Tax Planning for Texas PI MDs & Chiros: Liens, Reductions & Depreciation

Texas is a massive PI economy — commercial trucking corridors, oilfield injury work, and major plaintiff firms in Houston, Dallas, and San Antonio, alongside a large lien-based provider community.

PI medical providers in Texas sit in a genuinely odd tax position: large receivables that may pay 50 cents on the dollar years later, revenue that arrives in settlement-driven lumps, and equipment-heavy operations with real planning opportunities.

The recurring issues

• Accounting method matters. Cash vs. accrual treatment changes when lien income is taxed — and for practices with large LOP books, the difference is enormous. This deserves an actual analysis, not a default.
• Reductions and write-offs. Negotiated reductions and uncollectible liens need consistent, defensible treatment so your returns match your books.
• Equipment & depreciation strategy. Imaging and treatment equipment purchases interact with Section 179 and bonus depreciation — timing them against high-collection years is free money.
• Entity & compensation design. The right structure for a multi-provider or multi-location practice changes with revenue mix and state rules.

What proactive looks like

Quarterly projections that account for expected settlement collections; equipment purchases planned against income, not habit; and retirement structures sized to your real (reduction-adjusted) profitability.

Serving Texas providers

We've done exactly this work for PI medical practices for more than two decades, and we bring it to MDs, chiros, and injury clinics across Texas.