Medical practices & clinics
Books and taxes for chiropractors.
Prepaid care packages, cash visits, personal injury cases that settle a year later, and supplements sold at the front desk. Gus sorts all of it, an accountant checks every transaction, and you get one number a month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
January came in at $17,500. Two personal injury cases finally settled and paid out, so I booked them the month the check landed, not the month of the accident.
- Personal injury settlement, OrtizInjury case settlements
- 12-visit package, DelgadoPrepaid care packages
- Standard Process orderSupplement inventory
- Chattanooga decompression leaseTreatment equipment
- Front desk payrollStaff wages
Why your books are different
A chiropractic office's books go wrong in four specific places.
You are not billing one visit at one price. You are running cash visits, prepaid packages, wellness plans, and personal injury cases that can take a year to pay out. A generalist can't tell a slow month from a settlement that just hasn't landed yet.
-
1
Personal injury cases pay out long after the care
A patient hurt in a car accident may be treated for months before their case settles and an attorney's office finally sends payment, sometimes a year or more later and for less than billed once liens and fees are subtracted.
What we doBooks the settlement as income the month the check arrives, so a slow patch does not get confused with a case that is simply still working through the legal process. -
2
Prepaid care packages get spent before they are earned
A patient who buys a 12-visit package pays the whole amount up front, but the care is delivered over weeks or months. Booked as one month's income, the package payment inflates that month and hides how many visits are still owed.
What we doKeeps prepaid package revenue visible as its own line, separate from single cash visits, so one big package sale does not read as a great month on its own. -
3
Supplement sales blend into adjustment revenue
Supplements, pillows, and braces sold at the front desk carry a different margin than an adjustment does. Rung through the same till and the same category, you cannot tell which one is actually paying the bills.
What we doKeeps retail supplement and product sales in their own line so treatment revenue and retail margin never get confused. -
4
Decompression and laser equipment reads as a supply run
A spinal decompression table or a therapeutic laser can cost as much as a used car. Filed as supplies, it wrecks the month it was bought and hides what it is worth over years.
What we doFlags a big equipment purchase the day it lands, logs it as equipment, and lets the accountant decide how it gets written off.
Your categories
The categories Gus keeps for a chiropractic office.
Set up once for how patients pay and what the office spends. You never pick a category. He does, and an accountant checks it.
Money in
- Cash visitsSingle adjustments paid at the time of the visit.
- Prepaid care packagesMulti-visit packages paid up front, kept apart from single visits.
- Insurance visit reimbursementsDeposits from payers for covered chiropractic care.
- Injury case settlementsPersonal injury and auto accident payouts, booked when the check lands.
- Supplement and product salesFront desk sales of supplements, pillows, and braces.
Money out
- Supplement inventoryStock purchased from suppliers such as Standard Process or Metagenics.
- Treatment equipmentDecompression tables, laser units, and adjusting tables, logged so they get written off right.
- Staff wagesFront desk and clinical assistant pay, kept apart from the doctor's own compensation.
- Rent and utilitiesThe office lease and utilities for adjusting rooms and the waiting area.
- Malpractice insuranceAnnual or quarterly premiums for the practicing chiropractor.
- Practice management softwareScheduling, charting, and billing software subscriptions.
- Marketing for new patientsLocal ads, referral incentives, and the website that brings patients in.
What we watch for you
- Package revenue owed
How much prepaid package money still represents visits not yet delivered, tracked from what has been sold.
- Cash-pay share
How much of each month comes from cash visits versus insurance and injury settlements.
- Retail margin
What supplement and product sales bring in against what they cost, kept apart from treatment revenue.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things chiropractors ask Gus.
Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.
Yes, it counts the year the check actually lands, not the year the accident happened. I booked it this month so the timing stays honest.
Because those visits are still owed. I keep package sales in their own line so a big prepay doesn't read as a great month when most of the work is still ahead.
Supplement sales usually carry sales tax depending on your state and what you sell. I keep that revenue separate so the accountant can confirm what applies to you.
The tax side
The tax side of a chiropractic office.
Most of what matters here is timing personal injury settlements correctly and knowing where the pass-through deduction starts to phase out.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- The pass-through deduction phases outA chiropractic practice can lose part or all of the 20 percent pass-through deduction once taxable income passes $201,750 single or $403,500 joint, since medical practices are a specified service trade.
- Treatment equipment purchasesDecompression tables, laser units, and adjusting tables can usually be written off the year you buy them, with 100 percent bonus depreciation available for property acquired after January 19, 2025.
- Injury settlement timingA personal injury payout is income the year it is actually received, even if the accident and the treatment happened a year or more earlier. Keeping the date and case clear helps the accountant report it correctly.
- Retail sales tax on supplementsSupplements and retail products sold in the office are often subject to state sales tax, unlike the adjustment itself in most states. Rules vary, so this gets confirmed with your accountant.
Deductions chiropractors miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Supplement and retail inventory
- Decompression and laser equipment
- Malpractice premiums
- Practice management software
- CME and seminar travel
- License renewal fees
- Adjusting tables and tools
- Marketing for new patients
- Scrubs and clinical apparel
- X-ray equipment servicing
- Front desk supplies
General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.
All year, not just April
A chiropractic year, kept every month.
New Year's resolutions bring in new patients. Old injury cases settle on their own timeline. Your team keeps you ahead of both. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.
- January
Plan the year
Last year's return gets started, and you get a monthly set-aside so April is already handled, even with an injury settlement or two in the mix.
- April
Filed. Done.
Your return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where you stand, what you will owe, and whether a settlement or a strong package sales month changed the number.
- October
Before year end
Gus looks at equipment worth buying and anything worth doing before December, including any outstanding package revenue still to deliver.
What you get
What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.
Book a call- Monthly bookkeeping
Every transaction sorted into categories set up for chiropractors. You never categorize a thing.
- An accountant checks every transaction
Real review, every month, before your books close. Not a spot check.
- Your business tax return, filed
Prepared, reviewed, and signed by that same accountant every year.
- The monthly number
What you made, what you spent, what to set aside for taxes.
- Your own bookkeeper
A real person assigned to your business, in the app whenever you need them. No hold music.
- On your books all year
Every month, not just in April. Your team speaks up whenever something is worth your attention.
- Cancel any time
No contract. No cancellation call. Your books are yours.
Straight answers
Questions chiropractors ask first.
Do you handle billing for personal injury cases or work with attorneys?
No. Gus does not handle insurance billing, medical coding, or claims of any kind, and he does not deal with attorneys or liens. He simply books the settlement as income once the check actually lands in your account.
How do you handle a patient who buys a package but never uses all the visits?
Gus tracks package revenue as its own line as it is sold. What happens to unused visits is a business and legal question for your accountant or an attorney, not something Gus decides.
I sell supplements and pillows at the front desk. Does that complicate my taxes?
It adds a retail sales tax question in most states, but otherwise it just means keeping that revenue in its own category, which Gus already does.
My personal injury cases take a year or more to pay out. Is that a problem for the books?
No. Gus books the payout the month it lands, so a slow season is never confused with a settlement that just hasn't come through yet.
Can Gus tell me if my new decompression table pays for itself?
He can show you what it cost and how treatment revenue trends after you bought it. Whether it's paying off is a read you and your accountant do together.
Is a real accountant checking my books?
Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.
What does it cost, and can I cancel?
It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.
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What makes a bookkeeper worth paying for Every business we keep books for
Book a call
Pick a time. That's the whole signup.
Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.
- $197 a month to start
- An accountant on every transaction
- Cancel whenever