Tax & Compliance

What is Section 179 for medical equipment?

Section 179 lets medical practices immediately expense up to $2.5M of qualifying equipment placed in service in the tax year (for tax years beginning after Dec 31, 2024, per OBBBA — Public Law 119-21, signed July 4, 2025; $2.56M for tax year 2026 per Rev. Proc. 2025-32), instead of depreciating it over multiple years.

Reviewed by Stanislav Sukhinin, CFALast reviewed September 30, 2026

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Definition

IRC Section 179 is a tax election that allows businesses to deduct the full purchase price of qualifying equipment in the year placed in service, subject to annual limits and phase-outs.

The detail

Section 179 covers most tangible business property used more than 50 percent in business: medical and dental equipment, computers, office furniture, software, vehicles (with limits on passenger vehicles), and qualifying leasehold improvements. For tax years beginning after Dec 31, 2024, the OBBBA (Public Law 119-21, signed July 4, 2025) set the Section 179 limit at $2.5M, with a phase-out threshold of $4M. For tax year 2026, IRS Rev. Proc. 2025-32 indexes the limits to $2,560,000 and $4,090,000 respectively. Section 179 cannot create a net loss; it is limited to taxable business income. Bonus depreciation under Section 168(k) can be combined with Section 179 to accelerate cost recovery on amounts above the limit, with bonus depreciation permanently reinstated at 100% for property acquired and placed in service after January 19, 2025 (per OBBBA). The strategic timing question is whether to take the deduction this year or spread it across years to optimize bracket management. For owners already in the top 37 percent federal bracket (taxable income over $768,700 for married couples filing jointly in 2026, or $640,600 for single filers, per Rev. Proc. 2025-32), taking the deduction now typically saves more total tax. For practices anticipating higher future income, spreading can be optimal. If you plan to buy equipment on the exhibit floor at a meeting like the Chicago Dental Society Midwinter Meeting, settle the Section 179 timing before you sign, not after.

  • Section 179 expense limit is $2.5M for TY 2025 / $2.56M for TY 2026, with a phase-out threshold of $4M / $4.09M (OBBBA Public Law 119-21; TY 2026 amounts per IRS Rev. Proc. 2025-32).

    Source: IRS Rev. Proc. 2025-32

  • The Section 179 deduction is limited to taxable income from the active conduct of a trade or business; any cost disallowed by that limit carries forward to the next year.

    Source: IRS Publication 946

  • Bonus depreciation under Section 168(k) is permanently reinstated at 100% for property acquired and placed in service after January 19, 2025 (per OBBBA).

    Source: IRS: Working Families Tax Cuts, businesses

What this means for clinic owners

From Sorso

Section 179 matters in healthcare because medical equipment is expensive and generally qualifies. A common mistake is buying equipment in December purely for the deduction. Buy what the practice needs, then time the purchase for tax efficiency, never the reverse.

Stanislav Sukhinin, CFA

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Related questions

How much does it cost to start a med spa?

The most detailed public figure is $491,792 to $906,189 to open one med spa, from dermani MEDSPA's 2026 franchise disclosure, covering buildout, equipment, opening inventory and three months of operating funds. Sorso estimate: about $430,000 to $840,000 for an independent spa built to the same standard, after taking out the $55,000 franchise fee, the $5,000 training fee and $3,000 to $8,000 of training travel. Leasehold improvements ($124,257 to $309,376) and equipment ($117,062 to $194,300) are the two biggest lines.

What tax deductions are available to medical practices?

Medical practices can deduct ordinary business expenses including staff wages, rent, equipment depreciation, supplies, malpractice insurance, CME, retirement plan contributions, and qualified business income (QBI) where eligible.

What retirement plans work best for clinic owners?

The best retirement plans for clinic owners are a Solo 401(k) or SEP-IRA for solo practices (up to $72,000 for 2026, or $80,000 in a Solo 401(k) with the age-50 catch-up) and a 401(k) paired with a cash balance plan for high-earning partners, which Fidus Actuarial's 2026 illustrations put at about $252,000 a year at age 50 and $382,000 at age 60 for an owner at the $360,000 compensation cap.

What is the QBI deduction for healthcare?

The Section 199A Qualified Business Income (QBI) deduction allows a 20 percent deduction on qualified business income from pass-through entities, but it phases out for healthcare specified service trades or businesses (SSTB) above income thresholds ($403,500 MFJ for 2026 per IRS Rev. Proc. 2025-32).

How do I structure a practice for tax efficiency?

A tax-efficient practice structure usually starts with an S corporation election for the clinical practice (held in a PC or PLLC where state law requires one) and a retirement plan sized to the owners' income, with a separate real estate LLC or MSO added for liability, financing or exit reasons. Those extra entities do not preserve the QBI deduction when the same owners hold 50 percent or more of both sides.

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.

Stanislav Sukhinin, CFA — Founder of Sorso
Stanislav Sukhinin, CFA

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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