Equipment & specialty rentals

Books and taxes for medical equipment rental companies.

Insurance-billed wheelchair and oxygen rentals, private-pay home deliveries, hospital discharge accounts, and sanitizing between rentals. Gus keeps every payer straight, an accountant checks every transaction, and you get one number a month.

Book a call What we handle
  • From $197 a month
  • An accountant on every transaction
  • Cancel whenever
DecemberExample month
$12,500
what you made

December came in at $12,500. Two insurance-billed rentals from October finally paid out this month, so I marked them against the month they were actually delivered.

  • Private-pay wheelchair rentalPrivate-pay rentals
  • Insurance reimbursement, oxygen concentratorInsurance-billed rentals
  • Sanitizing and sterilizing suppliesSanitizing and sterilization
  • Delivery van fuel and maintenanceDelivery and setup
  • Brightree software subscriptionBilling software
Money in$38,900
Money out$26,400
Set aside for taxes$3,300
An example month. Yours will have your numbers.

Why your books are different

Medical equipment rental books go wrong in the same four places.

A generalist sees deposits and bills. Your business gets paid by families the same day and by insurance months later, sanitizes every wheelchair and bed between patients, and sometimes sells a piece outright instead of renting it. When the books miss that, a slow month on paper hides real work already done.

  1. 1

    Insurance reimbursement lags behind the delivery

    A private-pay rental gets paid the day equipment goes out the door, while an insurance-billed rental for the same wheelchair can take sixty or ninety days to reimburse. Booked only when the cash lands, a slow month on paper can hide real deliveries that already happened.

    What we doNotes which rentals are still waiting on insurance reimbursement, so a slow-looking month is not mistaken for a slow one of actual work.
  2. 2

    Sanitizing costs get buried in general supplies

    Disinfecting a hospital bed or wheelchair between patients is not optional, and it is a real recurring cost, but lumped into a vague supplies line, you cannot tell whether your rental price actually covers the cleaning it requires.

    What we doKeeps sanitizing and sterilization costs in their own line so pricing can be checked against what proper cleaning actually costs.
  3. 3

    A one-time equipment sale looks like a rental

    Sometimes a family buys a wheelchair outright instead of renting it, but if that sale lands in the same category as recurring rental income, you cannot see how much of your revenue is actually dependable rental business.

    What we doBooks outright equipment sales separately from rental income, so rental revenue and one-time sales never get confused.
  4. 4

    A hospital bed and wheelchair purchase reads like a bad month

    Buying new hospital beds, wheelchairs, or oxygen concentrators to grow the fleet is a real equipment purchase, but filed as a straight expense it flattens a good month and skips the write-off equipment gets.

    What we doFlags an equipment purchase the day it shows up, logs it as equipment, and routes the depreciation decision to the accountant.

Your categories

The categories Gus keeps for a medical equipment rental business.

Set up once for how you get paid and what you spend. You never pick a category. He does, and an accountant checks it.

Money in

  • Private-pay rentalsWheelchairs, walkers, and beds paid directly by a patient or family.
  • Insurance-billed rentalsEquipment billed to Medicare, Medicaid, or a private insurer.
  • Hospital and hospice accountsStanding accounts for discharge equipment from care facilities.
  • Monthly oxygen and equipment rentalsOngoing monthly billing for concentrators and long-term equipment.
  • Equipment salesOutright sales of equipment a family buys instead of rents.

Money out

  • Sanitizing and sterilizationDisinfectant, wipes, and sterilizing supplies used between every rental.
  • Equipment purchasesNew wheelchairs, hospital beds, and oxygen concentrators added to the fleet.
  • Delivery and setupVan fuel, maintenance, and driver wages for home and facility deliveries.
  • Repairs and partsBatteries, tires, tubing, and motor repairs on rented equipment.
  • Billing softwareBrightree or similar software for insurance billing and claims tracking.
  • Licensing and complianceState durable medical equipment supplier licensing and renewals.
  • InsuranceGeneral liability and equipment coverage for gear placed in patient homes.

What we watch for you

  • Insurance receivables outstanding

    What is billed to insurance but not yet paid. It shows how much of your income is still on the way.

  • Private-pay share

    Private-pay rentals against insurance-billed ones. It shows how much of your cash flow arrives right away.

  • Sanitizing cost per rental

    Cleaning costs against rental income. A rising number may mean pricing needs a second look.

  • The set-aside

    What you will owe in taxes, tracked against income when it is earned, not just when insurance finally pays.

Ask Gus

Things medical equipment rental 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.

An insurance claim from two months ago just paid out. Which month does that count in?

I count it against the month the equipment actually went out, and note it as outstanding until then, so a slow-paying claim does not make an old month look worse than it was.

A family bought a wheelchair outright instead of renting it. Does that count the same as a rental?

No, I book that as a separate sale, not rental income, so your rental numbers still show what the fleet itself is earning.

Can Gus handle filing the Medicare paperwork for a new rental?

That is outside what I do. I keep your books and your set-aside straight, but insurance claims and medical billing paperwork stay with your billing software and your own process.

The tax side

The tax side of a medical equipment rental business.

Most of what goes wrong here is timing, between when equipment goes out and when insurance actually pays, and a fleet purchase filed as an expense instead of equipment.

What your return has to get right

Your accountant signs it, so it gets done right the first time.

  • Depreciating the equipment fleetWheelchairs, hospital beds, and oxygen concentrators bought for rental are usually depreciable equipment. Section 179 expensing and 100 percent bonus depreciation for property acquired after January 19, 2025 are often available, and the accountant decides the timing.
  • Reporting income when it is earnedIncome is generally counted when the equipment goes out, not necessarily when an insurer finally pays. Gus tracks both so nothing gets missed or double-counted.
  • Contractor 1099sA home delivery driver or equipment technician not on payroll gets a 1099-NEC if paid $2,000 or more in 2026, due January 31.
  • The pass-through deductionMost owner-operators can take up to 20 percent of business profit off their taxable income. It comes out right when the books are right all year.

Deductions medical equipment rental companies miss

Your bookkeeper knows what to look for in your statements. You never have to.

  • Sanitizing and sterilizing supplies
  • Delivery van fuel and repairs
  • Wheelchair and scooter batteries
  • Oxygen concentrator maintenance
  • Billing software subscriptions
  • DME licensing and renewal fees
  • Equipment tubing and parts
  • Delivery crew uniforms
  • Business liability insurance
  • Storage and warehouse rent
  • Card processing fees
  • Phone and fax for provider communication

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 equipment rental year, kept every month.

Referrals and rentals come in whenever a patient needs equipment. Your taxes come on a 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.

  1. January

    Plan the year

    Last year's return gets started, the 1099 list for delivery and repair help is ready, and you get a monthly set-aside so filing season is already handled.

  2. April

    Filed. Done.

    Your return is filed and signed. No surprise bill, because the set-aside has been running since January.

  3. July

    Halfway check

    Where you stand, what you will owe, and how outstanding insurance claims are shaping up against the year.

  4. October

    Before winter demand

    Winter often brings more falls and more referrals for mobility equipment. Gus looks at fleet purchases and moves worth making before December.

What you get

Starts at$197a month

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 equipment rental companies. 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 equipment rental owners ask first.

How does Gus handle income that is billed to insurance but not paid yet?

He counts it against the month the equipment actually went out and flags it as outstanding until the insurer pays, so a slow claim does not make a real working month look thin.

Can Gus file my Medicare or insurance claims?

No. Your team keeps your books and your tax set-aside on track, but insurance claims and medical billing codes stay with your billing software and your own process.

A family bought equipment outright instead of renting. How is that different in my books?

It gets booked as a separate sale rather than rental income, so your recurring rental revenue and one-time sales never get confused with each other.

Can I write off new wheelchairs and beds the same year I buy them?

Often yes, since medical equipment bought for rental is usually depreciable. Sometimes spreading the write-off across a few years fits your situation better, and the accountant makes that call.

My books are behind because insurance payments come in so late. Is that a problem?

No. Send the bank statements you have. Gus sorts them, notes what is still outstanding, and most owners know where they stand inside a week.

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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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