How much does healthcare accounting cost per month?
Sorso's outsourced healthcare accounting starts at $2,000 a month; we know of no survey that publishes a market rate, so other firms' quotes vary with transaction volume, number of locations and how much review you get. The in-house alternative costs more: one accountant at the BLS median wage of $83,680 (May 2025) comes to about $102,600 a year, roughly $8,550 a month, once benefits are added (Sorso estimate).
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Definition
Healthcare accounting is the monthly bookkeeping, reconciliation, financial statement preparation, and compliance work specific to medical and dental practices.
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. We know of no association fee survey for outsourced healthcare accounting, so any tiered price list you see is one firm's own rate card. Compare scope instead. Bookkeeping covers transaction entry and reconciliations. Full-service accounting adds the monthly close, financial statements and someone who answers for them. Controller-level work adds department or location P&Ls, month-end variance commentary and review by a CPA. Every added location brings more bank accounts, payroll and payer mix to reconcile. Sorso accounting engagements start at $2,000 per month, with the books closed within 15 business days. The in-house benchmark comes from BLS: the median annual wage was $83,680 for accountants and auditors and $50,670 for bookkeeping, accounting and auditing clerks in May 2025. Benefits come on top. In BLS's June 2026 employer-cost survey, private employers of management, business and financial staff paid $15.42 per hour worked in insurance, retirement and legally required benefits against $68.32 in wages and paid leave. Sorso estimate: that is about 23 percent on top of salary, so an accountant at the median costs roughly $102,600 a year ($83,680 × 1.226), or about $8,550 a month. Some low quotes come from firms that do the production work offshore, which is a reasonable structure but a different trade to understand before signing.
The median annual wage for accountants and auditors was $83,680 in May 2025; the lowest 10 percent earned less than $56,020 and the highest 10 percent more than $144,090.
Source: BLS Occupational Outlook Handbook: Accountants and Auditors
The median annual wage for bookkeeping, accounting, and auditing clerks was $50,670 in May 2025, and $49,860 in healthcare and social assistance.
Source: BLS Occupational Outlook Handbook: Bookkeeping, Accounting, and Auditing Clerks
In June 2026, private employers of management, business and financial staff paid $59.85 per hour worked in wages, $8.47 in paid leave, and $15.42 in insurance, retirement and legally required benefits.
Source: BLS Employer Costs for Employee Compensation, Table 4 (June 2026)
What this means for clinic owners
From Sorso
If your monthly fee buys transaction entry and reconciliations but no month-end close, no financial statements and nobody reviewing them, you are buying bookkeeping, not accounting. The two get conflated, but only one produces statements you can use to make decisions.
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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.
Explore Fractional CFO →Accounting
Healthcare-specialist accounting
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 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. For tax, S corporations and partnerships of individuals can generally use cash at any size, while C corporations and partnerships with a C-corporation partner need average gross receipts of $32 million or less (2026) unless they qualify as a personal service corporation owned by its clinicians. Clinics preparing for a sale or bank financing typically also need accrual statements.
What records do I need to keep for an IRS audit?
Keep tax records for at least 3 years after filing (the general period of limitations), 6 years if you left out income of more than 25 percent of the gross income on the return, 4 years for employment tax records, and asset records until the limitations period ends for the year you dispose of the asset. Fraudulent or unfiled returns have no limit, HIPAA documentation must be kept 6 years, and medical record retention is set by state law.
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.
How much does it cost to start an outpatient mental health practice?
Sorso estimate: about $20,000 for a solo therapist launching on telehealth, and almost all of it is working capital to live on while insurance panels approve you. That is four months of the $59,350 median wage BLS reports for mental health counselors in May 2025 ($59,350 × 4 ÷ 12 = $19,783), matching the almost-four-month upper end of the credentialing times Colorado's insurance regulator reported. Software is small next to that (SimplePractice lists solo plans from $49 a month), prescribers add an $888 DEA registration, and a brick-and-mortar office adds rent and buildout on top.
Bench vs Pilot vs a healthcare-specialist CFO: which does my clinic need?
Bench is generic small-business bookkeeping on entry tiers, with no healthcare or CFO layer. Pilot is startup-oriented bookkeeping plus CFO, with a health vertical aimed at healthtech, medtech and biotech startups rather than established clinics that bill insurance. A healthcare-specialist firm is built for operating practices: payer-mix reconciliation, billing-to-books tie-out, and provider-level P&L. For an operating clinic that runs on Medicare and commercial contracts, the specialist is the fit; Bench and Pilot fit non-clinic or healthtech businesses.
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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