CPA-led · Med spas only · All 50 states
The accountant for med spas.
See what each treatment earns, what you still owe clients in prepaid packages, and what to set aside for tax. Balance Partners runs the books, monthly close, injector payroll, sales tax and year-round tax planning for med spas and aesthetics practices — led personally by Jenny Gao, CPA, EA.
Med Spa Core from $1,500 a month · fractional CFO, controller and tax director for practices past $1M · we reply within one business day.
Your bookkeeper, tax preparer and payroll coordinator are the same person — not three vendors pointing at each other.
Packages, injectables, commissions, retail sales tax and MSO books are the engagement, not an afterthought.
Defined scope and named deliverables before you commit. From $1,500 a month, month-to-month after onboarding.
Sound familiar?
Where med spa books go wrong — and what changes.
Six things we find in almost every new file, and the monthly rhythm that fixes them.
What we usually find
- Package and membership sales are booked as revenue when the card is charged, so the treatments still owed are invisible and growth months look better than they are.
- Injectables are expensed when purchased, so margin swings with the ordering calendar instead of the treatment calendar.
- Provider commissions live in a spreadsheet that never ties to payroll or to the POS production report.
- Retail skincare is taxable in most states and treatments usually are not, but the POS mapping mixes them on the sales tax return.
- The MSO and the professional entity share a bank account and nobody has reconciled the intercompany balance.
- A $180,000 device was financed with no plan for Section 179, bonus depreciation or the state add-back.
What changes once it is handled
- Monthly close by the 10th business day with a deferred-revenue rollforward tied to the POS
- Injectables and retail as inventory; cost of goods sold booked as product is used
- Commission accruals from the production report, tied to payroll
- Retail sales tax by state, treatments kept separate, returns filed
- MSO / professional-entity books, intercompany reconciled, management fee documented
- Tax planned before year-end from live numbers — equipment, salary, estimates, QBI
How we work with you
One engagement runs the practice. Two projects and three fractional roles sit beside it.
Med Spa Core carries the books, close, sales tax, payroll coordination, cash and tax for one monthly fee. Cleanup and a pre-opening setup are one-time projects. Controller, CFO and tax director are for practices past $1M. All services →
The engagement
from $1,500/monthMed Spa Core
Bookkeeping and monthly close, package and membership liabilities, injectables inventory, provider commissions, retail sales tax, payroll coordination, cash and tax — one engagement, one monthly fee, led by Jenny Gao, CPA, EA.
What is inside
One-time projects
Cleanup & catch-up
A diagnostic, then a fixed-fee rebuild of prior months, package liabilities, inventory and returns. No monthly commitment.
New med spa launch
For funded practices about to open: entity sequencing, chart of accounts, POS and payroll set up before the first sale.
Fractional leadership
For practices past about $1M, with two or more locations or an MSO alongside a professional entity. Scoped after a diagnostic as a flat monthly fee.
Fractional CFOMonthly CFO meeting, 13-week cash forecast, budget, KPI dashboard, device and second-location models.Fractional ControllerOwnership of the close, controls, inventory, package liability and MSO / professional-entity books.Fractional Tax DirectorQuarterly tax strategy, entity and owner-pay design, MSO fee treatment, multi-state registrations, notices.Works with the systems you already use
The numbers we keep in front of you
Four numbers that move a med spa's profit and cash.
Gross margin by service line
Injectables, energy devices, skincare and retail each carry their own product cost and provider cost. One blended margin hides which room is making money.
Package and membership liability
What the practice still owes clients in treatments, rolled forward every month and tied to the POS.
Revenue per provider hour
Production divided by scheduled hours, by provider, so staffing and compensation rest on capacity rather than gut.
Cash after tax and debt
The 13-week view of cash after payroll, product, device payments, estimates and distributions — the number most owners never see until it is a problem.
Founder-led by design
One CPA who knows your whole practice.
Jenny Gao is a Florida-licensed CPA and IRS Enrolled Agent with more than 13 years of accounting and tax experience, including corporate accounting for public and pre-IPO companies. She reviews every client's close personally, prepares the tax work and leads every fractional engagement — which is why the client list is kept deliberately small.
Owners hire Balance Partners because they want one professional who knows the books, the taxes, the payroll and how each affects the others in an aesthetics practice. And because Jenny is an Enrolled Agent, she can represent you before the IRS if it ever comes to that.
How it works
From first call to a clean monthly rhythm.
Fit call
Twenty minutes on your locations, providers, POS, payroll and what is not working today.
Diagnostic
We read the QuickBooks file, POS exports, payroll and prior returns and tell you in writing what has to be fixed first.
Written proposal
Scope, deliverables, timeline and a flat monthly fee. Cleanup quoted separately as a fixed project.
Monthly rhythm
Books closed on a schedule, liabilities rolled forward, KPIs delivered, tax planned before year-end.
From the library
51 med spa guides, written by a CPA.
Packages and memberships, injectables inventory, injector pay, sales tax, entity choice, MSO books, cash flow — each with sources and a review date. Browse all guides → · Quick answers →
Free downloads
Four tools we hand new clients — free for any med spa owner.
The month-end close checklist, a chart of accounts built for aesthetics, the 2027 tax and filing calendar and the pre-opening financial setup checklist. Enter a work email and your state once and download all four.
The med spa month-end close checklist
Twelve steps in ten business days, the close calendar and a deferred-revenue rollforward worksheet.
Chart of accounts for an aesthetics practice
Service-line revenue and COGS, package and membership liabilities, provider pay and MSO accounts, with POS mapping rules.
The 2027 med spa tax & filing calendar
Every federal deadline with the Florida items alongside, weekend shifts already applied, plus the recurring sales tax and payroll items.
Opening a med spa: financial setup checklist
Entities, registrations, banking, POS and payroll setup, pre-opening costs and the first close — 90 / 60 / 30 days and launch month.
Where we work
Tampa Bay, Florida. Med spas in all 50 states.
State-specific pages for the states with the most med spas: Florida · Texas · California · New York · Arizona · Georgia · Illinois · New Jersey · Colorado · Nevada · North Carolina · Washington · Massachusetts · Pennsylvania.
Questions
Common questions from med spa owners.
What does a med spa accountant do that a regular bookkeeper does not?
Five things, every month: record prepaid packages, memberships and gift cards as liabilities and release them to revenue as treatments are delivered; track injectables and retail as inventory so cost of goods sold follows the treatment; accrue provider commissions from the production report; separate taxable retail from non-taxable treatments for sales tax; and keep MSO and professional-entity books with a documented management fee. A generalist books deposits as revenue and purchases as expenses, which overstates profit in growth months and hides problems until tax time.
What does Balance Partners cost?
Med Spa Core starts at $1,500 a month for a single-location, single-entity practice, month-to-month after onboarding with thirty days' written notice. Fractional controller, CFO and tax director work is scoped after a diagnostic as a flat monthly fee. Cleanup is a one-time fixed project. See how pricing works.
Do we have to be in Florida?
No. Balance Partners is based in Tampa and works remotely with med spas in all 50 states, from the reports your POS, bank and payroll systems already produce. Sales tax, payroll and entity rules are handled state by state.
Which practices are the best fit?
Med Spa Core fits single- or two-location practices doing roughly $500K–$5M a year, including funded practices about to open. Fractional leadership fits practices past about $1M, with two or more locations, or with an MSO alongside a professional entity. We are not the right fit for pre-revenue solo startups without a funded opening plan, tax-return-only needs, or owners shopping on price alone.
Who does the work?
Jenny Gao, CPA, EA — a Florida-licensed Certified Public Accountant and IRS Enrolled Agent with more than 13 years of accounting and tax experience — reviews every close, prepares the tax work and leads every fractional engagement personally. Balance Partners works directly with owners only and does not take overflow or white-label work from other accounting firms.
Request a 20-Minute Fit Call
No obligation. Tell us about your setup and we reply within one business day with times for a 20-minute call. If we’re not the right fit, we’ll tell you.
Request a 20-Minute Fit Call →