Skin, nails & body art
Books and taxes for medical tattoo and areola restoration artists.
Post-mastectomy areola restoration, scar camouflage work, referrals from plastic surgeons, and pigment matched carefully to each client's skin. 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
October came in at $9,800. Referrals from two plastic surgeons picked up, likely tied to breast cancer awareness month, and I kept those bookings apart from walk-in scar work.
- Areola restoration sessionRestoration sessions
- Consultation depositDeposits held
- Medical-grade pigment orderPigment and needles
- Surgeon referral marketingReferral marketing
- Clinical suite rentStudio rent
Why your books are different
Medical tattoo books go wrong in the same four places.
A generalist sees a session payment and a supply bill. Your business is careful pigment matching for scar and areola work, referrals from surgeons who send clients your way, and a clinical setting that costs more to run than a typical studio. When the books do not know that, your real referral value stays invisible.
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1
Referral bookings and walk-in work get lumped together
A client referred by a plastic surgeon and a client who found you through a flyer both pay the same session fee, but if that income is not tracked by source, you cannot tell which referral relationships are actually worth cultivating.
What we doTags session income by referral source where the data allows it, so you can see which relationships bring in real business. -
2
Consultation deposits get counted before the session happens
A client pays a deposit to hold a restoration session weeks out, and if that deposit lands as income the day it is paid, the month it was collected looks better than it should and the session month looks worse.
What we doHolds deposits as a balance until the session happens, then books the full job as one sale that month. -
3
Medical-grade pigment costs get treated like standard tattoo ink
Pigment matched carefully for scar and areola work costs more than standard tattoo ink, and averaged in with general supplies, you cannot see the real product cost behind a restoration session.
What we doKeeps medical-grade pigment spend in its own line, so per-session cost is accurate. -
4
Referral marketing to surgeons gets missed as a real cost
Building relationships with plastic surgeons often means marketing materials, sample books, or visits that are a real cost of getting referrals, but they rarely get tracked as their own expense.
What we doKeeps referral marketing spend in its own line, so you can see what it costs to build that pipeline.
Your categories
The categories Gus keeps for a medical tattoo practice.
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
- Restoration sessionsAreola restoration and scar camouflage sessions, tagged by referral source where possible.
- Consultation feesStandalone consults booked apart from the restoration session itself.
- Deposits heldTracked as a balance until the restoration session takes place.
- Touch-up sessionsFollow-up sessions outside any included touch-up window.
Money out
- Pigment and needlesMedical-grade pigment matched to skin tone, plus needles and cartridges.
- Referral marketingMaterials and outreach to build surgeon referral relationships.
- Studio rentClinical suite or studio lease.
- Licensing and insuranceTattoo license, health permits, and liability insurance.
- Continuing educationMedical tattoo and areola restoration certification courses.
- Sterilization suppliesAutoclave service and sharps disposal.
What we watch for you
- Deposits held
Money collected for sessions not yet completed, so income is not counted early.
- Referral share
How much of your income comes from surgeon referrals against walk-in clients.
- Cost per session
Pigment and needle spend against sessions booked, tracked from your own numbers.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things medical tattoo artists 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.
I tagged sessions by referral source where I could tell from your notes. That relationship brought in three sessions this month, worth tracking as it builds.
No, I hold it as a deposit until the session happens. It becomes income the month the work is actually done.
That depends on the client's coverage and how the surgeon's office handles it. Insurance billing is above my pay grade, so a real accountant is looking at that side.
The tax side
The tax side of a medical tattoo practice.
Most of what goes wrong here is timing and untracked marketing cost. Deposits counted early, referral spend missed, and a set-aside nobody started until April.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Equipment write-offsTattoo machines, magnifying lamps, and clinical furniture can usually be written off the year they are bought. Bonus depreciation is back to 100 percent for property acquired after January 19, 2025.
- Contractor 1099sAny contractor or fill-in artist paid $2,000 or more in 2026 gets a 1099-NEC by 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.
- Quarterly estimated taxesNothing withholds tax from session income automatically, so most owners pay estimated taxes April 15, June 15, September 15, and January 15.
Deductions medical tattoo and areola restoration artists miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Medical-grade pigment
- Needles and cartridges
- Autoclave and sterilization supplies
- Barrier film and sharps disposal
- Referral marketing materials
- License renewal and health permits
- Liability insurance
- Certification and continuing education
- Clinical suite furniture
- Magnifying lamp and lighting
- Sanitizing supplies
- Card processing 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 tattoo practice year, kept every month.
Awareness months and surgeon referral cycles shape bookings more than any single season. Your team keeps you ahead of both those swings 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, 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 running since January.
- July
Halfway check
Where you stand, what you will owe, and whether your referral relationships changed the number.
- October
Before year-end
Referral bookings often pick up around breast cancer awareness month. Gus looks at equipment worth buying 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 medical tattoo and areola restoration artists. 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 tattoo artists ask first.
Can Gus track which surgeon referrals actually bring in business?
Where your notes allow it, yes. He tags session income by referral source, so you can see which relationships are worth continuing to invest in.
Do consultation deposits count as income right away?
No. Gus holds deposits as a balance until the session happens, then books the full job as income that month, so nothing gets counted before the work is done.
Does Gus handle insurance billing for mastectomy-related work?
No, insurance billing and claims are not part of the offer. Your team keeps your books and flags income clearly, and any insurance question goes to the accountant or your billing contact.
Is medical-grade pigment tracked differently from regular tattoo ink?
Yes. It gets its own category since it costs more and is matched carefully to each client, so your per-session cost stays accurate.
My practice's books have never separated referral clients from walk-ins. Can that be fixed?
Yes. Send the bank statements you have. Gus sorts what he can by referral source, the accountant checks it, 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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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