Top 7 Fractional CFO Firms for Aesthetic Practices in 2026

For med spa owners and aesthetic surgery practices. Updated October 2, 2026 · Prepared by Prospyr. Prospyr makes practice software, not finance or accounting 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 terms change, so confirm everything in a written engagement letter before you sign.

What does a fractional CFO do for an aesthetic practice?

A fractional CFO gives your practice senior financial leadership for a few hours or days a month instead of a full-time salary. For a med spa or aesthetic surgery practice, that usually means a monthly review of your profit and loss, a cash flow forecast, budgets, margin by service line (injectables, lasers, surgery, retail), provider compensation modeling, and a plan for big decisions like a second location, a new device, or a sale. Many also run tax planning. The key difference from a bookkeeper is direction: a bookkeeper records what happened, a CFO helps you decide what happens next.

The 7 fractional CFO firms at a glance

How we chose this list

We started with firms that offer fractional, part-time or outsourced CFO work and name med spas, aesthetic practices or plastic surgeons on their own websites. Then we looked at four things a practice owner can check before a sales call:

1. Aesthetic focus. Does the firm name med spas or aesthetic surgery as a market, or is it a generalist?
2. CFO scope, not just compliance. Does it publish forecasting, cash flow, KPI or budgeting work, or only tax returns?
3. Published terms. Does it state a price, a minimum revenue, or a guarantee?
4. Who does the work. Does it name its CPA, enrolled agent or CFO?

Fractional CFO work for aesthetic practices is a thin niche. Several firms on this list are accounting or tax firms that offer CFO-level advisory as one service. We say so where it applies. The order is our editorial view, not a measure of results.

1. Bennett Financials

Bennett Financials describes itself as a fractional CFO and tax strategy firm for US service businesses doing $2M to $20M in revenue, founded in 2018 by Arron Bennett in Knoxville, Tennessee. It has a dedicated page for plastic surgeons running $2M to $10M+ cash-pay practices.

What stands out:

• One published price. $5,000 a month, as of October 2026, with no tiers. The retainer lists bookkeeping, tax returns, tax planning, a live CFO dashboard, monthly CFO meetings and exit planning.
• Defined onboarding. It states the full system is installed within 120 days.
• A named framework. It benchmarks practices against its "60/15/15" targets for gross margin, sales and marketing, overhead and operating profit.
• Free first step. A 20-minute "Profit & Tax Leak Check" with no documents, followed by a one-page summary within 24 hours.
• Named team. The site lists a CPA controller, enrolled agent tax strategist and bookkeepers, and reports serving 50+ service businesses.

Right for: aesthetic surgery practices and larger med spas above $2M in revenue that want bookkeeping, tax and CFO work from a single firm at a fixed fee. Ask: how many aesthetic practices it serves today, who your monthly CFO contact is, and what the exit terms are.

2. Med Spa Accountant

Med Spa Accountant is a CPA-led firm founded by Michael De Lucia, CPA, CFP®, who previously ran DeLucia CPA for 12 years. It states that it works exclusively with med spas and aesthetic medical practices.

What stands out:

• Published fit and price. It names its best fit as med spas generating $750,000+ a year, and says typical engagements start at $995 a month, as of October 2026.
• Honest "not a fit" list. Startups, solo operators, and practices that only want a tax return.
• Advisory scope. Monthly financials, KPI dashboards showing which services drive profit, proactive tax planning, entity review, and growth planning for new providers or locations. Payroll compliance oversight is an add-on priced separately.

Right for: an established, multi-provider med spa that wants CFO-style reporting and tax planning from accountants who only serve this industry. Ask: how much of the engagement is bookkeeping versus advisory, how often you meet, and who your day-to-day contact is. For a tax-and-accounting-first comparison, see our list of CPAs for med spas.

3. Elite Aesthetic Growth Advisors

Elite Aesthetic Growth Advisors serves med spa owners and aesthetic surgeons. Its services include strategic tax planning, "CFO Support for Growth" (budgets, performance analysis, financial controls), tax resolution and audit representation, consulting, and tax preparation.

What stands out:

• Tax representation. It represents owners before tax authorities in audits and disputes, which most CFO firms do not.
• Experience. CEO Michael Moran is an enrolled agent who reports more than 35 years of tax and accounting experience, with a tax manager and bookkeeper also listed.

Right for: owners who want CFO-level guidance alongside year-round tax planning, or who are facing an IRS issue. Ask: who prepares your monthly financials, how often you review them together, and how fees are set.

4. Meliora Consulting

Meliora Consulting PLLC is a boutique tax advisory and fractional CFO firm founded by Michelle Stricklin, CPA, who lists licenses in Virginia, Oklahoma and Nevada and over fourteen years of tax experience. Its fractional CFO service lists monthly KPI reviews, cash flow monitoring and forecasts, budgets and scenario modeling, and fundraising support. It also has a dedicated MedSpa Tax & Advisory service.

The firm's About page says its core specialty is corporate tax and technology businesses, so med spas are one market rather than the only one. It is listed in the American Med Spa Association (AmSpa) vendor directory, where it offers members a complimentary 20 to 30 minute "Med Spa Tax Checkup" covering entity structure, owner pay and estimated taxes.

Right for: a med spa that wants forecasting and scenario modeling from someone with a strong tax background. Ask: how many med spas it serves, and how the CFO work and tax work are priced together.

5. Atteign

Atteign is an accounting and advisory firm in Austin, Texas that works with med spas nationwide. Its med spa page lists revenue tracking by service line, expense management, payroll and commission accounting for W-2 and 1099 providers, deferred revenue for prepaid packages and gift cards, and KPI reporting. Its financial advisory service covers cash flow forecasting, budgeting, KPI dashboards and pricing or expansion advice. That page frames the work as fractional CFO support.

Right for: a single-location med spa that wants clean monthly books and light CFO advisory from the same team. Ask: whether advisory is included or billed separately, and who reviews your package and membership liability each month.

6. MedSpaCPA

MedSpaCPA is run by Jim Ciurlik, CPA, MBA, through his virtual outsourced accounting and financial advisory firm. It positions itself around med spa profitability: full-service accounting, key performance indicator tracking, tax reduction and planning, employee benefit outsourcing, and help sourcing equipment and practice financing.

What stands out: a published 60-day money-back guarantee. If you are not satisfied within the first 60 days, it states it will refund the monthly fees you paid in that period.

Right for: owners who want a CPA to manage the numbers and tax planning together and like a refund window while they test the fit. Ask: what monthly KPIs you will receive and how many med spas it currently serves. Most testimonials on the site come from other kinds of businesses.

7. Cavin CPAs & Advisors

Cavin CPAs & Advisors is a general CPA firm in Chesterfield, Missouri. Its part-time CFO service lists monthly, quarterly or annual financial statements, forecasting, payables and receivables, cash flow guidance, tax planning, sales and payroll tax compliance, and accounting system setup. Healthcare is one of several industries it lists.

Cavin is a Platinum vendor in the AmSpa vendor directory under bookkeeping and accounting.

Right for: practices in the St. Louis area, or owners who prefer a traditional full-service CPA firm that can also act as a part-time CFO. Ask: how many med spa or aesthetic surgery practices it serves, and which person would be your CFO.

Questions to ask any fractional CFO

1. How many aesthetic practices do you serve today? Ask for a reference from a med spa or aesthetic surgery practice of similar size.
2. Who is actually my CFO? Get the name, credentials (CPA, EA, CFP®) and how many practices that person handles.
3. What do I receive each month? Ask for a sample report: profit by service line, provider productivity, cash forecast, and deferred revenue from packages and memberships.
4. Is bookkeeping included? A CFO is only as good as the books. Find out who closes the month and by what date.
5. What is the fee, term and exit notice? Compare a flat retainer with hourly billing, and get the cancellation terms in writing.
6. Will you sign a business associate agreement (BAA)? Most CFO work uses summary data, but if the firm will see patient names, invoices or chart-linked reports, ask for one.
7. Who owns the files? Confirm you keep your accounting file, payroll records and models if you leave.

Where Prospyr fits

A fractional CFO works from the numbers your practice software produces: revenue by service and provider, package and membership balances, and product costs. The cleaner those reports are, the less time you pay a CFO to rebuild them in a spreadsheet. If you're reviewing your system too, see how Prospyr handles analytics and memberships, our guide to financial dashboard benchmarks for aesthetic clinics, or book a practice demo.

Frequently asked questions

How much does a fractional CFO cost for a med spa?

It depends on revenue and scope, and most firms don't publish a price. Of the firms on this list, Med Spa Accountant says typical engagements start at $995 a month, and Bennett Financials publishes a flat $5,000 a month that includes bookkeeping and tax work, both as of October 2026. Ask whether bookkeeping and tax returns are in the fee or billed separately.

When does a med spa need a fractional CFO?

Usually when the decisions get bigger than the bookkeeping. Common triggers are adding a second location, buying a large device, hiring a provider on a new pay plan, taking on a loan or investor, or planning a sale. Med Spa Accountant, for example, names $750,000 a year in revenue as its best-fit starting point.

What is the difference between a fractional CFO and a CPA?

A CPA is a license; a fractional CFO is a role. Many fractional CFOs are CPAs, but a CPA engagement may cover only tax returns. A CFO engagement adds forecasting, budgets, KPI reviews and decision support. See our lists of CPAs for med spas and bookkeeping services for med spas if you need those first.

Can a fractional CFO help with taxes?

Yes, often. Several firms here, including Bennett Financials, Elite Aesthetic Growth Advisors and Meliora Consulting, combine CFO work with tax planning. For entity structure and deeper planning, see our list of tax strategists for medical practice owners.

Want your company considered?

We review this list quarterly. Fractional CFO firms that serve med spas or aesthetic surgery practices 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, plus the AmSpa vendor directory where noted. Firms did not review this article before publication. It is not a guarantee of results or a substitute for checking references and professional licenses. Read our methodology or report a correction.