Mental & behavioral health
Books and taxes for ketamine clinics.
A six-infusion package paid up front, a medical director's monthly fee, a ketamine and monitoring supply order, and a nurse's hourly pay for infusion days. 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
July came in at $19,000. Two clients paid for full six-infusion packages up front, so I booked the packages as they were used, not all at once.
- Infusion package paymentInfusion series revenue
- Single session, private paySingle infusion revenue
- Medical director feeMedical director
- Ketamine and supply orderDrug and monitoring supplies
- Infusion nurse payrollClinical staff wages
Why your books are different
A ketamine clinic's books go wrong around packages and medical oversight.
A generalist sees a deposit and a supply bill. Your clinic sells prepaid infusion packages, pays a medical director to oversee treatment, and buys a controlled medication along with real monitoring equipment. When the books flatten all of that, revenue gets counted before it is earned and costs get mistaken for overhead.
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1
Prepaid infusion packages get counted as income the day they are sold
A client who pays for six infusions up front has not actually received that care yet, and booking the full amount as income the day it is paid overstates that month and understates the months the infusions actually happen in.
What we doBooks package revenue as each infusion is delivered, not all at once, so income lines up with the care actually provided. -
2
Medical director fees look like a routine bill
A medical director overseeing treatment protocols is often paid a flat monthly or per-visit fee, and lumped into general professional fees, it is easy to lose track of what medical oversight actually costs against what the clinic brings in.
What we doKeeps medical director fees in their own line so that cost is always visible against clinic revenue. -
3
The ketamine itself and monitoring supplies get mixed with general clinical supplies
The medication, along with monitoring equipment like pulse oximeters and blood pressure cuffs, is a real and recurring cost specific to infusion treatment, and buried inside general supplies it hides what each infusion actually costs to deliver.
What we doKeeps drug and monitoring supply costs in their own line so the real cost per infusion is visible. -
4
Nurse pay for infusion monitoring blends into general clinical wages
A nurse who monitors clients through a forty-five-minute infusion is doing specific, billable-adjacent work, and if that pay is lumped with general staff wages, the clinic cannot see the true labor cost of each infusion session.
What we doKeeps infusion nursing pay in its own line so labor cost against sessions delivered stays visible.
Your categories
The categories Gus keeps for a ketamine clinic.
Set up once for how the clinic gets paid and what it spends. Nobody hand-sorts a category. Gus does, and an accountant checks it.
Money in
- Infusion series revenuePrepaid packages, recognized as each infusion is delivered.
- Single infusion revenueOne-off sessions paid at the time of treatment.
- Consultation feesInitial screening and medical consultation, billed apart from infusion sessions.
- Maintenance session revenueFollow-up infusions for clients past their initial series.
Money out
- Medical directorFees paid to the overseeing physician for treatment protocols and supervision.
- Clinical staff wagesPay for the infusion nurse or clinical monitoring staff.
- Drug and monitoring suppliesKetamine, IV supplies, and vital sign monitoring equipment.
- Facility costsTreatment room rent, utilities, and maintenance.
- Malpractice insuranceCoverage for the medical director and clinical staff.
- Licensing and registrationState medical licensing and controlled substance registration fees.
What we watch for you
- Package recognition lag
Prepaid package revenue not yet delivered as infusions, so income and care stay lined up.
- Cost per infusion
Drug and monitoring supply cost against infusions delivered, so pricing reflects real cost.
- Medical oversight cost
Medical director fees against total revenue, so that cost stays visible as the clinic grows.
- The set-aside
What the clinic will owe, tracked every month, so April is a number already known.
Ask Gus
Things ketamine 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.
No. I only book the two infusions delivered as income this month. The rest sits as unearned until the client actually comes in, so your numbers reflect real care given.
I keep it in its own line so you can see it against your revenue. It is a real cost of running the clinic safely, and whether the new rate makes sense is worth discussing with the accountant against your margins.
If she works your schedule, in your clinic, using your protocols, she is almost certainly an employee. I flagged it so the accountant can walk through the classification with you.
The tax side
The tax side of a ketamine clinic.
Most of what goes wrong here is timing and labels: package revenue counted too early, and medical oversight and drug costs buried inside general expenses.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Revenue recognition on prepaid packagesIncome from a prepaid infusion package should generally be recognized as each session is delivered, not all at once when it is sold. Getting this right keeps monthly profit honest.
- Worker classification for clinical staffAn infusion nurse who works your schedule and protocols is almost always an employee, not a contractor. A medical director may be a legitimate contractor depending on the arrangement.
- Equipment depreciationMonitoring equipment and treatment room fixtures can usually be written off in the year bought, with 100 percent bonus depreciation available for property acquired after January 19, 2025.
- The pass-through deductionMost owners can deduct up to 20 percent of business profit before it is taxed, though this often shrinks for a personal-service medical business at higher income.
Deductions ketamine clinics miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Medical director fees
- Malpractice insurance premium
- Controlled substance registration fees
- State medical license renewal
- Monitoring equipment purchases
- IV and infusion supplies
- Staff continuing education
- Treatment room rent
- Background check fees for new hires
- Client screening and consultation forms
- Business insurance beyond malpractice
- Professional association dues
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 ketamine clinic's year, kept every month.
Demand for infusion series can run fairly steady year to year, but package timing shifts revenue between months. Gus keeps the clinic ahead of both the numbers and the tax deadlines. 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, controlled substance registration renewal is on the radar, and the monthly set-aside is planned.
- April
Filed. Done.
The business return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where the clinic stands, what it will owe, and whether package sales this year changed the number.
- October
Before year-end
Gus looks at any equipment purchases and moves worth making before December.
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 ketamine 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 ketamine clinic owners ask first.
How does Gus handle a prepaid infusion package?
He books the income as each infusion is actually delivered, not all at once when the package is purchased, so a month's revenue reflects the care given that month.
Is our medical director a contractor or should they be on payroll?
A medical director paid a flat fee for periodic oversight is often a legitimate contractor, but the details matter. Gus flags the arrangement so the accountant can confirm it.
Does Gus track our controlled substance inventory?
No. Gus books drug and supply costs from your bank and supplier statements, but does not manage inventory logs or controlled substance compliance. That stays with your clinical protocols.
Our clinic mostly runs cash and card payments, not insurance. Does that simplify things?
It does simplify the deposit side, but package timing and medical director fees still need careful tracking, which Gus handles the same way regardless of how clients pay.
We just bought a second monitoring setup for a new treatment room. How does that get handled?
Gus flags it as equipment the day it shows up and logs it separately from routine supplies, so the accountant can decide how it gets written off.
Our books have never separated package revenue from single-session revenue. Can that be fixed?
Yes. Gus can look back through past deposits, split package revenue from single sessions, and carry that structure forward without extra work on your end.
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