Does a fractional CFO need to be a CPA?
No. CFO work such as forecasting, budgeting, KPI reporting, cash planning and lender or buyer models needs no license; the CPA license is what the law requires to sign audit or review reports on financial statements and to use the CPA title. For an IRS audit, collection case or appeal, CPAs, attorneys and enrolled agents are the professionals with unlimited representation rights, so the practical setup is a CFO for decisions and a CPA firm for tax and attest work.
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Definition
A fractional CFO is a part-time senior finance executive retained by the month. A CPA (certified public accountant) holds a state license that is legally required for attest work, such as audits and reviews of financial statements, and for use of the CPA title.
The detail
The license and the job are different things. State accountancy laws reserve a short list of work for licensed CPAs, and Texas is a clean example. Only a license holder may issue a report on another person's financial statements or perform an attest service such as an audit or review, and nobody else may use the title "certified public accountant" or "CPA". The same statute says it does not stop non-licensees from providing management advisory services or preparing financial statements without issuing a report. Forecasts, budgets, KPI dashboards and cash plans sit on that side of the line. Your state has its own accountancy act, so check it; Texas is our example here, not a national rule.
Tax has a separate rule set. Any tax professional with an IRS preparer tax identification number (PTIN) may prepare federal returns for pay. Representation is tiered: enrolled agents, CPAs and attorneys have unlimited rights and can handle audits, payment and collection issues and appeals, while other preparers have limited rights or none. That is the practical reason to keep a CPA or enrolled agent on the tax side even when your CFO is neither.
The CFO role itself has no licensing requirement. The Bureau of Labor Statistics says financial managers typically need a bachelor's degree and 5 years or more of experience in another business or financial occupation, and that professional certification is not required. Credentials still tell you something. A CPA license signals depth in accounting and tax. The CFA charter is an investment analysis credential: three exams, about 300 hours of recommended study per level, and at least 4,000 hours of relevant work experience over no fewer than 36 months. Neither tells you whether someone can read a payer mix or model a second location.
We say this plainly because it applies to us. Stan Sukhinin is a CFA charterholder with 19 years in corporate finance, including UniCredit and Société Générale, and he is not a CPA. Sorso is not a CPA firm: we run the monthly books and the fractional CFO work, and we partner with licensed CPAs for tax filings and attest work. When you interview any fractional CFO, ask who files your return, who would sign reviewed or audited statements if a lender asked for them, and how the handoff at year end works. Get those answers before you sign.
| Work | License or credential required? | Who can do it |
|---|---|---|
| Audit or review report on your financial statements | Yes, a CPA license | A license holder (Tex. Occ. Code §901.456) |
| Using the title "CPA" | Yes | A person holding a CPA certificate (§901.451) |
| Representing you in an IRS audit, collection case or appeal | Yes, for unlimited rights | CPAs, attorneys and enrolled agents (IRS) |
| Preparing your federal tax return for pay | A PTIN | Any tax professional with a PTIN (IRS) |
| Financial statements without an accountant's report | No | Anyone (§901.456(b)(2)) |
| Forecasts, budgets, KPI reports, cash plans, lender and buyer models | No | Anyone qualified, including a CFO who is not a CPA (§901.456(e)) |
Texas Occupations Code chapter 901 is the state example; every state has its own accountancy act. IRS rules are federal.
In Texas, only a license holder may issue a report on another person's financial statements or perform an attest service; non-licensees may prepare financial statements without issuing a report and provide management advisory services.
Source: Texas Occupations Code §901.456 (statutes current through the 2025 sessions)
Enrolled agents, certified public accountants and attorneys have unlimited representation rights before the IRS, including audits, payment and collection issues, and appeals.
Source: IRS, Understanding tax return preparer credentials and qualifications (updated January 2026)
Financial managers typically need a bachelor's degree and 5 years or more of related experience; professional certification is not required.
Source: BLS Occupational Outlook Handbook, Financial Managers (accessed September 2026)
The CFA charter requires passing three exams and at least 4,000 hours of relevant work experience completed in no fewer than 36 months.
Source: CFA Institute, CFA Program (accessed September 2026)
What this means for clinic owners
From Sorso
Hire for the job you need done. If a bank, landlord or buyer asks for reviewed or audited statements, or the IRS opens an exam, you need a CPA firm (or an enrolled agent or attorney on the IRS side). If the problem is that you can't see your numbers, can't forecast cash or don't know whether a second location will pay, that is CFO work, and the credential matters less than whether the person has worked inside practices like yours. If you have both, make sure they talk: the CFO's year-end numbers are where the CPA starts.
Talk it through
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Book a free 30-minute call with Stan Sukhinin, CFA. Bring the question and, if you have it, last month's P&L. He will tell you what he would check first.
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How clinic owners typically work with us after a question like this
Fractional CFO
Strategic CFO for $3M–$50M clinics
Forecasts, location-level P&L, exit prep. Starts at $4,000/mo.
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Books done right by people who understand clinic finance. Starts at $2,000/mo.
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How much does a fractional CFO cost?
Most fractional CFO engagements are quoted at $3,000 to $10,000 a month, rising to $10,000 to $20,000 or more when the work is heavy, according to fractional CFO firm The Good CFO. Sorso's fractional CFO service for clinics starts at $4,000 a month. A full-time CFO costs far more: BLS counts CFOs among chief executives, whose median pay in healthcare and social assistance was $197,090 a year in May 2025, before bonuses, benefits or a search fee.
What is the difference between a CFO and a controller?
A controller manages historical accounting (close, statements, audit, compliance), while a CFO is forward-looking (forecasting, capital allocation, M&A, strategy). Most growing clinics need both, sequenced controller first.
What does a fractional CFO actually do?
A fractional CFO owns financial forecasting, KPI dashboards, cash flow management, capital decisions, and strategic finance work, delivered on a monthly retainer instead of a full-time salary.
What is the difference between a fractional CFO and a bookkeeper?
A bookkeeper records what already happened: daily transactions, reconciliations, and clean financial statements. A fractional CFO uses those statements to plan what should happen next: forecasts, KPIs, strategic decisions, and growth or exit modeling. A bookkeeper on staff earns a median $49,860 a year in healthcare and social assistance (BLS, May 2025), and fractional CFO engagements are commonly quoted at $3,000 to $10,000 a month (The Good CFO). Clean books come first; CFO work pays off once the next decision is large enough to justify it.
Founder of Sorso and a CFA charterholder. Before Sorso, Stan spent 19 years in corporate finance at institutions including UniCredit and Société Générale — managing a $450M loan portfolio and making senior partner at a major mezzanine lender by 29 — then built a fractional CFO firm exclusively for outpatient healthcare clinics.
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