Dental
Books and taxes for pediatric dentists.
Medicaid payments at a lower rate, parent copays, sedation fees, and sealant materials that get used all week long. Gus sorts every deposit, an accountant checks every transaction, and you get one number each month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
August made $14,200. Medicaid's payment came in under the fee schedule as usual, and I kept the sealant lab costs apart from the crown work.
- Medicaid batch depositInsurance and Medicaid
- Parent card paymentsPatient copays and cash
- Patterson Dental orderDental supplies
- Space maintainer lab billLab fees
- Nitrous gas refillSedation supplies
Why your books are different
A pediatric practice's books go wrong in four familiar places.
Your practice runs on Medicaid rates, sedation visits, and a school calendar that moves your busiest and slowest weeks around. A generalist bookkeeper who does not know that turns a normal pattern into a false alarm.
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1
Medicaid pays on its own schedule
A cleaning and sealant visit billed at $310 might carry a $140 Medicaid rate, and the payment can take weeks longer than a commercial claim. Booked at the full billed amount, the month looks stronger than the cash on hand.
What we doBooks the Medicaid payment as what lands, keeps the rate gap out of revenue, and tracks how long Medicaid deposits are taking to arrive. -
2
Sedation fees get lost in the noise
A nervous six-year-old might need nitrous or a sedation visit billed on top of the procedure itself. Lumped into general services, you cannot tell how much of a slow month came from fewer sedation cases.
What we doKeeps sedation and behavior management fees in their own line, apart from cleanings and restorative work. -
3
A no-show week looks like a slow month
A run of parent cancellations during a school testing week can make a month look like the practice lost patients, when it is really a scheduling week, not a real slowdown.
What we doFlags months where a dip lines up with the school calendar instead of an actual drop in demand. -
4
Sealants and space maintainers share one line
Sealant material and a custom space maintainer from the lab are priced and used completely differently, but a generic bookkeeper often dumps both into one supplies category, hiding which service is worth the chair time.
What we doKeeps sealant materials and lab-made appliances in separate categories so you can see what each service really costs.
Your categories
The categories Gus keeps for a pediatric dental practice.
Set up once for how the practice gets paid and what it spends. You never pick a category. He does, and an accountant checks it.
Money in
- Medicaid and CHIP paymentsReimbursements at a lower, slower rate than commercial insurance, with the gap kept separate.
- Commercial insurance paymentsPPO deposits for families with private coverage.
- Parent copays and cash payWhat parents pay at checkout, by card or cash.
- Patient financingCareCredit payouts for larger treatment plans, net of the fee.
Money out
- Dental suppliesPatterson Dental and Henry Schein orders, including sealant material and fluoride.
- Lab feesSpace maintainers, crowns, and custom appliances from the lab.
- Sedation suppliesNitrous oxide and any oral sedation medication.
- Hygienist and assistant payBase wages and any production bonus, kept apart from front desk pay.
- Practice and scheduling softwareDentrix or Open Dental, plus reminder texts that cut down on no-shows.
- MarketingSchool partnerships, local ads, and the website that bring in new families.
What we watch for you
- Medicaid share
How much of production comes from Medicaid against commercial insurance, since the rates differ so much.
- No-show rate
How many booked visits do not show, since it moves with the school calendar more than most practices.
- Sedation case volume
How many visits need nitrous or sedation, since that changes both revenue and chair time.
- The set-aside
What you owe as the Medicaid and commercial insurance mix shifts, tracked all year so April holds no surprise.
Ask Gus
Things pediatric dentists 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.
Medicaid's fee schedule is set well under what commercial plans pay for the same cleaning or filling. I book what actually lands and keep the gap separate so it does not look like lost revenue.
I checked. It lines up with the district's testing schedule, not a real drop in new patients. Worth a closer look if it happens outside that window.
As lab fees, kept apart from your regular supply orders, so you can see what appliance work is actually costing you each month.
The tax side
The tax side of a pediatric dental practice.
Most of what goes wrong here is timing and labels. Medicaid rates booked as if they were the full billed amount, and sedation equipment filed like ordinary supplies.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Medicaid and CHIP timingMedicaid and CHIP payments often land weeks after commercial claims and at a lower contracted rate. Neither changes what counts as income once the payment clears, only when.
- Sedation equipment and monitorsPulse oximeters, nitrous delivery systems, and monitoring equipment can usually be written off the year you buy them, under the same equipment rules as any other practice tool.
- Hygienist and assistant classificationWhether a hygienist or assistant counts as an employee depends on how much control the practice has over their schedule and methods, not just how they are paid.
- Contractor 1099sA locum pediatric dentist or a sedation specialist brought in for a day, paid $2,000 or more in 2026 and not on payroll, gets a 1099-NEC by January 31.
Deductions pediatric dentists miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Sealant and fluoride materials
- Nitrous and sedation supplies
- Loupes and headlights
- Kid-friendly clinic scrubs
- Malpractice insurance
- Practice software subscriptions
- Recall texting service
- Waiting room toys and books
- Continuing education
- Pediatric dental society dues
- Biohazard pickup
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 pediatric practice's year, kept every month.
Kids show up on the school district's schedule. Your taxes come on the calendar's 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 for the new year
Last year's return gets started, your contractor list for any relief dentist is ready, and a monthly set-aside begins so April is not a scramble.
- April
Return filed and signed
Your business return is filed. Since the set-aside has been running since January, there is no scramble to cover a surprise number.
- July
Summer checkup
Summer brings the year's busiest run of checkups before school starts again. Gus checks where the practice stands and what you will owe at the halfway point.
- October
Before the holiday slowdown
Bookings often thin out around the holidays. Before that hits, Gus flags equipment worth buying and anything worth doing 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 pediatric dentists. 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 pediatric dentists ask first.
How does Gus handle Medicaid payments that come in lower than billed?
He books what Medicaid actually pays and keeps the rate difference separate from revenue, so your numbers reflect real collections rather than the amount originally billed for the visit.
Our no-show rate swings a lot with the school calendar. Does that confuse the books?
No. Gus tracks the pattern month to month, so a slow week during school testing does not get mistaken for a real drop in new patients.
Do sedation cases need to be tracked separately?
Usually yes, since they carry their own supply costs and fees. Gus keeps nitrous and sedation visits in their own category so you can see how much of the month came from them.
My spouse works the front desk and is on payroll. Does that change anything?
It can. Family members on payroll need to be doing real work for real pay, or it can raise questions later. Gus flags anything that looks off so the accountant can take a look.
My books are a mess from the last few months. Can Gus still help?
Yes. Send the bank statements you have. Gus sorts through what is there, the accountant reviews it, and you will have a clear number soon.
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.
More in dental
We keep books for the business next door too.
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- Endodontists
- Oral surgeons
- Periodontists
- Orthodontists
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- Dental implant centers
- General dentists
- Compounding pharmacies
- Durable medical equipment (DME) suppliers
- Elective 3D/4D ultrasound studios
- Independent pharmacies
- Medical billing companies
- Mobile nursing & concierge nurse services
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- Mobile x-ray & ultrasound services
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- Birth doulas
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- Herbalists & apothecaries
- Hypnotherapists
- Lactation consultants
- Midwives & birth centers
- Neurofeedback clinics
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