Medical practices & clinics
Books and taxes for naturopathic doctors.
Cash-pay visits, an in-house apothecary stocked with herbs and tinctures, IV nutrient therapy, and licensing that looks different in every state. 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
March came in at $13,800. Apothecary sales were strong this month, so I kept that revenue apart from visit fees to show you the real split.
- New and follow-up visit feesCash-pay visit revenue
- Herb Pharm wholesale orderApothecary inventory
- IV nutrient therapy sessionsIV therapy revenue
- IV supply orderIV therapy supplies
- Practice management softwareSoftware subscriptions
Why your books are different
A naturopathic practice's books go wrong around the apothecary and the IV room.
You're running a visit-based practice, a small retail apothecary, and sometimes an IV therapy service, all under one roof, with a scope of practice that shifts depending on which state you're in. A generalist treats it as one blended business and loses the real picture of what each part is worth.
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1
Apothecary inventory blends into visit revenue
Herbs, tinctures, and supplements sold from an in-house apothecary are true retail inventory, bought wholesale and marked up, and if that revenue gets mixed with visit fees you cannot tell if the apothecary is actually profitable on its own.
What we doKeeps apothecary sales and their wholesale cost in their own lines, apart from visit revenue, so the retail margin is visible on its own. -
2
IV nutrient therapy has its own supply cost
An IV drip session includes real per-bag costs for the vitamins, minerals, and supplies used, and if that cost isn't tracked against IV revenue specifically, you can't tell if the pricing on that service actually covers what it costs to deliver.
What we doKeeps IV therapy revenue and its supply cost in their own lines, so the margin on that service is a real number, not a guess. -
3
What you can bill depends entirely on your state
Some states license naturopathic doctors as primary care providers who can bill insurance and prescribe certain medications, while others do not license the profession at all, which changes what revenue category even applies to your practice.
What we doSets up your categories to match how your state actually lets you practice and bill, rather than assuming a structure that doesn't apply to you. -
4
Longer visit types get priced and booked inconsistently
A comprehensive initial intake often runs far longer and costs more than a standard follow-up, and if both land in one generic visit category, you cannot tell which one is actually worth more of your calendar.
What we doKeeps initial and follow-up visit revenue apart, so you can see which visit type is actually filling your schedule most profitably.
Your categories
The categories Gus keeps for a naturopathic practice.
Set up once for how visits, apothecary sales, and IV therapy all get paid. You never pick a category. He does, and an accountant checks it.
Money in
- Cash-pay visit revenueInitial and follow-up visits paid directly by the patient.
- Insurance visit reimbursementsDeposits from payers, where your state license allows billing insurance.
- Apothecary salesHerbs, tinctures, and supplements sold in-house.
- IV therapy revenueVitamin and nutrient IV sessions, kept apart from visit fees.
Money out
- Apothecary inventoryWholesale stock from suppliers such as Herb Pharm or a similar herbal supplier.
- IV therapy suppliesVitamin and mineral IV fluids, bags, and lines used per session.
- Clinical wagesNurses and clinical support staff, kept apart from provider compensation.
- Continuing educationNaturopathic licensing renewal and specialty training.
- Malpractice or liability insuranceCoverage that varies by state licensing status.
- Rent and utilitiesOffice space for consultations, apothecary display, and the IV room.
- Practice management softwareScheduling, charting, and inventory tools.
What we watch for you
- Apothecary margin
What retail herb and supplement sales bring in against wholesale cost.
- IV therapy margin
What IV sessions bring in against their per-session supply cost.
- Visit type mix
How much revenue comes from comprehensive intakes versus shorter follow-ups.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things naturopathic doctors 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 apothecary sales against what the wholesale stock cost you, so the real margin is a number you can look at instead of a feeling.
I track what each session brings in against the vitamin and supply cost per bag, so you can see the margin. What to charge is your call, not mine.
It can change what categories apply, since billing and prescribing rules vary a lot by state. That's a scope of practice question above my pay grade, so I'd flag it for the accountant to set up correctly.
The tax side
The tax side of a naturopathic practice.
Most of what matters here is tracking apothecary inventory correctly and knowing where the pass-through deduction starts to phase out.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- The pass-through deduction phases outA naturopathic practice can lose part or all of the 20 percent pass-through deduction once taxable income passes $201,750 single or $403,500 joint, since medical practices are a specified service trade.
- Apothecary cost of goods soldHerbs, tinctures, and supplements held for resale are generally tracked as inventory, with their cost recognized as items sell rather than when they're purchased.
- IV therapy supply costsVitamin and mineral IV fluids used for IV sessions are generally deductible as the cost of delivering that service, tracked against the revenue it brings in.
- State licensing and scopeWhether your naturopathic license lets you bill insurance or prescribe certain medications varies significantly by state, which can affect how your revenue is categorized and reported.
Deductions naturopathic doctors miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Apothecary wholesale inventory
- IV therapy supplies
- Continuing education and licensing
- Malpractice or liability premiums
- Practice management software
- Retail display and apothecary fixtures
- Patient education materials
- Marketing for new patients
- Professional membership dues
- Office and consultation supplies
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 naturopathic practice year, kept every month.
Apothecary sales, IV sessions, and visit volume each move on their own rhythm. Your taxes come on a fixed 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.
- 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 apothecary or IV therapy revenue changed the number.
- October
Before year end
Gus looks at anything worth doing before December, including whether apothecary inventory levels make sense for the season.
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 naturopathic doctors. 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 naturopathic doctors ask first.
Do you bill insurance for visits in states where I'm licensed to?
No. Gus does not handle insurance billing, medical coding, or claims of any kind. Your practice management software or billing service still does that. Gus works from what actually lands in your bank account.
How do you separate apothecary revenue from visit fees?
By the category the deposit lands in. Apothecary sales and their wholesale cost stay in their own line, apart from what patients pay for visits.
We're adding IV therapy. Does that need special bookkeeping?
Yes, and Gus already handles it by keeping IV revenue and its per-session supply cost in their own lines, so the margin on that service is visible.
My scope of practice is different than a colleague's in another state. Does that matter to the books?
It can, since what you're allowed to bill and prescribe varies by state. Gus sets up categories that match your actual scope rather than assuming one structure fits everyone.
Do I owe sales tax on herbs and tinctures I sell?
Retail herbal products are often subject to state sales tax even when a visit is not. Gus keeps apothecary sales in their own line so the accountant can confirm what applies to you.
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