Top 10 Tax Strategists for Medical Practice Owners in 2026

For med spa, aesthetic and medical practice owners. Updated October 2, 2026 · Prepared by Prospyr. Prospyr makes practice software, not tax or accounting services, and none of the firms below is a Prospyr product or partner. Each summary reflects what the firm publishes on its own website, checked October 2026. Fees, eligibility rules and savings estimates change, and tax law changes too, so get an engagement letter and a written plan before you act on any strategy.

What does a tax strategist for medical practice owners do?

A tax strategist plans how your practice and your household are taxed before the year ends, not after. For a practice owner that usually means choosing the right entity (an LLC taxed as an S corporation, a professional corporation, or a split structure with a management company), setting a defensible owner salary, timing equipment purchases, funding retirement plans, and, if you own your building, ordering a cost segregation study so parts of it depreciate faster. A strategist differs from a tax preparer in one way: the work happens during the year, with a written plan you can follow.

The 10 tax strategists and cost segregation firms at a glance

How we chose this list

We looked for firms a practice owner could call this month and checked four things on each firm's own website:

1. Healthcare focus. Does the firm name physicians, med spas or aesthetic practices as a market?
2. Planning, not just filing. Does it describe year-round planning, entity work or a written strategy, beyond preparing returns?
3. Published terms. Does it publish fees, minimums, contract length or guarantees before the first call?
4. Real estate coverage. For owners who buy or build their space, does it offer, or clearly hand off to, a cost segregation study?

Firms 1 to 7 are tax planners and CPAs. Firms 8 to 10 are cost segregation specialists that usually work alongside your CPA rather than replacing one. The order is our editorial view, not a measure of results.

1. Med Spa Accountant

Med Spa Accountant is a CPA firm that works only with med spas. Its founder, Michael De Lucia, CPA, CFP, states he ran DeLucia CPA for 12 years before starting this firm. It serves med spas in every state and lists tax planning and preparation, bookkeeping with CPA review, KPI reporting, growth consulting and entity structure work, with payroll compliance oversight as a separately priced add-on.

What stands out:

• Published price. Engagements typically start at $995 a month, month to month with no long-term contract, as of October 2026.
• Clear fit. It states it is the best fit for med spas doing $750,000 or more a year, especially multi-provider and multi-location practices.
• Aesthetic detail. It describes tracking injectable inventory, cash-pay revenue and provider compensation, and reporting which services (Botox, fillers, laser) drive profit.
• Savings claims. It advertises average tax savings of "up to $35k" per practice and gives examples of $25,000 to $40,000 a year in payroll tax savings from restructuring provider compensation. Treat these as the firm's own figures.

Right for: an established med spa that wants one CPA for books, taxes and structure. Ask: what the $995 tier covers at your revenue and provider count, and how compensation restructuring is documented if the IRS asks.

2. Cerebral Tax Advisors

Cerebral Tax Advisors, based in Knoxville, Tennessee, states it specializes in medical professionals, including physicians in private practice and dentists. It offers tax planning, tax preparation, bookkeeping, IRS representation and CFO services.

What stands out:

• Stated minimums. Its main planning package requires at least $400,000 in annual taxable income and a business earning $50,000 or more as an independent contractor. An investor package covers high W-2 earners who invest in real estate.
• Defined process. It lists four sessions: a 45-minute discovery call, a 90-minute deep dive, a 90-minute plan delivery with a written PDF, and a 60-minute implementation session.
• Guarantee. It guarantees it will identify at least twice your plan fee in first-year savings from tax code strategies, or refund the payment.
• What is included. Entity setup and payroll if needed, a reasonable compensation analysis, and a review of three prior years of returns. It requires at least three months in a maintenance package.

Right for: a physician owner with high income who wants a structured, written plan. Ask: the flat fee in writing, and the cost of the maintenance package after month three.

3. Physician Tax Solutions

Physician Tax Solutions, in Garden Ridge, Texas, was founded by David Auer, author of The Richest Doctor. It serves physicians, 1099 and locum tenens doctors, and practice owners with tax preparation, year-round tax planning and retirement planning under what it calls its Strategic Wealth System.

What stands out:

• Entity topics. Its site covers S corporation elections, professional corporations versus PLLCs, self-employment tax, home office rules, Section 179 and bonus depreciation, and the qualified business income deduction.
• Preparation and planning together. The same firm files the returns it plans.

Right for: a physician with 1099 or practice income who wants planning and filing from one firm. Ask: the annual fee, and how often you meet during the year.

4. Morey CPA & Associates

Morey CPA & Associates describes itself as a wellness accounting firm. It lists aesthetic medicine practices, plastic surgeons, dermatologists, med spas and wellness centers as its markets, and offers tax reduction planning, bookkeeping, payroll for wellness businesses and business consulting. Its main office is in San Clemente, California, with offices listed in Los Angeles, Newport Beach and San Diego.

Right for: an aesthetic practice in Southern California that wants a local CPA who knows the specialty, from opening to sale. Ask: who on the team handles tax planning, and how many med spas they file for today.

5. MedSpaCpa

MedSpaCpa is the practice name of Jim Ciurlik, CPA, MBA, in Elm Grove, Wisconsin. It serves med spa owners and other healthcare entrepreneurs with accounting, KPI analysis, tax reduction, planning and preparation, employee benefit outsourcing, and equipment and practice financing help. Ciurlik reports Big 4 accounting experience, CFO roles, and past work with physicians and dentists.

Right for: an owner who wants a small, founder-led firm. It offers a 60-day money-back guarantee on monthly fees. Ask: whether entity restructuring is in scope, and who covers the work if the founder is unavailable.

6. MDcpas

MDcpas is a New York-based healthcare CPA and consulting firm that lists physicians, dental practices and 30+ medical specialties, including dermatology, among the practices it serves. Services include entity selection, accounting and tax, real estate investments, retirement planning, estate planning and exit strategies.

Right for: a physician owner, especially in the Northeast, who wants tax work tied to retirement, estate and exit planning. Ask: how much of its work is with cash-pay or aesthetic practices.

7. The Doctor's CPA

The Doctor's CPA, in Orlando, Florida, focuses on locum tenens physicians and other medical professionals, especially those moving from W-2 to 1099 income. Its core package covers bookkeeping, payroll, financial statements, tax filing and profit review meetings, with tax planning and retirement planning as add-ons.

Right for: a physician who works as a medical director or contract injector on the side and needs an entity and a quarterly tax routine. Ask: whether it takes on a full med spa practice or mainly individual physicians.

8. KBKG

KBKG is a specialty tax firm with offices in Los Angeles, New York, Atlanta, Chicago, Dallas and Houston. It reports over $11 billion in tax benefits claimed and more than 25 years in business, and works with CPAs as well as owners directly. Healthcare is one of its listed industries.

What stands out:

• Medical buildings. Its cost segregation page names medical offices and hospitals among its case study building types.
• Stated threshold. It targets buildings purchased, built or remodeled in the last 15 years with more than $1,500,000 spent.
• Typical result. It states that on average 20% to 40% of building components fall into 5-, 7- or 15-year categories instead of 27.5 or 39 years.

Right for: a practice owner who bought or built out a building above that threshold. Ask: for the free preliminary analysis, and whether a tenant build-out in a leased space qualifies.

9. Engineered Tax Services

Engineered Tax Services offers cost segregation studies, R&D tax credits, 179D energy deductions and 1031 exchange services for investors, business owners and high-income individuals. It reports more than 75,000 studies completed and more than 25 years in business, and works through CPA firm partnerships. Its homepage does not name medical practices as a market.

Right for: a practice owner with real estate who wants a large, established study provider. Ask: examples of medical office studies and the fee for your building size.

10. CSA Partners

CSA Partners is a nationwide cost segregation firm that reports more than 30,000 studies and 20+ years in business. It describes site visits with photo documentation and engineering analysis, and serves real estate owners, developers and CPAs. Its homepage does not name medical practices as a market.

What stands out: a stated guarantee to refund its engagement fee if a significant depreciation finding is disallowed on audit.

Right for: an owner who wants audit protection in writing. Ask: what counts as "significant" under the guarantee.

Questions to ask any tax strategist

1. What will you do during the year, not just at filing? Ask for the meeting schedule, the deliverable (a written plan) and who updates it when your income changes.
2. How will you set my reasonable salary? If your practice is taxed as an S corporation, the owner salary must hold up to the IRS. Ask how the firm documents it.
3. How does my ownership structure affect taxes? Many med spas use a management company alongside a physician-owned practice because of state corporate practice of medicine rules. Your attorney sets the structure; your strategist should plan around it. See our list of healthcare attorneys for med spa ownership.
4. What is the full fee, and what is extra? Ask for the engagement letter, the minimum term and the cost of add-ons like payroll, multi-state returns or amended returns.
5. What happens in an audit? Ask whether representation is included and who signs off on aggressive positions.
6. Do you work with cost segregation firms? If you own your building, ask which study providers the firm has worked with and how the study reaches your return.
7. What reports do you need from my practice? Monthly revenue by service, provider pay and inventory cost make planning faster and cheaper.

Where Prospyr fits

A tax strategist plans with the numbers your practice produces. Prospyr's analytics shows revenue per provider and service mix, and inventory management tracks product on hand, which gives your CPA cleaner monthly numbers to plan with. For the books underneath the plan, see our list of bookkeeping services for med spas, or book a practice demo.

Frequently asked questions

Should my med spa be an S corporation?

Often, but not always. An S corporation election can lower self-employment tax once profit is well above a reasonable owner salary, but it adds payroll, a separate return and state fees. Ask a CPA to run both versions with your real numbers, and read our tax planning guide for aesthetic practice growth.

What is cost segregation, and is it worth it for a medical office?

Cost segregation is an engineering study that sorts a building's costs into shorter depreciation lives so you can deduct more sooner. It is usually worth pricing if you bought, built or substantially remodeled a building you own. KBKG, for example, targets projects above $1.5 million. Your CPA decides how the results are used on your return.

How much does a tax strategist cost?

Few firms publish fees. Among the firms on this list, Med Spa Accountant lists engagements from $995 a month as of October 2026, and Cerebral Tax Advisors uses a flat fee quoted after a discovery call, with a guarantee tied to the fee. Expect planning to cost more than return preparation alone.

Is a tax strategist different from a CPA?

Sometimes. Many tax strategists are CPAs, but not every CPA does planning. Ask whether the firm builds a written plan during the year or mainly prepares returns after it ends.

Do I need a separate firm for cost segregation?

Usually, yes. Cost segregation studies are done by engineering-based specialists such as KBKG, Engineered Tax Services or CSA Partners, and your CPA uses the study on your return.

Want your company considered?

We review this list quarterly. Tax and accounting firms that serve medical and aesthetic practice owners 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 tax advice, a guarantee of savings, or a substitute for checking credentials and references. Confirm a CPA's license with your state board of accountancy. Read our methodology or report a correction.