Dermatology Practice Bookkeeping & Accounting
Fairlight CPA handles bookkeeping, payroll, and tax for dermatology practices — where an insurance-billed medical side and a cash cosmetic side live under one roof and deserve separate economics. We keep both lanes, and the margin of each, visible monthly.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems dermatology practices actually have
Medical and cosmetic are two P&Ls in one practice
Insurance dermatology and cash cosmetics have different margins, marketing costs, and growth math. Blended books make the cosmetic side look like free money and the medical side look worse than it is.
Pathology and biologic costs need matching
Path lab fees and high-cost biologics hit as bills; tying them to the encounters they belong to is what makes per-service margin real.
Cosmetic packages prepay like a med spa
Laser series and injectable packages create deferred revenue and refund exposure on the cosmetic side — clinic books rarely carry it correctly.
Extender economics drive growth
PAs and NPs carry substantial derm volume; their realized collections versus comp is the expansion decision, and it needs provider-level books.
What Fairlight takes off your plate
The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how dermatology practices actually make and spend money.
- Medical/cosmetic revenue split with separate margin reporting
- EOB-to-deposit reconciliation on the medical side; package and retail tracking on the cosmetic side
- Provider-level collections and comp across physicians and extenders
- Monthly close by the 15th; inventory for cosmetic retail and injectables
- Business and personal tax prep, quarterly estimates, and CFO reporting
The three numbers we keep in front of you
No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.
Margin by lane
medical versus cosmetic profitability after their own costs — not blended
Revenue per provider
physicians and extenders separately, against their comp
Cosmetic deferred revenue
packages sold but not delivered — cosmetic-side liability
Revenue cycle & tax notes
Revenue & reconciliation
Medical-side remittances get EOB-level reconciliation with your biller; cosmetic-side POS, financing payouts, and packages get retail-grade tracking. Two revenue engines, both tied to the bank monthly.
Tax & entity
Cosmetic retail triggers sales tax where medical services don't, and equipment (lasers especially) creates large, plannable depreciation elections; we map both before year-end.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $800/mo. Every fee is quoted and fixed in writing before any work begins.
Dermatology accounting FAQs
Can you actually split medical and cosmetic?
Yes — coding categories, deposits, and costs get mapped into two lanes with shared-overhead allocation, so each side's margin stands on its own.
We're adding a cosmetic wing — what should we watch?
Deferred-revenue discipline on packages, laser depreciation timing, sales tax on retail, and marketing cost per cosmetic patient — all four are on the monthly reports from day one.
What does it cost?
Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $800/month. Exact fee fixed in writing after a short call.
Related healthcare specialties
Get the financial side handled
A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for dermatology practices.
The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.