Practice Sale · Professionals

Selling a Medical or Dental Practice? Defer the Tax.

After decades building a practice, the sale can be taxed brutally in a single year — federal capital gains, recapture on your equipment, the 3.8% surtax, and California's 13.3%. Here's how to spread it out and keep more.

You've spent a career building a medical, dental, or professional practice. When you sell — to a partner, an associate, a DSO, or a group — the proceeds can be taxed at the worst possible rate because it all lands in one year. The good news: the structure of the sale, and the timing of the tax, are both things you can plan.

The taxes hiding in a practice sale

How a structured installment sale helps

Under IRC §453, you can receive the proceeds — and pay tax on the capital-gain portion — over a schedule of future years instead of a lump sum. For a retiring practitioner, this can double as a guaranteed retirement income stream funded by an A-rated carrier, while keeping more of the gain in lower brackets. The recapture on your equipment is generally recognized up front, so plan that piece deliberately.

Before you sign:
  • Negotiate the goodwill/equipment/non-compete allocation — it sets your tax.
  • Set up the deferral structure before you have the right to the money.
  • A DSO or group buyer often offers cash + equity — each piece is taxed differently.

The takeaway

A practice sale is the financial event of your career. Don't let a one-year tax bill take a third of it. Plan the structure and timing before the letter of intent — ideally with your CPA and a deferral specialist at the table.

Frequently asked questions

How is the sale of a medical or dental practice taxed?

It's taxed as a mix: capital gains on goodwill and practice appreciation, depreciation recapture on equipment (ordinary income), the 3.8% NIIT, and California state tax up to 13.3%. How the price is allocated across these categories significantly affects the total.

Can I defer the tax when I sell my practice?

Yes. A §453 structured installment sale lets you receive the proceeds and pay tax on the capital-gain portion over several years instead of all at once — which can also provide guaranteed retirement income. Depreciation recapture is generally recognized in the year of sale.

How does purchase-price allocation affect my taxes?

Amounts allocated to goodwill are taxed as capital gain, equipment as depreciation recapture (ordinary), and a consulting or non-compete agreement as ordinary income. Negotiating this allocation before closing directly changes your tax bill.

What if the buyer is a DSO or group offering cash plus equity?

Each component is taxed differently — cash at sale, rollover equity often deferred until a later liquidity event. Coordinating the structure and timing is important; a structured installment sale can apply to the cash portion.

When should I plan the tax structure for my practice sale?

Before you have the legal right to the proceeds — generally before closing. Once you can access the money, constructive receipt taxes it, so the deferral planning must happen before the deal closes.

Thinking about a big sale?

Before you sign anything, run your numbers with someone who structures the deal to be tax-smart and audit-ready from day one.

Call 213-414-2808 Run the Numbers →