Tax for outpatient therapy practices
A CPA for physical therapists
An outpatient PT practice usually runs two revenue models at once and staffs with a mix of employees and PRN clinicians. Both of those have tax consequences that show up long before the return does.
Where this return differs
What is actually different about physical therapists at tax time
Not a longer version of the same advice. These are the places this practice type reliably differs from the return next to it.
Cash pay and insurance are not the same revenue
Insurance revenue arrives net of contractual adjustments and lands in a different period than the visit. Cash pay and prepaid packages arrive before the work is delivered. Reporting them the same way misstates income and makes every planning number downstream wrong.
Prepaid packages are not income when collected
A block of visits sold in advance is an obligation until the visits are delivered. Treated as revenue on the day the card clears, it produces tax on work you still owe, in a year you did not earn it.
PRN clinicians raise a classification question
Whether a PRN therapist is an employee or a contractor is determined by the arrangement, not by the pay code. It drives employment tax and, if you have a retirement plan, who has to be covered.
How it works
What working together looks like
A call first
Thirty minutes to hear what you have and whether this is a fit. If it is not, we will say so and point you somewhere useful.
A written scope and a fixed fee
You get both in writing before work starts, so the return you expected does not arrive with an hourly surprise attached.
Documents through a secure portal
Upload once, in one place, rather than emailing a K-1 with your Social Security number sitting in the attachment.
The questions, while they still matter
Anything that changes your number gets raised when it can still be acted on, not in a footnote after filing.
Then the next twelve months
Estimated payments, an entity change, a new state, a sale. Tax years are consecutive and treating them that way is most of the value.
What this firm does, and what it does not
PizzelloCPA, PLLC is a licensed CPA firm registered with the North Carolina State Board of Certified Public Accountant Examiners as firm no. 35339. It prepares returns and does tax planning. It does not perform attest services: no audit, no review, no compilation. If a lender or a landlord has asked you for an audited or reviewed financial statement, that is a different engagement at a different firm, and we will say so rather than stretch to fit it.
Books and the return are two different jobs. bookkeepz, LLC, an affiliated company, keeps monthly books for physical therapists and other private practices, and its bookkeeping page for physical therapists covers that side. bookkeepz is not a CPA firm and does not do tax work. Most clients who need both use both, under separate engagements.
Questions
What physical therapists ask
I sell visit packages up front. How should that be handled?
As an obligation until the visits are delivered, rather than as revenue at the point of sale. The mechanics depend on your accounting method, and getting it right changes both your taxable income and how usable your own numbers are.I treat patients in more than one state. Does that create a filing obligation?
It can, and mobile and telehealth practices run into this more than clinic based ones. It is far easier to identify where you are working during the year than to reconstruct it afterward.Is an S corporation election worth it for a PT practice?
It is worth running once the practice is consistently profitable. The answer depends on a defensible salary for a treating owner who also manages the clinic, and on the payroll cost the election adds.Can you keep my books too?
No. This firm prepares returns and plans. bookkeepz, LLC, an affiliated company, does the monthly bookkeeping and is not a CPA firm.Talk to a CPA who has seen this practice before
Thirty minutes, no charge. Bring last year’s return and the thing you were not sure about.