Introductory Tax Planning Checklist for Medical Practices
Make sure you're getting all the basics down
Note: This checklist covers foundational tax planning strategies for medical practice owners. Every situation is different—there may be more advanced strategies (charitable planning, cost segregation, captive insurance, etc.) that are appropriate depending on your specific circumstances. Use this as a starting point, not a ceiling.
Entity Structure
- Are you operating as the right entity type? (Sole prop, LLC, S-corp)
- If profit exceeds $80,000–$100,000, have you evaluated S-corp election?
- If you're an S-corp, is your salary "reasonable" and documented?
Key question: Would a different structure save me self-employment tax?
Retirement Plans
- Do you have a retirement plan in place?
- Are you maximizing contributions to your current plan?
- Have you compared your plan to alternatives? (SEP vs Solo 401(k) vs Cash Balance)
- If income consistently exceeds $400,000+, have you considered a Cash Balance Plan?
Key question: Am I sheltering as much as I can from taxes?
Deductions
- Home office: If you work from home regularly, are you taking this deduction?
- Vehicle: Are you tracking business miles? (Standard rate vs actual expenses)
- Equipment: Any purchases this year that qualify for Section 179?
- Health insurance: Are premiums being deducted correctly?
- Professional development: CE courses, conferences, subscriptions?
Key question: What expenses am I paying that I'm not deducting?
Income & Expense Timing
- Can any income be deferred to next year? (Collections timing, billing delays)
- Can any expenses be accelerated into this year? (Prepayments, purchases)
- Is there equipment you've been considering that could be purchased before year-end?
Key question: Should I shift anything between this year and next?
Estimated Taxes
- Are quarterly estimated payments set up?
- Are payments calibrated to this year's expected income (not just last year)?
- Will you avoid underpayment penalties?
Key question: Am I paying the right amount throughout the year?
Year-End Review (October–December)
- What's my projected profit for the year?
- Have I scheduled a planning conversation with my accountant?
- What actions need to happen before December 31st?
- Is documentation in order? (Mileage logs, home office records, receipts)
Key question: What can I still do before the year ends?
Quarterly Rhythm
| Quarter |
Key Focus |
| Q1 (Jan–Mar) |
Set foundation: estimated payments, retirement plan strategy |
| Q2 (Apr–Jun) |
Mid-year check: actual vs projected, adjust if needed |
| Q3 (Jul–Sep) |
Pre-year-end planning: create written plan for Q4 |
| Q4 (Oct–Dec) |
Execute: retirement contributions, purchases, documentation |
Quick Reference: Contribution Limits (2026)
| Plan Type |
Max Contribution |
| SEP-IRA |
25% of compensation, up to $72,000 |
| Solo 401(k) |
$24,500 employee + 25% employer, up to $72,000 |
| Solo 401(k) (50+) |
$32,500 employee + 25% employer, up to $80,000 |
| Cash Balance |
Varies by age, typically $100,000–$300,000+ |
Ready to Take the Next Step?
Pick one item from this checklist that you haven't addressed.
Schedule a conversation to review it. That's it. One item. Start there.
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