Best CPAs for Med Spas (2026): 8 Accounting Firms Compared

For med spa owners. Updated October 2, 2026 · Prepared by Prospyr. Prospyr makes practice software, not accounting or tax services, and none of the firms below is a Prospyr product. Each summary reflects what the firm publishes on its own website, checked October 2026. Fees, scope and credentials change, so confirm everything in a signed engagement letter before you hand over your books.

What does a CPA for a med spa do?

A CPA for a med spa keeps your books accurate, files your business and personal tax returns, and plans ahead so you don't overpay. The med spa version of that job adds a few things a general accountant may not know well: provider pay mixes of W-2, 1099 and commission, retail product inventory, equipment purchases and depreciation, membership and package revenue that is paid before it is earned, and practice ownership structures that involve a medical director or a separate management company. The differences that matter between firms are scope, who actually holds the CPA license, and how fees are billed.

The 8 med spa CPA and accounting firms at a glance

How we chose this list

We started with firms that name med spas or aesthetic practices as a market on their own websites, then checked four things a practice owner can verify before a call:

1. Med spa focus. Does the firm have a page or a whole site about med spas, or is it a general practice with a line in an industry list?
2. Who holds the license. Is the work led by a CPA, an enrolled agent (EA), or a bookkeeper? All three are useful, but they are not the same thing.
3. Scope. Does the firm cover bookkeeping, payroll, tax filing and planning, or only part of that?
4. Published terms. Does it publish a price, a minimum, a contract term or a guarantee?

Firms with a med spa-specific offer and published terms are near the top. The order is our editorial view, not a measure of results. Your state, revenue and ownership structure may point you somewhere else.

1. Med Spa Accountant (DeLucia CPA)

Med Spa Accountant is the med spa practice of DeLucia CPA, founded by Michael De Lucia, CPA, CFP. It serves med spas nationwide and covers tax planning and preparation, monthly bookkeeping and financial reporting, entity and structure work, and growth advisory, with payroll compliance oversight as an add-on.

What stands out:

• Published price and fit. It states that typical engagements start at $995 a month and that it is the best fit for med spas doing $750,000 or more a year (as of October 2026).
• No long contract. It describes engagements as month to month.
• Specific examples. It advertises up to $35,000 in average tax savings per practice it serves and gives an example of restructuring provider compensation to save $25,000 to $40,000 a year in payroll taxes. Treat these as the firm's own figures.

Right for: a multi-provider med spa past its first year that wants a CPA, not just a bookkeeper, and wants to know the starting cost before the first call.

Ask: what $995 a month includes, whether personal returns are extra, and who prepares your books day to day.

2. Flint & Associates (medspa.cpa)

Flint & Associates runs a med spa-specific practice at medspa.cpa. The site describes a licensed CPA firm based in New York that serves med spas and aesthetic practices in all 50 states, with revenue from about $300,000 to $15 million.

What stands out:

• Wide scope. Tax preparation and filing, year-round tax planning, med spa bookkeeping, fractional CFO services, payroll and HR compliance, and entity and structure work.
• Billing model. It states flat monthly fees, not hourly billing, agreed before work starts. The amounts are not published.
• Tools. It lists itself as a Xero Certified Partner and a Gusto partner.
• Published claims. It advertises average annual tax savings of $38,400 and $2.4 million or more in tax savings for the practices it serves over the last 12 months. These are the firm's own numbers.

Right for: an owner who wants one firm for books, payroll, tax and CFO-level planning. If you only need CFO work, compare it with our list of fractional CFOs for aesthetic practices.

Ask: which CPA leads your account, which accounting software you would have to move to, and how the flat fee changes as you add a location.

3. Account Sense

Account Sense is a CPA firm that names med spas as one of its three focus markets, along with medical practices and woman-owned businesses. It states it has worked with med spas since 2006 and has been fully virtual since May 2025.

Its med spa page lists outsourced accounting and bookkeeping, tax planning and preparation, payroll, fractional CFO services, cash flow work, equipment purchase guidance and staff compensation strategy. It says it tracks practice measures such as revenue per patient and elective versus surgical procedures, and that its operations manager has managed a med spa.

Right for: an owner who values a long track record with med spas and wants pricing built around their needs, not a fixed package. Ask: who your CPA is by name, and how a custom quote is built.

4. Morey CPA & Associates

Morey CPA & Associates describes itself as offering accounting, bookkeeping, tax and advisory services designed for aesthetic medicine practices. It lists med spas, plastic surgeons and dermatologists among the practices it serves, from a San Clemente, California office and offices in Los Angeles, Newport Beach and San Diego.

Its aesthetic practice page covers bookkeeping, payroll, financial reporting, cash flow, tax planning, budgeting and forecasting, profitability analysis, inventory and growth consulting. It also says it supports owners from opening through sale.

Right for: Southern California med spas and surgical practices that want a local firm with an aesthetic focus. Ask: who leads aesthetic engagements, and how fees are set.

5. Strategic Accounting and Tax Solutions

Strategic Accounting and Tax Solutions, in Grand Rapids, Michigan, focuses on wellness and beauty businesses, including med spas, hydration therapy and weight loss businesses. Its med spa page lists outsourced accounting, online bookkeeping, payroll, cash flow, budgeting, bank reconciliations and tax reduction planning.

It is one of the few firms on this list that publishes package prices (as of October 2026): New Business at $500 a month, Controller at $700 a month with business and personal tax returns and quarterly reviews, a custom-priced CFO package, and an Annual Business Review package from $2,000 a year.

Right for: a newer or single-location med spa that wants a fixed monthly cost with tax returns included. Ask: which CPA signs your returns, and whether there is a transaction or payroll headcount limit in each package.

6. MedSpaCpa (Jim Ciurlik, CPA)

MedSpaCpa is the practice of Jim Ciurlik, CPA, MBA, based in Elm Grove, Wisconsin. It describes itself as a virtual outsourced accounting and financial advisory firm that started with independent physicians and dentists in Wisconsin and now serves healthcare and med spa owners across the US.

It lists full-service accounting, practice performance measures, tax planning and preparation, employee benefit outsourcing, and help with equipment and practice financing. It offers a 60-day money-back guarantee: if you are not satisfied in the first 60 days, it states it will refund the monthly fees paid in that period.

Right for: an owner who wants a small firm and a direct relationship with the CPA. Ask: how many med spas he works with today, and who covers your account during tax season.

7. Elite Aesthetic Growth Advisors

Elite Aesthetic Growth Advisors, in Boulder, Colorado, states that it specializes in working with med spa owners and also serves aesthetic surgeons. It is led by Michael Moran, an enrolled agent who reports more than 35 years in tax and accounting.

Its services are tax-led: tax strategy and year-round planning, income tax preparation, tax review, IRS representation for audits and disputes, CFO support and business consulting.

Right for: an owner whose main need is tax planning or an open issue with the IRS. Note that the firm is led by an enrolled agent, not a CPA. EAs are licensed by the IRS to represent taxpayers, but if you need audited or reviewed financial statements for a lender or buyer, you will need a CPA firm. Ask: whether bookkeeping is handled in-house and what the fee covers.

8. Matheney and Matheney CPAs

Matheney and Matheney CPAs has offices in Spokane Valley, Washington and Coeur d'Alene, Idaho. It focuses on health and wellness businesses, with medical spas first on its list, and its med spa page covers outsourced accounting, online bookkeeping, payroll, cash flow, budgeting, projections and tax reduction planning.

Right for: a med spa in eastern Washington or northern Idaho that wants a CPA it can meet in person. Ask: how many med spas it serves, and how it handles provider commission payroll.

Questions to ask any med spa CPA

1. Who holds the license? Ask for the name of the CPA (or EA) who will sign your returns, and check the license with your state board of accountancy.
2. What is included in the fee? Bookkeeping, payroll, sales tax filings, business returns and personal returns are often priced separately. Get the list in writing.
3. How will you handle prepaid revenue? Memberships, packages and gift cards are paid before the treatment is delivered. Ask how the firm records them so your monthly profit is not overstated.
4. How do you handle provider pay? Ask about commission, W-2 versus 1099 status for injectors and medical directors, and payroll tax planning.
5. What do you need from our practice software? Ask which sales, payment and inventory reports they want each month, and who pulls them.
6. Will you sign a BAA? If the firm will see patient names next to treatments, for example in sales reports, ask whether it signs a business associate agreement. Better still, send summary reports without patient details.
7. Who owns the books if we leave? Confirm that the accounting file, payroll records and tax workpapers you need stay accessible to you.

Where Prospyr fits

Your CPA works from the numbers your practice software produces: daily sales, payments, refunds, memberships, packages and product inventory. Clean category and payment data in your practice platform means fewer hours of cleanup at month end. Prospyr's analytics and inventory management are built to give your accountant those reports. If you are reviewing your practice software too, book a practice demo.

For more background before your first call, see our med spa tax compliance guide and med spa KPIs with benchmark formulas.

Frequently asked questions

Do I need a CPA or is a bookkeeper enough for my med spa?

Most med spas need both. A bookkeeper records transactions and reconciles accounts each month; a CPA files returns, plans taxes and can advise on entity structure. Many firms on this list do both under one fee. If you want bookkeeping on its own, see our list of bookkeeping services for med spas.

How much does a CPA cost for a med spa?

It depends on scope, but the firms on this list that publish prices start at $500 to $995 a month as of October 2026. Strategic Accounting and Tax Solutions lists packages at $500 and $700 a month, and Med Spa Accountant states engagements typically start at $995 a month. Most other firms quote after a call.

Should my CPA be a med spa specialist?

It helps but is not required. A specialist is more likely to know provider commission pay, prepaid memberships and the ownership rules that apply to med spas. A strong general CPA can do the work if they ask the right questions, so test them with the questions above.

Can a CPA set up my med spa's ownership structure?

A CPA can advise on the tax side of an entity choice, but med spa ownership rules are set by each state, so a healthcare attorney should draft the structure. The CPA and the attorney should talk to each other before you file anything.

Want your company considered?

We review this list quarterly. CPA and accounting firms that serve med spas can send their website and what they offer practices to info@prospyrmed.com. Inclusion is editorial and not paid.

Editorial scope

This list is based on each firm's public website, checked October 2026 with AI-assisted research. Firms did not review this article before publication. It is not a guarantee of results, tax savings or a substitute for checking references and licensure with your state board of accountancy. Read our methodology or report a correction.