Medical practices & clinics
Books and taxes for mobile x-ray and ultrasound services.
Facility contracts, a portable x-ray unit that cost as much as a truck, remote radiologist reads billed apart from the scan, and annual equipment certification. 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
November came in at $17,500. The portable ultrasound unit finished its first full month on a new facility contract, so I tracked that revenue against the equipment cost separately.
- Golden Years Care Center contractFacility contract revenue
- Radiologist reading fee payoutProfessional interpretation fees
- Portable x-ray unit leaseImaging equipment costs
- Annual x-ray certificationEquipment certification costs
- Per-study home visit feesDirect study fee revenue
Why your books are different
A mobile imaging service's books go wrong around equipment and the read.
You're carrying expensive portable equipment between facilities and homes, splitting revenue with a radiologist who reads the images remotely, and paying for annual certifications a normal service business never sees. A generalist has no framework for any of it.
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1
The technical fee and the reading fee are two different payments
Performing the scan and reading the images are billed and paid separately, with the technical fee for the study going to your service and a professional reading fee going to the radiologist who interprets it, sometimes on different schedules.
What we doKeeps technical study revenue apart from professional interpretation fees paid out, so each study's economics stay clear instead of blending together. -
2
Portable equipment is a major cost, not a supply run
A portable x-ray unit or ultrasound machine can cost tens of thousands of dollars, and filed as a supply purchase, it wrecks the month it was bought and hides what it's worth over years.
What we doFlags a big equipment purchase the day it lands, logs it as equipment, and lets the accountant decide how it gets written off. -
3
Annual certification costs look like a random spike
Imaging equipment typically needs annual calibration and certification, a real recurring cost that shows up once a year and can look like an unexplained expense if it's not tracked as its own category.
What we doKeeps equipment certification costs in their own line, tagged to the month they happen, so an annual expense reads as expected, not alarming. -
4
Facility contracts and one-off home visits get blended
A standing contract with a nursing facility pays differently than an occasional home visit fee, and blended together you cannot tell which relationship is actually filling your schedule.
What we doKeeps facility contract revenue apart from direct study fees, so you can see which relationships are driving the business.
Your categories
The categories Gus keeps for a mobile imaging service.
Set up once for how facility contracts, studies, and equipment all get paid. You never pick a category. He does, and an accountant checks it.
Money in
- Facility contract revenueStanding agreements with nursing homes and care facilities.
- Direct study fee revenuePer-study fees for home visits outside a standing contract.
- Technical component revenueWhat your service is paid for performing the scan itself.
- After-hours and stat study feesPremium fees for urgent studies requested outside normal rounds.
Money out
- Imaging equipment costsPortable x-ray and ultrasound units, logged so they get written off right.
- Professional interpretation feesWhat a radiologist is paid to read and interpret the images.
- Equipment certification costsAnnual calibration and certification for imaging equipment.
- Technologist wagesRadiologic technologists and sonographers, kept apart from other costs.
- Vehicle costsFuel and maintenance for the vehicle transporting equipment between stops.
- Liability insuranceCoverage for technologists working in facilities and homes.
- Lead shielding and protective suppliesAprons and shielding used to protect patients and staff.
What we watch for you
- Facility versus direct revenue mix
How much comes from standing facility contracts versus one-off study fees.
- Equipment cost recovery
How imaging equipment cost compares to the revenue it's generated so far.
- Reading fee share
What professional interpretation fees take against your technical study revenue.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things mobile imaging 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.
I keep technical revenue and professional interpretation fees in separate lines, so you can see exactly how the split works on each study.
It's not random, it's yearly. I keep certification costs in their own line, tagged to when they happen, so it reads as expected instead of alarming.
I keep facility contract revenue apart from direct study fees, so you can compare the two directly. Which is worth pursuing more is your call.
The tax side
The tax side of a mobile imaging service.
Most of what matters here is timing equipment purchases and worker classification for contract technologists.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Imaging equipment purchasesPortable x-ray and ultrasound units can usually be written off the year you buy them, with 100 percent bonus depreciation available for property acquired after January 19, 2025.
- Contract radiologist reading feesA radiologist who reads studies remotely and 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.
- Vehicle costs for equipment transportA vehicle used mainly to transport imaging equipment between stops can generally deduct actual costs or standard mileage, whichever your accountant finds works out better.
- Employee or contractor for technologistsA technologist who works your set schedule and uses your equipment is usually an employee, even if paid per study, while one who sets their own terms across multiple services may be a contractor.
Deductions mobile x-ray and ultrasound services miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Equipment certification and calibration
- Imaging equipment maintenance
- Lead shielding and protective supplies
- Liability insurance
- Vehicle fuel and maintenance
- Licensing and registration renewal
- Radiologist reading fees
- Scheduling software
- Uniforms and identification badges
- Cell phone for dispatch
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 mobile imaging year, kept every month.
Facility contracts, equipment certification, and study volume each move on their own schedule. Your taxes run on a fixed one. 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, any contract radiologist's 1099 is ready, 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 facility contracts or equipment costs changed the number.
- October
Before year end
Gus looks at equipment worth buying and anything worth doing before December, including whether certification renewals are coming up.
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 mobile x-ray and ultrasound 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 mobile imaging owners ask first.
Do you bill facilities or insurance for studies?
No. Gus does not handle insurance billing, medical coding, or facility invoicing. He works from what actually lands in your bank account.
How do you separate what we're paid from what the radiologist is paid?
Technical study revenue and professional interpretation fees are kept in separate lines from the start, so the split on each study is always clear.
Our certification bill only comes once a year. Does that confuse the books?
No, Gus keeps it in its own category tagged to when it happens, so a once-a-year cost reads as expected rather than a mystery expense.
Is it worth pursuing more standing facility contracts instead of one-off visits?
Gus can show you facility contract revenue against direct study fees so you're comparing real numbers. Which to pursue is a business decision for you.
We just bought a new portable ultrasound unit. Does that all come off this year?
Usually it can. Gus logs it as equipment, not supplies, and flags it so the accountant makes the call with your whole year in view.
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