How money actually reaches a medspa.
Most medspa revenue is paid by the patient, so there are few insurance claims to chase. The revenue cycle is the path from the sale at checkout to cash the practice has earned and kept. Fees take a cut along the way, because processors and financing companies keep a share of each payment. Packages, memberships, and gift cards bring in cash before the work is done. Refunds and chargebacks can pull cash back out. So the number that matters is earned cash after fees, not gross sales in the software.
Where medspa sales and cash drift apart
- Processing and financing feesCard processors keep a small share of every payment. Patient financing companies usually keep a larger share, so a financed sale pays the practice less than its full price.
- Packages and membershipsCash for a six-treatment series arrives on the first day. The revenue is earned only as each treatment is done, so the sale month looks better than it really was.
- Discounts and promotionsBundles, event pricing, and loyalty credits lower what a patient really pays. If the software records list price and the discount in separate places, gross sales can look higher than the cash supports.
- Refunds and chargebacksA refund or a disputed charge takes cash back weeks after the sale. A chargeback often carries its own fee as well, so it can cost more than the sale it reverses.
- Gift cardsA gift card is cash for work the practice still owes. Rules on expiry and unclaimed balances vary by state, so confirm how they apply to you with a CPA or attorney.
Reconciling practice software to the bank
Your practice software is where sales get recorded. Boulevard, Zenoti, and Aesthetic Record all produce sales reports, but none of them is your bank. The processor pays out in batches, takes its fees first, and may hold some funds. So the deposit on any given day rarely matches that day's sales report.
A monthly reconciliation ties the two together. Start with gross sales in the software, add any sales tax collected, and then take out discounts, refunds, chargebacks, and fees. Tax on retail product belongs to the state, and the rules vary by state, so confirm yours with a CPA. What is left should match deposits for the month, and any gap needs a reason.
Say a practice records $100,000 in sales for the month with no retail tax. Patients paid for $20,000 of that through a financing company that keeps 8% in this example, which is $1,600. The card processor keeps 3% of the other $80,000, which is $2,400. Refunds and one chargeback take back another $1,500, so the practice should look for $94,500 in the bank and not $100,000.
Provider commissions on booked versus collected revenue
Many medspas pay injectors and aestheticians a share of what they produce. The question is which number that share is based on. Booked revenue is what the provider sold or performed at full price. Collected revenue is what the practice kept after discounts, refunds, and fees.
Paying on booked revenue means the practice carries every discount and refund on its own. The provider is paid in full on a sale that a promotion cut or a refund later reversed. Over a year, that gap can grow into a real cost.
Paying on collected revenue keeps the provider and the practice on the same side. It also means the commission report has to pull from reconciled numbers. So the plan should say in writing which number is used, how packages are counted, and when a refund comes back out of pay. Pay plans also raise wage rules that vary by state, so have an attorney review the structure.
Matching the practice software to the bank each month and building commission reports from those reconciled numbers is part of our accounting and monthly close work for medspas.
Frequently asked
How much do patient financing companies charge a medspa?
It depends on the company, the plan length, and the terms offered to the patient. Plans with no interest for the patient usually cost the practice more, because the practice pays for that offer. Check the merchant fee for each plan in your agreement. Then record the full sale and the fee separately, so the cost of financing shows in the books.
Should I pay injector commissions on booked or collected revenue?
Many practices find collected revenue works better, because commissions then follow the cash the practice actually keeps. Booked revenue is simpler to track, but it leaves the practice carrying every discount and refund. Whichever you choose, put it in writing. Wage rules vary by state, so have an attorney review the plan.
Why don't my Boulevard or Zenoti sales match my bank deposits?
Processors pay out in batches, keep their fees before depositing, and sometimes hold funds. Refunds, chargebacks, and financed sales also arrive on their own schedules. A monthly reconciliation lists each of these items so the gap between sales and deposits is explained. A gap that stays unexplained usually points to a missing fee, an unrecorded refund, or a payout that never arrived.
Medspa resource center
Or read the cross-practice version: revenue cycle in practice accounting →