Bookkeeping for Acupuncturists and TCM Practitioners
Bookkeeping led by Andrew Pizzello, CPA, for solo and group acupuncture practices. Treatment package tracking, herbal medicine retail and inventory, modality coding, multi-state licensure, S-Corp planning, and HIPAA-aware workflows. From $199/mo.
Acupuncture Practices Are Three Businesses in One Treatment Room
Most acupuncture practices blend three economically distinct activities: cash-pay treatments (often sold as multi-session packages), herbal medicine and supplement retail, and add-on modalities like cupping, electroacupuncture, or moxibustion. A handful of practices also bill insurance where coverage exists, which adds a fourth completely different revenue mechanic.
Generic bookkeepers see the deposits and book them all as one revenue line. The treatment package money comes in with no record of the visits you still owe. The herbal sales, which carry real inventory and state sales-tax obligations, get lumped into services. The result is books that look fine on the surface but lose track of prepaid visits, miss inventory tracking, and blur taxable herb sales into treatment revenue.
We built our workflow around how acupuncture and TCM practices actually operate. Every client gets revenue-stream segregation, a running schedule of prepaid treatment packages, herbal inventory tracking where it matters, and HIPAA-aware financial workflows, in an engagement led by Andrew Pizzello, CPA.
Acupuncturists We Serve
One-practitioner cash-pay practices, with or without modalities and herbal retail.
Multi-LAc shops with associate practitioners, comp splits, and partner draws.
Practices carrying meaningful herbal stock, including patent formulas and bulk herbs.
Sliding-scale and community-acupuncture models with high volume and lower per-visit revenue.
Cash-pay specialty practices serving athletes, chronic pain, and corporate wellness.
Practices in states or networks where acupuncture is covered, with EOB reconciliation.
What We Handle That Generic Bookkeepers Miss
Treatment Package Plans, Tracked Until Delivered
A prepaid session package is money collected for visits you still owe. Your monthly reports stay on the cash basis, and we keep a running schedule of unused visits, so you always know what is outstanding, including what you would owe back on a refund.
Herbal Medicine Inventory and Sales Tax
Herbal patents and bulk herbs are real inventory in many practices, and herbal sales typically carry state sales tax (rules vary by state, especially when prescribed). We track inventory and surface sales tax exposure so neither the IRS nor the state surprises you.
Cash-Pay vs Insurance Mix Tracking
Where insurance covers acupuncture, the reimbursement math looks nothing like cash-pay. We separate the streams so you know which is sustainable and which is breaking even after write-offs.
Modality Add-Ons (Cupping, Electroacupuncture, Moxa)
Add-on modalities have different time and revenue profiles than core acupuncture. We track them in the chart of accounts so you can see which add-ons actually grow margin and which fill schedule without paying.
Associate and Modality-Provider Comp
Many practices contract with massage therapists, herbalists, or other LAcs. Misclassification (1099 vs W-2) is a common state labor issue. We help document the working relationship and flag classification risk.
HIPAA-Aware Workflows, BAA Available
For practices that bill insurance or operate in HIPAA-covered settings, we sign Business Associate Agreements and segregate financial data from clinical by design.
S-Corp Election and Reasonable Comp
Acupuncture services are SSTB so QBI phases out fast. The S-Corp self-employment tax savings still pencil out for most LAcs once profit clears overhead. We benchmark reasonable comp against BLS data with adjustments for the retail/services mix.
Your Practice Software, Connected
AcuSimple, Unified Practice, Jane App, ChARM, Practice Fusion. We pull billing data from your practice software into QuickBooks Online cleanly so your clinical system stays the system of record for patient care, and QBO is the system of record for finance.
Packages Starting at $199/mo
Every package includes a dedicated bookkeeper, monthly reports, and tax-ready books. Surge adds a licensed CPA's review of every deliverable (PizzelloCPA, PLLC).
Solo LAc, clean books, package plan tracking
Herbal inventory, modality splits, sales tax tracking
Group practices, multi-revenue streams, live dashboard
Common Questions
How do you handle treatment package plans?
We keep a running schedule of each patient's unused visits, updated as visits are redeemed, and your monthly reports stay on the cash basis, so you always know what you still owe. The schedule does not change your taxes: on the cash method most practices use, a package payment is income in the year you receive it (IRS Publication 538). An accrual-method practice may be able to defer part of it to the next tax year, but no further.
Do you track herbal medicine inventory?
For practices with meaningful herbal stock, yes. We track inventory by SKU where it matters, calculate COGS, and surface margin on herbal sales. Smaller practices that prescribe per-patient still get clean COGS reporting without full inventory overhead.
What about sales tax on herbs and supplements?
Sales tax on herbs varies dramatically by state, and the prescribed-vs-retail distinction matters. We surface sales tax exposure during setup, and PizzelloCPA, PLLC, our affiliated CPA firm, handles collection and remittance if you have not already set it up, or we coordinate with your own CPA.
Do you work with acupuncturists in Los Angeles or elsewhere in California?
Yes. We are a fully remote firm and support acupuncture and TCM practices nationwide, Los Angeles and the rest of California included. Prepaid package tracking works the same everywhere; sales tax on herbs is where state rules differ, and we tailor that piece to your state.
Do you handle insurance billing for acupuncture?
Yes, where applicable. We reconcile EOBs against deposits, track contractual write-offs separately, and surface AR aging by payer. Most acupuncture revenue is still cash-pay, but where insurance covers it the economics need to be tracked separately.
Should my acupuncture practice elect S-Corp status?
Often, once profit clears about $80,000 for a solo. Acupuncture services are SSTB so QBI phases out quickly, but self-employment tax savings on owner draws are still meaningful. We benchmark reasonable comp during onboarding.
I have a contracted massage therapist. Should they be 1099 or W-2?
It depends on the state and the working relationship. Long-running, full-time-equivalent contractor arrangements are scrutinized by state labor departments. We will help you document the relationship cleanly and flag classification risk.
Do you integrate with Jane App or AcuSimple?
Yes. We pull billing data from your practice software into QuickBooks Online so your clinical system stays the system of record for patient care, and QBO is the system of record for finance.
What does pricing look like for a solo LAc?
Most solo practices start at our $199/mo Starter tier. Practices with significant herbal retail, multiple practitioners, or insurance billing usually land in Grow ($349/mo) or Surge (custom). Every engagement is led by Andrew Pizzello, CPA, and Surge adds a licensed CPA's review of every deliverable.
Cited authorities and resources
We benchmark our work against primary sources, not opinion. Some of the references we coordinate with for acupuncturists engagements:
- • BLS Occupational Employment & Wage Statistics for reasonable-compensation benchmarks.
- • IRS Form 2553 for S-Corp election timing and eligibility.
- • IRS Section 199A (QBI) guidance for the SSTB phaseout that applies to most private practices.
- • IRS Publication 946 for depreciation, Section 179, and bonus depreciation choices on practice equipment.
- • HHS HIPAA for Professionals for the workflow expectations on practices that touch PHI.
S-Corp planning, reasonable-comp analysis, and tax strategy are performed by our affiliated CPA firm, PizzelloCPA, PLLC, under a separate engagement (see PizzelloCPA’s tax services for acupuncturists). For legal questions, we coordinate with your attorney.
Guides from our blog for acupuncturists
Year-end bookkeeping for private practices · Sales tax on herbs and supplements
Not an acupuncturist?
We serve the full private practice ecosystem. Therapists & Counselors, Veterinarians, Optometrists & Ophthalmologists, Nurse Practitioners, Physical Therapists, Psychologists & Psychiatrists, Audiologists, Nutritionists & Dietitians, Speech-Language Pathologists, Dentists, Behavior Analysts (BCBAs), and more.
Books built for acupuncture and TCM practices
Book a free 30-minute consult. Bring a recent month's deposits, a typical package structure, and any herbal sales detail. We'll show you what's clean and where revenue is hiding.
Book Your Free ConsultOr call us: 855.297.BOOK (2665)