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Tax & Accounting for Medical Practices

Medical practices face S-corp vs PLLC structuring, QBI limitations, and retirement plan design that interact with how owners get paid.

Katie Gorles
Written by
Katie Gorles
Updated April 22, 2026

SSTB status and 199A

Medical practices are Specified Service Trades or Businesses (SSTBs) under Section 199A, which means the 20% QBI deduction phases out above $241,950 single / $483,900 MFJ for 2025. Structuring around the phase-out matters for partner-owners.

Retirement plan design

High-income practices benefit from layered retirement plans: 401(k) with employer match, profit sharing, and cash balance plan stacked. The total contribution can exceed $300,000 per high-income partner in the right structure.

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Partner compensation

Guaranteed payments, eat-what-you-kill, and hybrid structures each have different tax and partnership accounting mechanics. We help practice groups evaluate and document compensation agreements.

Common questions

Should a solo physician form an S-corp or a PLLC?
Usually PLLC electing S-corp taxation. The PLLC gives the required legal structure; the S-election captures the payroll-tax savings.

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