How much does healthcare accounting cost per month?
Healthcare accounting is the monthly bookkeeping, reconciliation, financial statement preparation, and compliance work specific to medical and dental practices.
Quick answer
Outsourced healthcare accounting typically costs $1,500 to $5,000 per month for a single-location clinic, depending on transaction volume, locations, and whether you need controller-level oversight.
The detail
Monthly healthcare accounting fees scale with three things: transaction volume, number of bank and merchant accounts to reconcile, and the level of human review on the output. Basic bookkeeping for a small single-location clinic runs $800 to $1,500 per month. Full-service accounting with monthly close, financial statements, and a dedicated accountant runs $2,500 to $5,000 per month. Controller-level work that includes department-level P&Ls, month-end variance commentary, and review by a CPA runs $4,000 to $8,000 per month. Multi-location practices add roughly 30 to 50 percent per additional location. Sorso accounting engagements start around $3,000 per month for single-location clinics with full close, location-level P&Ls, and KPI reporting.
Median annual wage for accountants and auditors was $81,680 in May 2024, putting fully loaded in-house cost at $110K to $130K per year.
Outsourced accounting for small businesses ranges from $500 to $5,000 per month based on AICPA practice management surveys.
Source: AICPA
Healthcare practices typically need higher service tiers because of payer reconciliation, contractual adjustments, and HSA/FSA tracking.
What this means for clinic owners
From Sorso
If you are paying less than $1,500 per month for accounting and your practice generates over $1M in revenue, you are almost certainly buying bookkeeping, not accounting. The two get conflated, but only one produces statements you can use to make decisions.
Related questions
How much does a fractional CFO cost?
A fractional CFO typically costs $3,000 to $10,000 per month for healthcare clinics, with most outpatient practices in the $4,000 to $7,000 range based on practice size and engagement scope.
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 financial KPIs should I track for my clinic?
The core 8 financial KPIs every clinic should track monthly are revenue, EBITDA, net collection rate, days in AR, denial rate, revenue per provider, overhead ratio, and rolling 13-week cash forecast.
What is the difference between accrual and cash accounting for clinics?
Cash accounting recognizes revenue when payment is received and expenses when paid; accrual accounting recognizes revenue when services are performed and expenses when incurred. Most clinics under $30M revenue can use cash; larger groups and those preparing for sale typically need accrual.
Founder of Sorso. 19 years in corporate finance. Managed a $450M loan portfolio before building a fractional CFO firm exclusively for healthcare clinics.
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