CPA for Doctors

Any licensed CPA can file an accurate return, but most general accountants are built for W-2 employees and small businesses, not for a physician earning across W-2, 1099, and entity income in multiple states. A CPA for doctors knows the elections and strategies that actually move a physician’s tax bill: S-Corp timing on 1099 income, multi-state locum filing, Real Estate Professional Status, and retirement-plan stacking. Accuracy is the floor; optimization is the point.

In practice the terms are used interchangeably, but the meaningful difference is compliance versus strategy. A general accountant for doctors records what already happened and files it correctly. A physician tax specialist structures your income, entities, and investments before the year closes to lower your lifetime tax burden, modeling locum contracts, REPS qualification, and the specific IRS rules that apply to medical professionals.

Yes. We serve doctors across all 50 states and handle multi-state filing for locum tenens physicians who practice in multiple jurisdictions. Our team understands state-specific nexus rules, reciprocity agreements, and apportionment methods that affect your tax liability in each state you work.

Absolutely. Multi-state filing is one of our core specialties. We track your days worked in each state, apply reciprocity agreements where available, allocate income using each state’s apportionment rules, and ensure you receive proper credit on your resident return to avoid double taxation.

Yes. We prepare and file personal returns (Form 1040), S-Corp returns (Form 1120-S), partnership returns (Form 1065), and any related state filings. We also handle payroll tax compliance, quarterly estimated payments, and entity formation so everything stays coordinated under one strategy.

Both. Alongside tax planning, we provide medical practice accounting and monthly bookkeeping for doctors: financial statements, payroll, and reporting, so your books and tax strategy stay under one roof. Accurate books are also what make strategies like reasonable compensation and the accountable plan defensible.

A healthcare CPA combines tax strategy with the accounting side of medicine: entity structure, reasonable compensation, retirement-plan design, real-estate offsets, and multi-state filing on the tax side, plus practice bookkeeping, payroll, and financial reporting on the accounting side. The value is a single advisor who understands how a physician earns, spends, and is taxed, rather than a generalist who sees only the return.

Yes. Even without 1099 income, W-2 physicians can stack an HSA, capture the mega backdoor Roth if the employer plan allows after-tax contributions and in-service distributions, optimize deferred-compensation elections, and use real-estate strategies (the short-term-rental material-participation exception, or REPS through a spouse) to offset W-2 income. The biggest W-2 lever is usually retirement-plan and real-estate coordination rather than entity structure.

An S-Corp only helps once you have meaningful 1099 net income (locum, expert witness, consulting, or a private practice) above a defensible reasonable salary. The savings come from avoiding self-employment tax on the pass-through portion above that salary, so the math depends entirely on how much profit sits above reasonable compensation, not on revenue. For purely W-2 physicians, an S-Corp does nothing. We run the break-even before recommending it.

It depends on your income level, current structure, and how much of your income is 1099 versus W-2. For physicians with significant 1099 income, an S-Corp election cuts self-employment tax, and the entity unlocks larger retirement and deduction strategies. When combined with real estate strategies like REPS and cost segregation, total savings can be substantial. Because the variables are so individual, we do not quote a savings number before we have done the work; we identify the opportunities first.

Yes. We work with physicians at every career stage. For residents and fellows, we focus on Roth conversions during lower-income years and early, clean setup for any moonlighting or side income, so you are positioned for larger savings the moment you become an attending.

Significantly. Two physician incomes push you deep into the top brackets and the additional Medicare surtax, and they multiply the retirement and real-estate decisions that have to be coordinated. We model the household as a single system, sequencing entity, retirement, and real-estate moves across both careers rather than treating them as two separate returns.

Yes, and side income is often where the easiest wins are. 1099 moonlighting, expert-witness work, telehealth, medical directorships, and content or consulting income can support an entity, a Solo 401(k), and a slate of business deductions that W-2 income alone cannot. We structure the side gig so it pays for retirement and lowers your effective rate at the same time.

Both let real-estate losses offset your physician income, but they qualify differently. REPS requires 750+ hours and more time in real estate than in medicine, usually only practical for a non-physician spouse. The short-term-rental exception does not require REPS at all: if the average guest stay is 7 days or fewer and you materially participate, the activity is treated as non-passive, so the losses flow against your W-2 or 1099 income. Many physicians qualify for the STR route when REPS is out of reach.

Book a free 30-minute call through our website. We review your current income sources, entity structure, and tax situation, and you walk away with a clear picture of the opportunities we see and recommended next steps. No obligation, no sales pressure. Most physicians know within 15 minutes whether we are the right fit.

Bring your most recent tax return (Form 1040 and any business returns), a summary of your income sources (W-2, 1099-NEC, 1099-MISC), current entity documents (if applicable), and details on any real estate holdings. The more context you provide upfront, the more specific our recommendations will be.

Some strategies must be in place before year-end (most retirement contributions, the Augusta Rule, intra-year entity moves), but several can still be captured afterward: late S-Corp elections under IRS relief procedures, cost-segregation studies and bonus depreciation claimed via an accounting-method change, IRA and HSA contributions up to the filing deadline, and amended returns where a clear opportunity was missed. The sooner we look, the more remains on the table.

No. We are based in Springfield, Illinois and work with physicians and doctors nationwide, so whether you are searching for a "CPA for physicians near me" or simply the right specialist regardless of location, we can help. Onboarding, planning sessions, and document exchange all happen remotely, and we coordinate multi-state filings regardless of where you live or take assignments.

Fees depend on the complexity of your situation: number of entities, states, real-estate holdings, and the depth of planning involved. Rather than quote a generic number, we scope your engagement on the discovery call so you see exactly what is included before deciding. The goal is for the strategy to be worth a multiple of the fee.

Every strategy we implement is built to be documented and defensible from day one: reasonable-compensation benchmarking for S-Corps, hour logs for REPS and material participation, fair-market rent support for the Augusta Rule, and contemporaneous records for travel and home-office deductions. We do not chase aggressive positions that cannot survive scrutiny; the goal is durable savings, not a number that unwinds under audit.