

Common mistakes

Closing from the bank feed instead of the POS, so revenue is net of fees and package money is income. Skipping the count because "we know what we used." Paying commission on package sales and accruing nothing. Booking the full equipment payment to expense. Filing sales tax from the POS report without ever reconciling the liability account. Leaving the period open, so a bill entered in December changes October. And producing a P&L with no deferred revenue schedule beside it, which is the single document that tells a med spa owner whether her cash is hers.

When to get help

If your current close has no deferred revenue rollforward, no inventory count and no commission accrual, the P&L you are reading is not wrong by a little; it is measuring something else. Those three steps are where we start with a new practice, usually as a fixed-fee cleanup.

Balance Partners is a CPA-led accounting practice in Tampa that runs this close for medical aesthetics practices nationwide. See our med spa accounting and tax services and monthly bookkeeping and accounting pages, or request a 20-minute fit call and bring last month's POS summary and your P&L; we will show you which steps are missing.

Jenny Gao, CPA, EA

Founder of Balance Partners. Florida-licensed CPA and IRS Enrolled Agent with more than a decade of accounting and tax experience. Jenny writes and reviews every guide on this site. About Jenny

This article is general educational information for U.S. business owners and is not accounting, tax, legal, payroll or financial advice for your situation. Rules change and vary by entity, state and facts. Balance Partners, LLC does not provide audit, review or other attest services. Last reviewed October 15, 2026.