Freight, trucking & delivery
Books and taxes for medical courier services.
Standing routes for labs and clinics, urgent specimen runs paid at a premium, coolers and biohazard supplies, and the on-call pay for after-hours pickups. Your own bookkeeper sorts it, an accountant checks every transaction, and you get one number a month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
August came in at $6,700. Overnight urgent calls picked up, so I kept that premium pay separate from your standard route contracts.
- Lab route contract paymentStanding route contracts
- Urgent run feeUrgent run premiums
- Cooler and ice pack suppliesSpecimen handling supplies
- Driver on-call payOn-call driver pay
- Vehicle maintenanceVehicle costs
Why your books are different
Medical courier books go wrong around routes and rush calls.
A generalist sees deposits and a fuel bill. Your business runs scheduled routes for labs and clinics that pay a steady contract rate, plus urgent calls in the middle of the night that pay a real premium, all while keeping specimens at the right temperature the whole way. When the books do not separate those, you cannot see what is actually driving your income.
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1
Urgent run premiums blur into standard route pay
An urgent run at 2 a.m. pays more than a scheduled afternoon pickup because of the urgency, but if both land in the same revenue line, you cannot tell how much of your income depends on being available around the clock.
What we doKeeps Urgent run premiums in their own category, separate from standing route contracts, so you can see what after-hours availability is really worth. -
2
On-call driver pay looks like regular payroll
Paying a driver to be available overnight for urgent calls is a real cost even on nights nothing comes in, but mixed into regular wages, it hides what staying on-call actually costs you.
What we doKeeps on-call pay in its own line, separate from scheduled route wages, so you can see the true cost of round-the-clock coverage. -
3
Specimen handling supplies disappear into general costs
Coolers, ice packs, and biohazard bags are a real recurring cost specific to this work, but lumped in with general vehicle expenses, you lose track of how much proper specimen handling actually costs per month.
What we doKeeps specimen handling supplies in their own category, so the real cost of doing the job right stays visible. -
4
A lost lab contract looks like a slow month
Losing one clinic's route can shrink your steady income fast, and without tracking revenue contract by contract, it just looks like an unexplained dip instead of a specific account worth winning back.
What we doTracks standing route revenue by contract, so a change in one client's business shows up clearly instead of hiding in the total.
Your categories
The categories Gus keeps for a medical courier service.
Set up once for how routes and rush calls pay you and what handling specimens properly costs. You never pick a category. He does, and an accountant checks it.
Money in
- Standing route contractsScheduled pickups for labs, hospitals, or clinics billed on a regular basis.
- Urgent run premiumsUrgent, on-demand runs billed at a higher rate.
- On-call retainer feesAny flat fee a client pays just to keep you available after hours.
- Mileage overage billingExtra charges for routes that run past a contract's included mileage.
Money out
- On-call driver payPay for staying available for urgent calls, separate from scheduled route wages.
- Scheduled route wagesDriver pay for standing, predictable pickups.
- Specimen handling suppliesCoolers, ice packs, biohazard bags, and temperature logs.
- Vehicle costsFuel, maintenance, and repairs on courier vehicles.
- InsuranceLiability and cargo coverage suited to transporting specimens.
- Background checks and trainingScreening and handling certification costs for drivers.
What we watch for you
- Revenue per contract
What each lab or clinic route brings in monthly. It shows which accounts matter most to keep.
- Urgent call volume
How often after-hours calls come in against what on-call coverage costs to staff.
- Cost per route
Fuel, wages, and supplies against routes run. It tells you if a route's rate still covers its cost.
- The set-aside
What you will owe, tracked every month, so filing season is a number already known.
Ask Gus
Things medical courier 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.
Yes. Urgent run premiums are kept separate from your standard route pay, so you can see exactly how much of this month came from urgent calls.
It is, and I already keep it apart from scheduled route wages, so you can weigh what round-the-clock coverage costs against what it brings in.
Yes, since I track revenue by contract, that specific drop will show up on its own instead of just looking like a slow month overall.
The tax side
The tax side of running a medical courier service.
Most of what trips up a medical courier is mixing standard and on-call pay, and losing track of which specific contract is actually paying the bills.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Vehicle deduction, mileage or actual costVehicle costs for your courier routes can usually be deducted either through the standard mileage rate, 72.5 cents a mile through June 2026 and 76 cents after, or through actual costs like fuel and repairs, whichever the accountant finds better for your specific routes.
- 1099s for contracted driversA driver not on payroll who is paid $2,000 or more in 2026 gets a 1099-NEC by January 31. Gus keeps that list all year.
- Worker classification for on-call driversA driver who works your routes, follows your schedule, and is on call for your clients usually counts as an employee, not a contractor, no matter how the pay is structured.
- The pass-through deductionMost medical courier owners can take up to 20 percent of business profit off their taxable income. It comes out right when route contracts, urgent pay, and supplies are tracked cleanly all year.
Deductions medical courier services miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Coolers and ice packs
- Biohazard bags and specimen supplies
- Vehicle fuel and maintenance
- Cargo and liability insurance
- Background check and training fees
- Phone and dispatch app fees
- Uniforms and gloves
- Temperature monitoring equipment
- Vehicle cleaning and sanitizing supplies
- Business licensing fees
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 medical courier's year, kept every month.
Labs and clinics need pickups every week of the year, and urgent calls do not wait for a convenient month. Your team stays on both, not just at filing time. 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, the 1099 list for contracted drivers is finalized, and you get a monthly set-aside so April is already handled.
- April
Filed. Done.
Your return is filed and signed. No surprise bill, because the set-aside has been building since January.
- July
Halfway check
Where you stand, what you will owe, and whether new lab contracts this year changed the number.
- October
Before winter illness season
Urgent call volume tends to climb once cold and flu season sets in. Gus looks at whether adding on-call coverage makes sense before it hits.
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 medical courier services. 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 medical courier owners ask first.
Can the books show me which lab contract is actually worth the most?
Yes. Revenue is tracked by contract, so you can see exactly what each route brings in and notice quickly if one changes.
How do you handle the premium I charge for urgent runs?
It is kept in its own category, separate from your standing route pay, so you can see how much of your income depends on urgent, after-hours work.
I pay a driver to be on-call even on nights with no calls. Does that get tracked fairly?
Yes. On-call pay is kept apart from scheduled route wages, so you can see the real cost of staying available around the clock.
Do supply costs like coolers and biohazard bags count as a real deduction?
Yes, they are ordinary costs of doing this work correctly, and Gus keeps them in their own category so the accountant can confirm what is deductible.
My drivers are a mix of W-2 and contract. Is that a problem?
No, but it matters for taxes. Gus keeps wages and contractor pay separate and flags anyone paid enough to need a 1099, and the accountant confirms the classification.
I have never separated my urgent income from my regular contracts in my records. Can you fix that going forward?
Yes. Send the statements you have. Gus sorts income by contract and call type from here forward, and most owners see a clear picture within a month or two.
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