Liguori Accounting

09/03/2026

Three questions we get from med spa owners every month, and where we answered them.

→ How does med spa accounting actually differ from regular small business accounting?
→ What should my bookkeeper be tracking every single month?
→ Which of my providers and treatments are actually profitable?

Swipe through for the short answers. Full breakdowns linked below.

The complete guide: https://www.liguoricpa.com/2026/07/20/med-spa-accounting-the-complete-guide-for-practice-owners/

Monthly bookkeeping and chart of accounts: https://www.liguoricpa.com/2026/08/05/med-spa-bookkeeping-what-to-track-every-month-and-how-to-structure-your-chart-of-accounts/

Measuring real profitability: https://www.liguoricpa.com/2026/08/05/how-to-measure-med-spa-profitability-provider-treatment-payroll-and-product-margins/

09/01/2026

Most med spa owners are not overpaying because they missed a deduction. They are overpaying because nobody planned.

By the time the return is being prepared, almost every lever has already closed. The moves that matter get made during the year, while you can still change the outcome.

Where the real money usually sits:

→ Entity structure, and whether your S-corp election is doing what you think it is
→ The salary-to-distribution split, and whether your salary is defensible
→ Depreciation timing on buildouts and equipment, including cost segregation
→ Retirement vehicles sized to what the practice can actually fund

We put seven of them in one place, with the numbers behind each.

https://www.liguoricpa.com/2026/05/15/7-tax-strategies-that-can-reduce-your-med-spas-taxable-income-by-six-figures/

Med spas with strong revenue are often overpaying taxes by six figures every year. Here are seven specific strategies med spa owners can use to legally and significantly reduce their tax burden.

08/27/2026

We work exclusively with med spas, and the responsiveness our clients talk about is the whole reason we built the firm this way.

"A five star review really does not justify the outstanding service Liguori Accounting provides. Nick and his team are outstanding. I cannot thank you enough for your help with my bookkeeping and accounting needs."
— Gage Maguire

Fast answers, a team that knows your industry, and books you can actually trust. That is the standard.
If you are tired of waiting days to hear back from your accountant, let's talk.

08/25/2026

Nothing tells the story better than the owners we work with.

"Bringing on Liguori Accounting has been the best financial decision for our company. They have provided us with top-quality and comprehensive bookkeeping, insightful CFO services and metric tracking over the past 9 months. We're 100% beyond grateful for their services and appreciative of the positive impact they've had on the growth of our company."
— Onyx Medical Aesthetics

This is exactly what we are built for: bookkeeping, CFO support, and the metric tracking that turns numbers into growth, all specific to med spas.

If your current accountant is not moving your business forward like this, we would love to be the comparison.

08/20/2026

Most med spa owners neglect their accounting until they are already in trouble. The goal is to flip that: to move from reacting to invoices to making informed decisions.

Nick Liguori joined Jared Roar on the Patient Magnet podcast to talk about the financial side of running a med spa beyond the treatments and bookings. They got into automated bookkeeping, understanding your numbers in real time, and the metrics that actually signal practice health, including profitability per treatment and break-even points.

If your financials feel like a source of anxiety instead of a decision-making tool, start here.

Listen: https://www.aestheticconversion.com/podcast/the-accounting-glow-up-financial-peace-for-med-spa-owners

Explore Nick Liguori: Financial Peace for Med Spa Owners — a podcast episode covering medspa SEO, growth insights for high-performing medspas nationwide.

08/18/2026

MSO structures are one of the biggest sources of both tax opportunity and compliance risk for med spa owners, and most of the trouble starts with how the accounts are set up.

Our founder Nick Liguori sat down with AmSpa on the Medical Spa Insider podcast to break down the tax implications of MSOs: where med spa structures get tripped up on the financial side, the specific pitfalls to avoid, and how to make sure your entities are set up correctly from the start.

If you operate under an MSO, or you are about to, this is the conversation to have before tax season, not during it.

Listen here: https://podcast.americanmedspa.org/e/understanding-the-tax-implications-of-msos/

This week, AmSpa’s President and CSO, Cathy Christensen, speaks with Nick Liguori, CPA, owner and founder of Liguori Accounting. They discuss the complexities of management service organizations (MSOs), common pitfalls for medical spa MSO taxes and how to properly set up your accounts. Their conve...

08/13/2026

A few years ago we made a decision that sounds backward: we started saying no to most potential clients.

We chose to work exclusively with med spas. That meant turning away good businesses that did not fit, even when revenue was on the line. Earmark CPE covered why that call became the single biggest growth driver for our firm.

What specializing actually did:

→ Made onboarding, training, and pricing dramatically simpler
→ Lowered our marketing spend while improving results
→ Let us build med spa specific expertise we never could have serving everyone

If you are a med spa owner wondering whether your CPA truly understands your business, the difference between a generalist and a specialist is the whole point.

Full story: https://earmarkcpe.com/this-cpa-firm-grew-to-1-million-by-saying-no-to-most-clients/

Rachel Dillon interviews Nick Liguori on building a million-dollar firm specializing exclusively in med spa accounting.

08/11/2026

"I'm showing all this profit, but there's no money in my account." We hear this constantly from med spa owners, and the answer is almost always sitting on the balance sheet.

Profit and cash are not the same thing, and the gap between them is where profitable practices get caught off guard. The usual culprit is timing: cash tied up in inventory you bought but have not used, bills coming due that have not hit your P&L yet, and money collected upfront for services you still owe.

Your P&L tells you whether you made money over a period. Your balance sheet tells you your position right now. Read one without the other and you will keep getting surprised.

We broke the whole thing down here: https://www.liguoricpa.com/2026/07/07/why-your-med-spas-pl-isnt-telling-you-the-whole-story/

Review your P&L and balance sheet together every month, and keep an eye on cash weekly so you always know you can cover payroll and inventory.

08/07/2026

Your bottom line tells you the business made money. It does not tell you which parts made it. And that second number is the one that should be driving your decisions.

A med spa is really several small businesses under one roof. Injectables, laser, retail, memberships, and weight loss all behave differently on cost and margin. Blend them into one profit number and a strong performer will quietly mask one that is losing money on every appointment.

To actually run the business, measure profitability at four levels:

→ By provider, revenue per hour against their fully loaded cost
→ By treatment, real cost per service against what you charge
→ By payroll, watched as a percentage of revenue
→ By product, because retail margins are often thinner than they look

The busiest provider and the most popular treatment are very often not the most profitable ones. You just cannot see it until you break it down.

Read the full post: https://www.liguoricpa.com/2026/08/05/how-to-measure-med-spa-profitability-provider-treatment-payroll-and-product-margins/

Your bottom line tells you whether the business made money. It does not tell you which parts of the business made it, and that is the number that actually changes decisions. To run a med spa well, you have to measure profitability at four levels: by provider, by treatment, by payroll load, and by pr...

08/05/2026

Most messy med spa books are not messy because the owner is careless. They are messy because the practice is running on a chart of accounts that was never built for aesthetics.

A generic setup lumps all your revenue together and buries product cost in a pile of expenses. For a med spa, that erases the two things that tell you whether you are actually profitable: your service margins and your product margins.

Here is what a med spa chart of accounts should actually separate:

→ Revenue by category, so injectables, laser, retail, and memberships each stand on their own
→ Cost of goods sold mapped to those categories, so you get a real gross margin
→ Inventory as an asset, because product on the shelf is not an expense yet
→ Deferred revenue as a liability, because a package paid today is not earned today

Get the structure right and the monthly numbers finally start telling the truth.

Full breakdown, including what a clean monthly close should include: https://www.liguoricpa.com/2026/08/05/med-spa-bookkeeping-what-to-track-every-month-and-how-to-structure-your-chart-of-accounts/

Good med spa bookkeeping comes down to two things: a chart of accounts built for an aesthetics practice and an accurate monthly close.