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Can I still get the QBI deduction as a dentist or doctor?

The short answer is yes, but only if your taxable income stays below certain thresholds. Medical and dental practices fall under a category called specified service trade or business, which changes how the qualified business income deduction works for you.

For most pass-through business owners, the QBI deduction allows them to deduct up to 20 percent of their qualified business income from their taxable income. But when your business is classified as a specified service trade or business, the rules get more restrictive. The IRS considers dentistry, medicine, and health services to be specified services, along with fields like law, accounting, consulting, and financial services.

Here’s how the income limits work for 2026. If you’re single, you can take the full QBI deduction if your taxable income is below roughly $200,000. Between approximately $200,000 and $250,000, the deduction phases out gradually. Above $250,000, the deduction is gone entirely. For married filing jointly, the full deduction applies below about $400,000 of taxable income, phases out between $400,000 and $500,000, and disappears above that upper threshold.

The practical reality is that many practice owners earn above these limits. A successful dental or medical practice often generates taxable income well into the phase-out range or beyond. If you’re there, the QBI deduction simply isn’t available to you, no matter how you structure things.

This is where other tax planning moves become more valuable. Retirement plan contributions can lower your taxable income significantly. A solo 401(k) or defined benefit plan allows much larger contributions than a simple IRA. If your practice operates as an S-corp, getting your compensation right matters too. The right mix of salary versus distributions affects both self-employment tax and your retirement contribution room. Practice owners who work with a CPA on bookkeeping and tax services often find these strategies deliver more savings than chasing a deduction they can’t fully use.

The point is that losing QBI doesn’t mean you’re out of options. It means the moves that actually reduce your tax bill look different. A tax strategy conversation can sort out which approaches make sense for your specific income level and practice structure.

At Smart Outsourced Solutions, Simona Leppala is a CPA and Enrolled Agent who works with medical and dental practice owners across New England and nationwide. If you’re not sure whether you qualify for QBI or want to explore the alternatives, reach out for a consultation on your situation.

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More Questions

How do you charge for tax preparation and tax planning?

Personal tax return preparation starts at $325, with final pricing based on the complexity of your return. Tax planning is scoped to the work involved or included as part of an ongoing monthly relationship.

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Can I deduct my home office as a consultant?

Yes, if the space is used regularly and exclusively for your business. You can choose the simplified method at $5 per square foot up to $1,500, or the actual expense method that deducts a share of your housing costs. Which one saves more depends on your rent, utilities, and office size.

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How often will I get my financials, and will you explain them?

You get financial statements monthly after the books are closed, typically within the first two weeks of the following month. We walk through what the numbers mean in plain language so you can actually use them for decisions.

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I pay subcontractors. What do I need to track to file 1099s?

You need a W-9 from each subcontractor before you pay them, and you need to track total payments per subcontractor through the year. When the totals cross the filing threshold, you file a 1099-NEC.

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I work with clients in multiple states. Does that change my taxes?

Working with out-of-state clients can create state tax filing obligations depending on where and how much business you do in each state. The rules vary, and this is worth reviewing proactively rather than assuming you have no obligations beyond your home state.

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I am switching from another bookkeeper. How does the transition work?

We get access to your QuickBooks Online file, review the last few months for accuracy, fix anything that's off, and pick up the ongoing work. Your involvement is minimal and the transition typically takes two to three weeks.

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Massachusetts bookkeeping and accounting firm helping service businesses across New England and nationwide. We go beyond recording transactions to show owners what their numbers actually say about their business. Founded by Simona Leppala, a CPA and Enrolled Agent.

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