Liguori Accounting

10/13/2026

If your med spa runs an MSO, here’s a question to answer before December 31: which entity is holding your profit?

In most structures, the MSO should carry the profit or loss at year end, and the PC should finish close to break-even. When profit gets stranded in the wrong entity, the wrong person ends up paying the tax.

This month is the time to check:
→ Patient revenue is landing in the PC’s account
→ Expenses are coded to the right set of books
→ Intercompany balances match across both entities
→ Your year-end true-up is projected before the year closes

Nick breaks it down in our newest post, with the full video inside:https://www.liguoricpa.com/2026/10/08/which-entity-should-show-the-profit-in-your-med-spa-mso-at-year-end/

10/12/2026

Every fall, we hear the same question: should I buy the laser before December 31 for the write-off?

“Clients often ask what the tax benefit is of buying a new laser. Those benefits are real, but they should not necessarily be the reason to purchase a piece of equipment.” Nick Liguori, CPA

→ Start with demand
→ Run the break-even math
→ Let the tax benefit be the bonus, not the reason

The full breakdown, including the break-even formula, is linked in the comments.

10/09/2026

Most of your 2026 tax bill is already decided. The part that isn’t gets decided in the next 12 weeks.

By March, your accountant can only report what happened. Right now, there’s still time to change it.

This is what we’re reviewing with clients this month:
→ A full-year projection, so April holds no surprises
→ Owner compensation, and whether it still fits your structure
→ Equipment purchases, and whether the timing helps or hurts
→ Retirement contributions, and which plans need action before year end
→ Estimated payments, so you’re not short or overpaid
→ For MSO practices, the year-end true-up between entities

None of this is complicated. It just has to happen before the year closes.

That’s the difference between tax compliance and tax strategy. We wrote about it in depth, and the link is in the comments.

10/08/2026

Q4 is when the year gets decided. Here are five reads to help you head into it with clear numbers.

→ The complete guide to med spa accounting
→ How to structure your chart of accounts
→ Measuring profitability by provider, treatment, payroll, and product
→ The break-even math on a new device
→ What to pull from your EMR every month

Every one of them is written for one industry: medical aesthetics.

Read the full library: https://www.liguoricpa.com/outsourced-accounting/cpa-blog/

09/24/2026

Most med spa owners start preparing for a sale about two years too late.

Practices in the $500,000 to $1 million EBITDA range typically trade in the 3x to 5x range. Stronger growth, multiple providers, documented systems, and diversified revenue can push past 6x.

On $700,000 of EBITDA, the difference between a 3x and a 5x exit is $1.4 million.

A meaningful share of that gap comes down to financial preparation, not clinical quality:

→ Clean books a buyer can diligence without discounting for uncertainty
→ Revenue and expenses sitting in the right entity if you run an MSO structure
→ Add-backs that are documented rather than explained in a meeting
→ A practice that runs without the owner in every chair

If a sale is anywhere on your horizon, the work starts well before the conversation does.

https://www.liguoricpa.com/2026/06/11/how-to-prepare-your-med-spa-for-a-sale-and-why-most-owners-start-too-late/

09/22/2026

Your P&L tells you what your med spa earned. Your EMR tells you where it came from.

Most owners have both and never put them side by side.

Five reports worth pulling every month:

→ Revenue by provider, then revenue per hour by provider
→ Rebooking rate, the cheapest number in the practice to improve
→ Discounts as a percentage of revenue, the quietest margin leak in aesthetics
→ Product consumed per treatment, by provider
→ Package and membership liability, tied back to your balance sheet

The benchmark we use: a provider should generate roughly three to five times their total compensation cost. Top performers run higher.

None of it reconciles unless your chart of accounts is built for a med spa in the first place.

New on the blog: what to pull from your EMR every month and how it connects to your books.

https://www.liguoricpa.com/2026/09/14/what-should-your-med-spa-be-pulling-from-your-emr-every-month/

09/17/2026

Is every provider on your team pulling their weight?

There is a benchmark for this. A provider should be generating roughly three to five times what they cost you, and that means total cost, not just salary. Payroll taxes and benefits count.

Nick explains why the bottom line hides this completely, and why provider-level numbers are usually where something jumps out.

→ Which EMR reports to pull: https://www.liguoricpa.com/2026/09/14/what-should-your-med-spa-be-pulling-from-your-emr-every-month/

→ Or book a discovery call and we will look at your provider numbers with you

09/15/2026

Before you sign for a new device, run one calculation.

Monthly payment, plus monthly operating cost, divided by your average treatment price. That is how many treatments you need every month just to break even. To actually make money on the machine, you need one more than that.

Where we see owners get caught:

→ Running the revenue side and skipping consumables, provider time, and room cost
→ Buying a device to fix a soft schedule, which adds a fixed payment instead of fixing anything
→ Letting the tax deduction drive the decision instead of the business case
→ Trusting the rep's ROI projection without rebuilding it on their own numbers

Equipment does not generate revenue. Patients do. The projection only works if the demand is already there.

New on the blog: how to know whether a machine will actually pay for itself.
https://www.liguoricpa.com/2026/09/03/how-do-you-know-if-a-new-med-spa-machine-will-pay-for-itself/

A new device pays for itself when the treatments it performs each month cover what it costs you each month. The math is simple: add the monthly payment to the monthly operating cost, divide by the average sale price of the treatment, and you have the number of treatments you need to book every month...

09/10/2026

The formula that tells you whether a machine is worth buying.

Nick breaks it down in under a minute: monthly cost, plus operating cost, divided by average sale price. That is your break-even treatment count. One more than that number is where you start making money.

Run it before you sign, not after.

→ Full breakdown on the blog: https://www.liguoricpa.com/2026/09/03/how-do-you-know-if-a-new-med-spa-machine-will-pay-for-itself/
→ Or book a discovery call and we will run it with you

09/08/2026

You sold $40,000 in packages last month. That money is in your account. It is not yours yet.

This is one of the most common bookkeeping mistakes we see when a med spa comes to us, and it is almost always a generalist bookkeeper recording package sales as immediate income.

What it does to your numbers:

→ Overstates revenue in the month of sale and understates it in every month you deliver
→ Creates a cash flow illusion that leads to hiring and buying decisions you cannot support
→ Can accelerate a tax bill on income you have not earned
→ Leaves your balance sheet without a liability that should absolutely be there

Quick test: pull your balance sheet. If you sell packages, gift cards, or memberships and there is no deferred revenue line, something is wrong.

https://www.liguoricpa.com/2026/04/07/deferred-revenue-for-med-spas-why-your-packages-gift-cards-and-memberships-might-be-distorting-your-books-2/

Deferred revenue for med spas isn't an abstract accounting concept. It directly affects the decisions you make about your practice.