How to Find a Good CPA as a Physician: Tax Planning, Credentials, and Cost
Updated: 16 hours ago
Most physicians find whoever does their taxes the same way they find a dentist: a colleague mentions a name in the lounge, and that's that. Sometimes it works out. Often it's fine for a few years, until you pick up a 1099 contract, open a practice, or form an S corporation, and your return outgrows your preparer's process.
If you're figuring out how to find a good CPA, look for four things:
A credential that lets them represent you before the IRS
Regular work with physicians, so your income types are familiar
Planning with you during the year, with check ins before the end of the year
A clear, upfront answer on what the fee covers
In This Blog
Do Physicians Need a CPA Who Specializes in Physicians?
Not always.
If you're a W-2 employed physician with one job, no side income, no rental property, and no plans to change any of that, a competent generalist can usually handle your return. Your income is high, but your return is still fairly standard.
A specialist earns their fee once your situation includes any of these:
1099 income from locums, moonlighting, expert witness work, or a contractor arrangement
An S corporation, PLLC, or other entity you own
Work in more than one state in the same year
A private practice with payroll, partners, or ownership purchases
Two physician incomes in one household
Rental property or other side income that interacts with your clinical income
Each of these adds rules a generalist may see a few times a year and a tax team focused on physicians sees every week. When we reviewed a large batch of physician returns, the same problems kept showing up, from overlooked deductions to entity mistakes. You can read what we saw when we opened 500 physician tax returns.
A useful test: ask yourself whether your situation changed in the last two years. If it did, it's worth checking whether your tax professional's approach changed with it.
What Credentials Should Your Tax Professional Have?
"CPA" is the credential most physicians look for. Two other credentials give you the same rights before the IRS.
Per the IRS, "Enrolled agents, certified public accountants, and attorneys have unlimited representation rights before the IRS" (IRS, preparer credentials and qualifications).
CPAs hold a state license. Enrolled agents (EAs) are credentialed by the IRS itself. Attorneys are admitted to practice law. Any of the three can represent you if the IRS comes asking about your return.
That's worth knowing because many physicians assume only a CPA can defend them in an audit. An EA who works only on tax can be just as qualified for your return.
Then there are preparers with only a PTIN, the IRS preparer tax identification number. The IRS says these preparers "are authorized to prepare tax returns," but a PTIN alone doesn't carry the unlimited representation rights the three credentials above do. Some other preparers have limited practice rights, per the same IRS page.
How to check before you hire:
Search the IRS Directory of Federal Tax Return Preparers with Credentials and Select Qualifications, linked from the IRS page on choosing a tax professional. It lists preparers with credentials recognized by the IRS plus those who completed the IRS Annual Filing Season Program, so check which one your preparer has.
Look up a CPA's license with the state board of accountancy where they practice.
Whether a credentialed preparer also plans ahead is a different question, which we cover in tax strategist vs. CPA for physicians.
How Much Does a CPA Cost for Physicians?
What a CPA costs depends on how many returns you need and how much judgment they take. A return with only W-2 income sits at the low end. An S corporation owner with payroll and filings in two states costs much more. Firms bill hourly, per return, or as an annual package that bundles planning.
There's no reliable, current national average for physician returns. The fee surveys we found are dated and rarely separate a simple W-2 return from a household with multiple entities.
What Drives the Fee?
An individual return with only W-2 income is one return.
A 1099 physician adds a business schedule and quarterly estimated payments.
An S corporation owner adds a separate business return, payroll, and a reasonable compensation decision.
Working in several states can add state filings, and the rules depend on the states involved.
Bookkeeping and payroll are often priced separately, and some firms price planning separately too.
Hourly, Flat Fee, or Annual Package?
Firms usually charge one of three ways:
Hourly: you pay for time spent, so a busy year costs more. Ask what the hourly rate covers and whether calls and emails are billed.
Flat fee per return: a set price for preparing specific returns. Predictable, but planning conversations during the year may cost extra.
Annual package: one yearly price for preparation plus planning, estimates, and support. Easiest to budget, as long as you know exactly what's included.
What Does Doc Wealth Charge?
We publish our pricing because we think you should be able to compare. As of September, 2026:
Plan | Built for | Price |
Concierge W-2 | Physicians with only W-2 income | $3,799 per year |
Concierge 1099 | Physicians with 1099 and/or K-1 income | $3,799 per year |
Concierge Plus | Practice owners, multiple real estate property owners, full service | $11,400 per year |
Each plan includes tax return preparation, tax planning calls, communication throughout the year, quarterly estimated taxes, and notice response. Bookkeeping starts at $300 a month on the 1099 plan and is included in Concierge Plus, which also covers payroll and two entities. Extra states, entities, and K-1s cost more on each plan. Costs charged by other providers, such as your payroll software subscription and payroll tax registration fees, are paid by you. See our pricing page for the full list.
If a lower quote leaves out quarterly estimates or planning calls, you'll likely pay for those separately later in the year.
Is a CPA More Expensive Than a Tax Preparer?
Compare what each quote covers. With a credentialed professional (CPA, EA, or Tax Attorney) you're paying for representation rights and, ideally, judgment. On a simple return, that may not add much. On a 1099 or S corporation return, the judgment is most of what you're paying for.
Are CPA Fees Tax Deductible?
Partly. For 2026, fees for preparing the personal side of your return generally aren't deductible. Miscellaneous itemized deductions remain suspended under current law, and the 2025 tax law (Public Law 119-21, widely called the One Big Beautiful Bill Act) made that suspension permanent (26 U.S.C. section 67(h)).
The business side is different. If you file Schedule C, the IRS instructions say to "include fees for tax advice related to your business and for preparation of the tax forms related to your business" as a business expense (Instructions for Schedule C, 2025, line 17). So the business share of your tax prep bill can be deductible, and the personal share generally isn't. Ask your tax team how they split the invoice.
Are CPAs Worth the Cost for Physicians?
It depends on what the fee buys. For a 1099 or S corporation physician, the value is in decisions made before the end of the year, like estimated payments and entity choices.
Take Dr. Maya Chen, a 1099 hospitalist. For the 2026 tax year, she expects about $420,000 of Schedule C income. Her 2025 adjusted gross income was well over $150,000, and her 2025 total tax was $110,000. All figures are for illustration only.
Estimated taxes: because her 2025 AGI topped $150,000 ($75,000 for married filing separately in 2026), the safe harbor based on the prior year for 2026 estimates is 110% of last year's tax, not 100% (2026 Form 1040-ES):
2025 total tax: $110,000
Safe harbor at 110%: $121,000
Four equal quarterly payments: $30,250 each
Paying the safe harbor amount on time, in each installment, generally protects her from the underpayment penalty. It doesn't settle her 2026 tax. If her income is higher than last year, she may still owe a balance in April.
A preparer she only hears from at filing time might have her pay 100% of last year's tax, or nothing at all, and she'd learn about the underpayment penalty the following spring. A tax team working with her during the year sets these payments early, before the first one is due in April, and adjusts them if her income changes. For more on this, see quarterly tax payments for 1099 physicians.
Fee deductibility: say her tax team's invoice attributes $1,500 of a larger fee to her business return and business tax advice.
Share related to the business: $1,500, reported on Schedule C, line 17, which lowers her Schedule C net profit by $1,500
Personal share: not deductible for 2026
Entity questions: at her income, the bigger planning question is whether an S corporation election makes sense, and what reasonable compensation would look like. That depends on her facts, and a preparer who only handles tax returns rarely raises it. See whether 1099 physicians should form an S corporation or LLC.
10 Questions to Ask Before Hiring a CPA
Before you choose a CPA, bring these to the first call and note how specific each answer is.
How many physician clients do you work with, and what kinds? You want someone who sees 1099 physicians, S corporation owners, or practice owners regularly, depending on which you are.
Do you do tax planning, or only tax preparation? Ask what planning looks like in practice, including when it happens and what you get from it.
How often will we meet during the year? A kickoff, a midyear review, and a Q4 review is a reasonable baseline for a complicated return.
Who is my point of contact? One named person who knows your file beats a shared inbox.
How do you set reasonable compensation for an S corporation owner? Listen for a documented method. A flat percentage with no reasoning is a warning sign.
How do you handle work in more than one state? Locums physicians especially need a clear answer here, since filing requirements vary by state.
Will you calculate my quarterly estimates? For higher earners, the safe harbor math above is the starting point.
How do you handle a backdoor Roth? Ask how they track your IRA basis and report conversions from year to year.
How quickly do you respond, and through what channel? A clear answer, such as a typical response window for email, tells you how the relationship will work in March.
What does your fee include, and what costs extra? Notices, amended returns, extensions, and planning calls are common additional services.
What Are the Red Flags When Choosing a Tax Professional?
Start with the IRS's own warnings in Tax Topic 254:
The fee depends on your refund. The IRS advises avoiding preparers who "base their fees on a percentage of the refund."
They won't sign your return. Paid preparers must have a PTIN to prepare all or substantially all of a return, and they're required to sign it and include that PTIN. A preparer who hands you an unsigned return to file yourself is a problem.
Two more we'd add from working with physicians:
You only hear from them in March. For a 1099 or S corporation physician, that usually means no one is planning.
They can't explain their own recommendation. If an entity change or deduction sounds aggressive and they can't walk you through the rule behind it, keep looking.
When Should a Physician Hire a CPA?
Ideally, a few months ahead of any big change. Good moments to bring in a tax team:
Before you sign a 1099 or locums contract
Before you form an entity or elect S corporation status
As you start your first year as an attending, when income jumps
Before the fourth quarter, while there's still time to act for the current year
Timing also matters because of deadlines. For taxpayers who file on a calendar year basis, S corporation returns are generally due March 15 and personal returns April 15 (26 U.S.C. section 6072). Dates shift when they fall on a weekend or holiday.
If you own an S corporation, your S corporation return is due a month before your personal return, so the business books have to close first.
An extension gives you more time to file. It doesn't give you more time to pay. Some planning moves also have earlier deadlines, so ask your tax team which ones apply to you. For how planning evolves over a career, see the six stages of physician tax planning.
How Doc Wealth Approaches This
We're physician founded and work only with physicians. Our elite team of Tax Attorneys, CPAs, and Enrolled Agents is built around physician returns.
We handle tax planning, tax preparation, bookkeeping, and payroll year round. If you're comparing options, start with our overview of what to expect from a CPA for doctors, then look at tax planning for doctors.
If your situation has outgrown tax preparation once a year, book a free 15 minute intro call with our tax team today. You'll get prompt, dependable communication from people who work on physician returns every day.
Disclaimer: This material is intended for educational and informational purposes only and does not constitute tax, legal, accounting, or financial advice. The content is general in nature and may not apply to your specific circumstances. Tax laws and financial regulations are subject to change and interpretation, and the application of these laws can vary based on individual situations. Before making any decisions, you should consult with a qualified tax advisor, legal counsel, or financial professional.
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