Tax return changes for healthcare practices

Health practices are a specified service trade, so the QBI deduction phases out for owners above the thresholds, which are $201,750 single and $403,500 joint for 2026. Practice employees cannot use the tips deduction, because workers in a specified service trade are excluded.

For staff benefits, the paid family and medical leave credit is now permanent and can be based on insurance premiums from 2026. The employer childcare credit cap rises to $500,000, and direct primary care arrangements no longer stop a patient from contributing to an HSA.

• What are the owners’ expected 2026 taxable incomes relative to the QBI thresholds?
• Does the practice offer paid family leave, and is it under a state mandate?
• Does the practice run a direct primary care membership model?

Separate leave wages and any leave insurance premiums in payroll and the ledger, so the 45S credit can be computed. Equipment purchases for the practice, such as imaging systems, belong in a fixed asset register with acquisition dates for bonus depreciation.