Specialized CPA Services for ABA & Home Care

ABA & Home Care

CPA, Tax Planning & CFO Services for ABA Therapy Clinics & Home Care Agencies | Northern Virginia, Maryland & Washington, DC

Running an ABA clinic or home care agency is one of the most meaningful ways to build a business, but the money behind the mission is unforgiving. We handle the tax, the books, and the CFO work so you can stay focused on the clients and caregivers who need you.

Two industries, one financial engine

ABA and home care look different. Under the hood, they run the same way.

Both deliver labor-intensive care, bill payers who reimburse slowly, and make payroll long before the money lands. That shared DNA is exactly what we specialize in.

ABA Therapy Clinics

Behavior analysis practices

Center-based, in-home, and school-based ABA providers scaling a BCBA and RBT workforce.

  • Authorization and CPT-coded billing
  • RBT and BCBA payroll and supervision
  • Autism-mandate payer reimbursement
  • Multi-site and multi-state expansion
Home Care Agencies

In-home care providers

Non-medical home care, home health, and personal care agencies managing a distributed caregiver workforce.

  • Medicaid, waiver, and private-pay billing
  • Caregiver payroll, overtime, and mileage
  • EVV and reimbursement timing
  • Franchise and territory economics

The shared engine

Labor plus slow-paying insurance plus fixed payroll equals a cash flow problem waiting to happen. We build the tax, accounting, and CFO systems that keep both models profitable and audit-ready.

We know where it hurts

The problems that keep care-business owners up at night

These are not hypotheticals. They are the issues we clean up for ABA and home care clients every season.

01

Worker classification

Paying RBTs or caregivers as 1099 contractors is the single most expensive mistake in this industry. The supervision that defines your care model is the same thing that makes 1099 status indefensible. We fix it before an auditor finds it.

02

Revenue that never lands

Delivered units past authorization, denied claims nobody reworks, contractual adjustments quietly eating your margin. We manage the revenue cycle as three buckets, not one fuzzy pile.

03

The profit-versus-cash gap

You can be more profitable and more broke at the same time, because every new client is payroll today against reimbursement weeks later. We forecast it and size the credit line before you need it.

04

Taxes built for your business

S-corp compensation you can defend, the QBI phase-out that catches health-service owners, and retirement plans that work with a W-2 clinical staff. Generic tax prep leaves this money on the table.

What we do

Full-service accounting for ABA and home care

One firm for the tax return, the monthly numbers, the growth decisions, and the eventual sale.

Tax

Tax strategy & planning

Entity structure, S-corp reasonable compensation, QBI planning, and year-round strategy built around a care business, not a generic template.

Books

Bookkeeping & revenue cycle

Clean monthly financials tied to your authorizations, billing, and payer mix, so you always know what you earned and what you actually collected.

CFO

Fractional CFO

Cash flow forecasting, KPI dashboards, payer profitability, and the decision support to answer the second-location and next-hire questions with numbers.

Payroll

Worker classification & payroll

Getting RBTs, BCBAs, and caregivers on the right side of the IRS and Department of Labor, with payroll that handles overtime and mileage correctly.

Value

Valuation & exit planning

Know what your clinic or agency is worth and build the clean, defensible financials that command a higher multiple when private equity comes calling.

Advisory

Multi-state & growth advisory

Nexus, licensing, and structure as you cross state lines or add locations, so expansion does not create a compliance mess you discover later.

Why a specialist

Your regular CPA isn't an ABA CPA. Your business feels the difference.

A generalist files a clean return and keeps you compliant on the basics. That is not the same as understanding a care-delivery business.

When your accountant already knows what an RBT is, why your payroll and reimbursements are out of sync, and how home care Medicaid billing actually flows, every conversation starts thirty minutes ahead. You are not explaining your industry. You are making the decision.

That head start compounds across worker classification, retirement planning, growth strategy, and the day you decide to sell.

What you should expect from an ABA or home care CPA

  • Works with other therapy and care businesses, not just yours
  • Speaks revenue cycle, authorizations, and EVV fluently
  • Treats worker classification as a priority, not a footnote
  • Plans around the QBI phase-out for health services
  • Can tell you what your business is worth today
How working together works

A clear path from first call to clean books

1

Consultation

A no-pressure call to understand your clinic or agency, your pain points, and where money is leaking.

2

Diagnostic

We review your structure, books, payroll, and revenue cycle and show you the risks and the opportunities plainly.

3

Build

We put the right entity, tax plan, bookkeeping, and reporting in place and clean up whatever needs fixing.

4

Run & grow

Ongoing tax, accounting, and CFO support so the numbers guide your growth instead of surprising you.

Questions we hear a lot

ABA & home care accounting, answered

You can absolutely use a generalist, and many owners start that way. The difference shows up in the industry-specific traps: worker classification for RBTs and caregivers, the insurance revenue cycle, the QBI phase-out for health services, and valuation for an eventual sale. A CPA who works with care businesses catches these before they become expensive. A generalist often does not.
Almost never, and this is the most common costly mistake in the industry. Staff who work your schedule, follow your protocols, and deliver care under supervision meet essentially every test the IRS and the Department of Labor use to define an employee. Misclassification exposes you to back payroll taxes, penalties, interest, and overtime claims, and it can derail a future sale. We help you classify correctly and clean up prior exposure.
We build your books and reporting around the revenue cycle: authorizations versus delivered units, billed versus collected, denials, and contractual adjustments. That gives you a real read on what you earned versus what actually reached the bank, plus the KPIs to fix the leaks. We are your accountant and fractional CFO, and we coordinate closely with your billing team or biller.
A fractional CFO gives you senior financial leadership, forecasting, dashboards, and decision support, without a full-time executive salary. You likely need one when you are making hiring or expansion decisions on gut feel, cash keeps surprising you, or you are adding payers, caregivers, or locations faster than your systems can handle.
Yes. ABA and home care are among the most actively consolidated healthcare niches. Buyers value on adjusted EBITDA times a multiple, and clean financials, correct worker classification, and documented systems raise both the multiple and your odds of closing. We help you build a business that survives diligence and commands a stronger price, and we can estimate what it is worth today.
Yes. We are based in Fairfax, Virginia and serve care businesses across Northern Virginia, Maryland, Washington DC, and beyond, including help with multi-state nexus, licensing, and structure as you expand.
Let's talk

Get a CPA who already knows your business

Request a free consultation and we will walk through your actual numbers, not a generic pitch. You will leave the call knowing exactly where your clinic or agency stands.