Healthcare Business Books Cleanup For Texas owners, the day sheet and the May report stay apart

The chair is in Dallas and the exam room stays put

We sit in Dallas. You stay in the exam room, and the deposit conversation is a video. No one from this practice gets on a plane to split one afternoon. Open the ledger the clinic already keeps on its own screen. Leave the payroll login titled in the clinic's name. The May report never asks you to slide that login across to us. What we do on the call is pull the visit off the shelf and get pay ready on the company you already hired to run payday. You are the person who presses that payday control. Once May has been filed, the control is still inside the login you started with.

An exam room in the Hill Country, an exam room on the Gulf, and an exam room in the Panhandle all join the same video. We are not opening another chair in any of those three places. Rooms that are not in Dallas, and rooms that are not in Fort Worth, still hear one line from us on that video. We are all Texans. The call still has two stacks. One is the day sheet you can point at with a finger. The other is the May report that carries the clinic's own name. Moving the room does not swap those stacks.

Use the first minute to name what is actually open. The shelf might be the open item. The May privilege report might be the open item. A renewal hour that lives only inside a spreadsheet might be the open item. Spend that hour on the wrong stack and the day sheet simply does not get it.

Lines on the day sheet, then the state question

On the national pages a clinic deposit is already broken into lines. There is the visit. There is the product that left with the patient. There is the amount a receipt called tax. There is the fee a card company kept. That set of lines is the habit we keep in every state. After the lines exist, Texas asks a further question: which of those lines this state taxes, and which report is still owed in a year when the tax itself comes out at zero.

Texas does not run your paycheck through a personal income tax of its own. The federal wage conversation still sits on top of that quiet. You remain the person who presses payday at the payroll company you picked, including on a Texas payroll. We can have the books ready for that press. The press itself stays yours.

Sixteen taxable services, and three visits left off

Take publication 96-259 in the January 2026 edition and count the taxable services it names under Tax Code section 151.0101. The count is sixteen. A physician's visit is absent from those sixteen. A chiropractic visit is absent. A physical therapy visit is absent. Professional medical care, as that publication draws the list, is simply not on it. Goods the clinic sells are still tangible personal property. An exemption is decided item by item. Handing the bag over in the exam room does not change the item.

Massage shows up as taxable only in the narrow parlor sense that same publication describes. Massage given by a physical therapist who holds a license, or by a massage therapist who holds a license, is a different fact from that parlor. The word painted on the door does not decide the tax. The sentence in the publication does.

Hiring someone to type medical dictation falls, under publication 96-259, outside data processing. Buying that typing does not, on the strength of that sentence, turn into a purchase of taxable data processing. Where a charge truly is data processing, the publication takes one fifth of the charge out of the tax. A PDF that says transcription and a PDF that says data processing are not the same purchase.

Read the panel before the shelf line moves

For the shelf we use Comptroller publication 94-155, the May 2020 edition. An over the counter drug or medicine meant for a human, carrying an FDA Drug Facts panel, is exempt from Texas sales tax on the terms written there. In that publication a drug is a product that is not an appliance, not a device, and not a food, that is put on the body, swallowed, or inhaled, and that is meant to diagnose, cure, mitigate, treat, or prevent disease, illness, injury, or pain. Meet that definition and still lack a Drug Facts label, and the exemption arrives only if a physician prescribes the product or dispenses it.

Wound care dressings sit on the exempt side of that publication with no prescription required. Gauze is in that group. Medical tape is in that group. A dietary supplement labeled as a dietary supplement is exempt on the same terms, and so is a product that carries a Supplement Facts panel. Cannabidiol does not get that treatment. The publication refuses to class a cannabidiol product as a dietary supplement, so the exemption does not attach, even when the bottle stands on the same shelf as a labeled supplement.

Fail those tests and the item stays taxable even if the clinic sold it in the same hour as something exempt. The counter has to show two amounts. Roll the whole afternoon into one sales number and the bottle disappears inside the visit. The sales tax return then has no honest figure to carry.

State slice, local slice, and the twentieth

Start with the state, before any city or transit board adds a slice. Before a city or a transit board adds anything, the state's own sales and use tax on a taxable bottle is 6.25 percent. A city, a transit authority, or a special district may add a local slice, and those local slices together stop at 2 percent. On one taxable sale the state slice and the local slices together stop at 8.25 percent. A clinic in Dallas can read one row of the Comptroller table: 6.25 percent from the state, 1 percent from the city, and 1 percent from the transit authority. That row is printed here so the shape is visible. A card listing every other city is not.

When the clinic collected tax, the sales tax return goes out on the twentieth. The Comptroller assigns the monthly rhythm or the quarterly rhythm. On a monthly rhythm, shelf sales taxed in January leave in February, still on the twentieth. A clinic the Comptroller has allowed onto a quarterly rhythm also sends the return on the twentieth. The visit that publication 96-259 left off the taxable list does not travel on that return. The bottle that failed the panel does travel on it.

May sits next to the day sheet

Read the 2026 franchise tax instructions and the taxable entities include a professional association, a professional corporation, an S corporation, and a limited liability company. A single member LLC is inside that last group. A sole proprietorship stays outside, unless the proprietorship is itself a single member LLC. Being disregarded on the federal income tax return does not, by itself, let the clinic skip the Texas report.

Think of the privilege tax as what the state charges an entity for being formed here or for operating here. Take a privilege report whose original due date is the first day of 2026 or any day after it. Annualized total revenue on that report can reach $2,650,000 and still sit on the no-tax-due side of the line. The reports for 2024 and for 2025 used $2,470,000. Revenue under that line can leave the tax at zero. The information report can still be owed, and the officer list on it can still be owed, unless the clinic is named on the skip list the instructions print. An S corporation formed in Texas, or an S corporation that has nexus, files the public information on Form 05-102. A taxable entity of another kind files Form 05-167, and the ownership shown there is kept confidential. Inside a combined group, every member formed in Texas and every member with nexus still lists its own people on its own sheet. That sheet is due the same day as the privilege report, and the sharing of that day continues in a year when the tax is zero.

Most entities see 0.75 percent printed as the rate. Retail and wholesale have a separate rate, 0.375 percent. We will not drop your clinic into either box from this page. The box is chosen on the report, from revenue the closed months already show. There is also an EZ computation for an entity whose revenue is $20 million or under. EZ uses 0.331 percent and it surrenders the margin deductions, the deduction for pay among them. Whether that trade is worth making is a question you ask of a year that has already closed.

The privilege report offers a clinic several paths for measuring margin. The path that begins with pay is the one this practice watches, because a clinic's wage is the number the day sheet can explain. Along the first path, seven tenths of total revenue stays inside the margin and the other three tenths drop away before a rate touches what is left. A second measurement removes cost of goods from revenue. A third measurement removes pay from revenue. A fourth measurement takes one million dollars off total revenue, a flat subtraction that has sat in the statute since the start of 2014. On the pay measurement, compensation is assembled from W-2 wages and from cash paid to officers, to owners, and to employees. Cash profit paid to a natural person may be included. Certain benefits may be included. Publication 98-806 offers workers compensation, health care, and retirement contributions as the examples. Pay reported on a 1099 is left out of that assembly. The payroll taxes the clinic pays on top of the wage are left out as well. For 2026 and for 2027 the cap on one person's compensation is $480,000. For 2024 and for 2025 that cap was $450,000. This page will not choose the measurement. We will not pick a margin path while the month you brought us is still receiving deposits.

Put the annual report on 15 May. If 15 May itself lands on a Saturday, a Sunday, or a holiday, only that May due day moves, and it moves to the next day the offices are open. A holiday that also slides an August extension or a November extension is a date you check on the live extensions page. We leave the slid day off this address on purpose. Extra time is not something you simply hope for. Either the money moves, or a Comptroller form reaches them, by the original due date. Even after that, the extra time is only tentative until the rules are met. For most entities the extension payment is aimed at the whole tax from the prior report, or at nine tenths of the tax the report in front of you will finally show. On the first report after the entity became subject to the tax, aiming at last year's tax in full is not available. The payment then aims at ninety percent of the report you are about to file.

A clinic the electronic payment rule does not cover can ask for more time inside Webfile, or by sending Form 05-164, and the time that ask can buy lasts until 15 November. Once last year's state fiscal year tax reached ten thousand dollars, the extension dollars have to travel electronically rather than as a paper check. For an entity in that group the first added date is 15 August, and a second added date, where a second one is allowed, is 15 November. Cross $500,000 of tax in the prior year and the request is made by a timely TEXNET payment under code 13080. Form 05-164 is left unfiled in that case. Read the cutoff hour for a TEXNET payment on the live extensions page during the week you pay. Copying that hour onto this address would be stale the week the Comptroller changes it.

A report that shows up after its own due date brings a $50 penalty, and each late report brings its own. Tax money that lands inside the first thirty days draws a penalty of 5 percent of that tax. Leave the tax unpaid after that opening month and the extra charge is one tenth of the tax that remains unpaid. Unpaid tax starts to draw interest on day sixty one after the due date. The percent charged as interest changes, and the Comptroller keeps the current percent on its interest page rather than on a clinic address like this one. We do not reprint that percent at this address.

Forfeiture of the charter has a practical sting. The company can lose its place in a Texas courtroom, whether it hoped to sue or hoped to defend, and some of the company's debts can fall on the people who were running it. A reader who wants the section numbers can open Tax Code 171.251, then 171.2515, then 171.252, then 171.255, which is where forfeiture of the charter is described. If a forfeiture letter from the Comptroller is already in the clinic's mail, bring that letter to the video. Changing the registered agent is a different errand. On the video, that agent swap is a letter the clinic sends to the Secretary of State, and the May information sheets stay in the tax folder instead of riding along in that letter. Form 05-102 is the wrong sheet for it, and Form 05-167 is the wrong sheet for it too. A newly named officer generally waits for the next annual filing. Send an amended report only when something on the filed report was wrong, or when the change cannot wait for the next year.

Lose enough nexus and the final report is due within 60 days of that loss. After the payment rules on a closing report are already satisfied, the clinic may take forty five further days past the original due date of that last report. Closing the clinic, or keeping the clinic alive and ending only the Texas connection, is the owner's decision on the video. We will not make that decision from this page. A research credit, starting with the 2026 report, follows filing rules of its own. Those rules stay on the Comptroller page that spells them out.

A federal extension moves only the day the federal return is due. May, for the privilege report, keeps the date it already had. When the payment rules are met, extra time on the privilege report moves only the state day. Neither of those extra days closes a month. Neither of them pulls a visit off a bottle. If the federal stack, or the May stack, is getting ahead of a month that is still open, we say so out loud before anyone signs either stack.

Renewal hours live in their own folder

The Texas Medical Board wants a physician to complete at least 48 credits of continuing medical education in each 24 month span. The span follows the biennial registration. It does not follow the calendar year. Half of that, which the board writes as 24 formal hours, is category 1 or category 1A. Inside those 24 formal hours, at least 2 hours are medical ethics or professional responsibility, and at least 2 hours are pain management, and that pain block includes safe prescribing of opioids and of other controlled substances. The first time a physician registers, that registration sits outside the hour count.

Until 1 September 2026, CE Broker is optional, except for a physician the board has picked for audit. A renewal dated on or after that September day needs an active basic CE Broker account, and the required coursework has to be reported in that account before the renewal goes through. The board has said it will not be able to check hours that live only in the physician's own spreadsheet, or only on some other platform. Closing a clean month in the books does not fill the account.

The Texas Board of Chiropractic Examiners wants 16 hours of continuing education in each year, counted from the first day of the birthday month, unless an exemption applies. During the first renewal period, no hours are due at that first renewal. A human trafficking course that the Health and Human Services Commission has approved is required for renewal under Occupations Code Chapter 116. That course is not part of the 16 hours. The board's street address is left off this page on purpose.

A Texas physical therapist completes 30 continuing competence units across each two year renewal. A physical therapist assistant completes 20. One contact hour is one unit. The hours have to be approved through the program the board chose, and the papers that prove completion are kept for four years after the license expiration date. The jurisprudence module is worth 2 units. An approved human trafficking course is worth 1 unit. Both of those units count toward the total the renewal asks for.

A physical therapist who has held a license for at least one year may treat without a referral for no more than 30 days in a row. Two conditions sit beside that permission. The professional liability policy has to be at least $100,000 on a single claim and at least $300,000 across the year. And the therapist either holds a qualifying doctoral degree or has finished at least 30 continuing competence units in differential diagnosis. Those dollar floors are written in the board's rule on how services are provided. This page repeats the floors. We do not sell a policy here, and we do not decide from this page whether a particular therapist meets the rule.

What the video can finish, and what it will not invent

The work described here is a clinic month that has stopped changing, the visit pulled off the shelf inside that month, the privilege report built from those finished months, and a renewal folder the clinic keeps because a board will ask to see it. We will not name a practice management export. No vendor page in the folder we rely on was read closely enough for us to describe one, so this address will not invent a sync between the exam room and the ledger.

Choose a time, or send the note, and the clinic is still not hired. The fee stays at zero until a letter exists. That letter has to name which months are in the work and what the fee is. Until the letter exists, the note only tells us which deposit to open first.

Keep going.