Medical practices & clinics
Books and taxes for hair restoration clinics.
Procedures priced by graft count, a full technician team working one case all day, financing payouts that land short, and medication subscriptions that renew every month. 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
March came in at $36,400. Two large graft-count procedures financed through Alphaeon paid out short, so I booked the lender's cut as a fee rather than a discount on the procedure.
- Alphaeon Credit payoutFinanced procedure revenue
- Cash-pay procedure, 2,800 graftsProcedure revenue
- Technician team payroll, procedure dayTechnician labor
- Medication subscription batchMedication subscription revenue
- PRP processing suppliesPRP processing supplies
Why your books are different
A hair restoration clinic's books go wrong around the graft count and the procedure day.
Every procedure is priced differently based on how many grafts it takes, staffed by a technician team working a single case for most of a day, and often financed through a lender who takes a cut. A generalist has no framework for any of that variability.
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1
Procedure revenue varies case by case
A transplant priced by graft count can range from a small touch-up to a full session costing many times more, and averaging procedure revenue together hides what's actually driving a strong or weak month.
What we doTracks procedure revenue by case size, so a shift toward smaller or larger procedures shows up as a real pattern instead of unexplained variation. -
2
A full technician team works one case all day
A single transplant procedure can tie up several technicians for six to eight hours, a labor cost concentrated into one case rather than spread across many patients like a typical visit-based practice.
What we doKeeps technician labor tracked against procedure days, so the real staffing cost of a case is visible instead of blending into general payroll. -
3
Financed procedures pay out less than invoiced
When a patient finances an $8,000 procedure through a company like Alphaeon Credit, the payout is the price minus the lender's fee, and booked as the full sale, both your pricing and your true cost read wrong.
What we doBooks the full procedure price as revenue and the lender's cut as its own fee, so your real pricing and your real cost both show up honest. -
4
Medication subscriptions blend into procedure revenue
Ongoing finasteride or minoxidil subscriptions bring in small, steady, recurring revenue, completely different in shape from a large, infrequent procedure fee, and blended together the steady base of the business disappears.
What we doKeeps medication subscription revenue in its own line, apart from procedure revenue, so the recurring base of the business stays visible.
Your categories
The categories Gus keeps for a hair restoration clinic.
Set up once for how procedures, subscriptions, and financing all get paid. You never pick a category. He does, and an accountant checks it.
Money in
- Procedure revenueCash-pay transplant procedures, tracked by graft count or case size.
- Financed procedure revenueThe full procedure price, with the financing company's cut booked as a fee.
- Medication subscription revenueRecurring finasteride, minoxidil, or similar ongoing medication sales.
- PRP treatment revenuePlatelet-rich plasma sessions, kept apart from surgical procedures.
Money out
- Technician laborProcedure-day staffing for graft harvesting and placement.
- PRP processing suppliesKits and consumables used to process platelet-rich plasma.
- Medication inventoryFinasteride, minoxidil, and related products dispensed to patients.
- Surgical suppliesInstruments and materials used during transplant procedures.
- Financing and card processing feesWhat lenders or a card processor keep before you get paid.
- Malpractice insuranceAnnual or quarterly premiums for the practicing physicians.
- Marketing for consultationsAdvertising that drives new procedure consultations.
What we watch for you
- Revenue per procedure
How procedure revenue is trending against typical graft counts, tracked case by case.
- Technician labor per case
What staffing a procedure day costs against what that case brought in.
- Subscription revenue trend
How the recurring medication subscription base is growing or shrinking.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things hair restoration clinic owners 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.
Likely, since I track procedure revenue by case size, and a run of smaller graft counts brings in less per case even with similar volume.
I keep technician labor tracked against procedure days, so you can see that cost directly against what the case brought in.
The financing company took its fee before paying out. I book the full invoiced price as revenue and the fee as a cost, so your real pricing still shows on the books.
The tax side
The tax side of a hair restoration clinic.
Most of what matters here is tracking procedure and subscription revenue separately 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 hair restoration clinic can lose part or all of the 20 percent pass-through deduction once taxable income passes $201,750 single or $403,500 joint, since aesthetic medical services are a specified service trade.
- Surgical and PRP equipmentSurgical instruments and PRP processing equipment can usually be written off the year you buy them, with 100 percent bonus depreciation available for property acquired after January 19, 2025.
- Medication inventoryFinasteride, minoxidil, and related products dispensed to patients are generally tracked as inventory, with their cost recognized as they're sold.
- Contract or covering physiciansA physician covering your clinic occasionally who bills you directly is often a contractor and gets a 1099-NEC if you pay them $2,000 or more in 2026, due January 31.
Deductions hair restoration clinics miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Surgical supplies
- PRP processing supplies
- Medication inventory
- Malpractice premiums
- Financing and card processing fees
- CME courses and travel
- Board certification renewal
- Marketing for consultations
- Scrubs and clinical apparel
- Technician training and certification
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 hair restoration clinic year, kept every month.
Procedure days, subscriptions, and consultations each move on their own rhythm. Your taxes come on a fixed schedule. 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 financed procedures still settling.
- 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 procedure volume or subscription growth changed the number.
- October
Before year end
Gus looks at equipment worth buying and anything worth doing before December, as consultations often pick up ahead of the new year.
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 hair restoration clinics. 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 hair restoration clinic owners ask first.
Do you handle insurance billing for procedures?
No. Gus does not handle insurance billing, medical coding, or claims of any kind. Hair restoration procedures are almost always cash-pay anyway, and Gus works from what actually lands in your bank account.
How do you track procedures that vary so much in size and price?
Gus tracks procedure revenue by case size, so a shift toward smaller or larger procedures shows up as a real pattern rather than unexplained variation.
Our procedure days need a full technician team. Can that cost be tracked separately?
Yes, technician labor is kept against procedure days, so you can see what staffing a case actually costs against what it brought in.
Why does a financed procedure show less revenue than we billed?
The financing company's fee comes out before the payout lands. Gus books the full invoiced amount as revenue and the fee as its own cost, so your real pricing still shows.
Do medication subscriptions need their own category apart from procedures?
Yes, and Gus already keeps them apart, since subscriptions are small and recurring while procedures are large and infrequent. Keeping them separate shows the real shape of the business.
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