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⚠️  Legal Disclaimer: This article is shared by Dental Accounting Group for general informational purposes only and does not constitute legal advice. The content was prepared by Tyler Jones of Helsell Fetterman LLP. Dental practice owners, DSOs, and associate dentists should consult a qualified attorney regarding their specific agreements and circumstances before taking action.

 

Washington Significantly Restricts Noncompetition Agreements: What Dentists and Their Employers Need to Know

By Tyler Jones, Helsell Fetterman LLP  |  Shared by Dental Accounting Group  |  March 2026

Washington has enacted sweeping changes to the enforceability of noncompetition agreements that will directly impact dental practices, associate dentists, and dental service organizations (DSOs). House Bill 1155, effective June 30, 2027, will render most noncompetition covenants void and impose new compliance obligations on both employers and workers.

This is a significant development for dental practice owners who have historically relied on noncompete provisions to protect patient goodwill, referral relationships, and workforce stability. Here is what you need to know.

 

Key Takeaways

Topic

Key Provision

Effective Date

June 30, 2027. Applies to noncompetition agreements regardless of when they were signed.

Most Noncompetes Void

Most noncompetition agreements — especially those involving employees — will be unenforceable beginning June 30, 2027.

Expanded Definition

The law broadly defines “noncompetition covenant” to potentially include restrictions on accepting business from clients, patients, or customers — capturing provisions that have historically straddled the line between noncompetition and nonsolicitation.

Patient Restrictions

Overly broad limitations on treating former patients may be treated as noncompetition covenants and rendered void.

Notice Deadline

By October 1, 2027, employers must notify current and former employees and contractors that covered noncompetition agreements are void and unenforceable.

Penalties

$5,000 statutory damages per violation, plus attorneys’ fees. The Washington Attorney General may also bring enforcement actions.

What Is Still Permitted

Nonsolicitation of employees and patients (generally limited to 18 months). Noncompetes tied to the sale of a dental practice with at least 1% ownership interest. Confidentiality and HIPAA-compliant protections for patient information.

 

What This Means for Dental Practice Owners and DSOs

Dental practices and DSOs have historically relied on noncompetition agreements to protect patient goodwill, referral relationships, and workforce stability. These tools will now be significantly limited.

Practice owners and DSOs should expect reduced ability to restrict where associate dentists practice after departure, and will need to place greater reliance on carefully drafted nonsolicitation and confidentiality provisions. Retention strategies that go beyond restrictive covenants will become increasingly important.

The broader definition of “noncompetition covenant” is particularly worth noting. Provisions that restrict accepting business from patients — which some agreements use in lieu of traditional noncompetes — may now be captured under the new law and treated as void.

 

What This Means for Associate Dentists

Associate dentists — particularly those employed by DSOs — should be aware that many existing noncompetition provisions may become unenforceable under the new law beginning June 30, 2027. Associates should review whether current agreements contain provisions that may be void under the new law, how patient-related restrictions are structured and whether they are overly broad, and evaluate opportunities to revisit restrictive covenants in connection with employment changes or renegotiations.

 

What Is Still Permitted

Not all restrictive covenants are eliminated. The following protections remain available:

•       Nonsolicitation agreements are still permitted, but are generally limited to 18 months.

•       Noncompetition covenants tied to the sale of a dental practice remain enforceable, provided the restricted party holds at least a 1% ownership interest in the practice being sold.

•       Confidentiality provisions and HIPAA-compliant protections for patient information remain valid.

 

Recommended Next Steps

 

For Practice Owners & DSOs

•       Review and revise all associate and employment agreements now — before the June 30, 2027 effective date.

•       Update template agreements used for future hires to comply with the new law.

•       Plan for the required statutory notice obligation due by October 1, 2027.

•       Invest in nonsolicitation and confidentiality provisions as your primary protective tools going forward.

•       Consider retention strategies that reduce reliance on restrictive covenants.

For Associate Dentists

•       Review your current employment agreement, particularly if you are affiliated with a DSO or multi-location group.

•       Identify any noncompetition provisions and assess whether they may be void under HB 1155.

•       Evaluate whether patient-related restrictions are overly broad and may be captured under the new definition.

•       Seek legal advice before signing new or amended employment agreements.

•       Consult an attorney when negotiating changes to existing agreements.

 

 

Required Action for Employers: By October 1, 2027, employers must make reasonable efforts to notify both current and former employees and independent contractors that any covered noncompetition covenant in their agreements is void and unenforceable under Washington law.

 

Failure to provide this notice may contribute to violations that trigger $5,000 in statutory damages per violation, plus attorneys’ fees.

 

About the Author

About the Author

This article was prepared by Tyler Jones of Helsell Fetterman LLP, a Seattle-based law firm. Tyler advises dental practices, DSOs, and associate dentists on employment agreements, noncompete provisions, practice acquisitions, and health care law. Dental Accounting Group is sharing this content as a resource for our dental practice clients.

Read the original article at Helsell Fetterman’s blog: https://www.helsell.com/2026/03/26/washington-significantly-restricts-noncompetition-agreements/

Contact Tyler Jones directly:  tj****@*****ll.com  |  206.689.2164

 

Questions? DAG Can Help You Navigate the Financial Side

While employment law questions should be directed to a qualified attorney like Tyler Jones at Helsell Fetterman, Dental Accounting Group can help you evaluate the financial and operational implications of these changes on your practice. Whether you are reviewing your associate compensation model, structuring a practice sale, or planning for workforce transitions, we are here to help.

Contact us at ma**@*****ds.com or 425.216.1612, or reach out to Tyler Jones at Helsell Fetterman for legal guidance specific to your agreements.

 

Disclaimer: This article is shared by Dental Accounting Group (DAG) for general informational purposes only. The legal content was authored by Tyler Jones of Helsell Fetterman LLP and is reprinted with attribution under a cooperative resource-sharing arrangement. This article does not constitute legal, tax, accounting, or investment advice, and does not create an attorney-client relationship between the reader and either DAG or Helsell Fetterman LLP. Laws and regulations are subject to change. Dental practice owners, DSOs, and associate dentists should consult a qualified legal professional regarding their specific agreements and circumstances before taking any action.

 

Original article: https://www.helsell.com/2026/03/26/washington-significantly-restricts-noncompetition-agreements/

 

© 2026 DG Accounting Professionals LLC. All Rights Reserved.
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Understanding your sales and use tax obligations in Washington State is essential for maintaining compliance and avoiding costly penalties. Whether you operate a dental practice, professional services firm, or retail business, staying current with these requirements can save you significant time and money.

This guide breaks down everything you need to know about Washington’s sales and use tax system, including recent legislative changes that took effect in late 2025.

Understanding Sales and Use Tax in Washington

What Is Sales Tax?

Sales tax is imposed on retail sales of most goods and certain services in Washington State. When your business sells taxable items or services to customers, you must collect the applicable sales tax at the point of sale and remit it to the Washington Department of Revenue (DOR).

The combined state and local sales tax rates vary by location, ranging from 6.5% (the state base rate) to over 10.5% in some areas, such as parts of King County. It’s important to apply the correct rate based on where the sale occurs. 

What Is Use Tax?

Use tax serves as the counterpart to sales tax. It applies when your business purchases taxable goods or services from out-of-state vendors (or in-state vendors who fail to charge sales tax) and uses those items in Washington.

The use tax rate equals the sales tax rate that would have applied if the purchase had been made locally. Business owners are responsible for self-reporting and remitting use tax on their Combined Excise Tax Return.

Who Is Subject to Sales and Use Tax?

Washington businesses are generally subject to sales and use tax obligations if they meet any of the following criteria:

•       Have a physical presence in Washington (office, employees, inventory, or business location)

•       Meet the economic nexus threshold of $100,000 or more in gross receipts sourced to Washington in the current or prior year

•       Sell taxable goods or services to Washington customers

•       Purchase items or services for use in Washington without paying sales tax

Special Considerations for Dental Practices and Service Businesses

While professional dental services are generally not subject to sales tax, practices must still collect sales tax on certain retail items sold to patients, such as oral care products sold over the counter. Additionally, dental practices must pay use tax on business purchases where applicable, including acquired assets when buying a practice.

Service businesses like dental practices are also subject to a state (and sometimes city) Business and Occupation (B&O) tax on gross receipts. This typically ranges from 1.5% to 2%, depending on the location of the business and whether there is an applicable city tax rate.

Recent Changes: ESSB 5814 and New Sales Tax Categories

Effective October 1, 2025, Washington’s ESSB 5814 extended retail sales tax to several new categories that may significantly impact your business operations.

Advertising Services Now Subject to Sales Tax

The new law broadly defines taxable advertising services as “all digital and nondigital services related to the creation, preparation, production, or dissemination of advertisements.” This encompasses a wide range of activities, including:

•       Website development and design

•       Logo design and branding

•       Search engine optimization (SEO) services

•       Acquisition of advertising space

•       Consulting and advice on advertising methods

Live Presentations and Speaking Engagements

Seminars, workshops, and continuing education events where participants attend in-person or via real-time telecommunication are now subject to sales tax. This has important implications for professionals who receive compensation for speaking engagements—they must now collect and remit sales tax to the Department of Revenue.

What Remains Exempt

Several advertising-related categories remain exempt from sales tax:

•       Radio and television advertisements

•       Newspapers

•       Fixed signage such as billboards

•       In-store displays

Outside of these specific exceptions, the State generally assumes that anything related to advertising is subject to sales tax.

What to Look For: Ensuring Compliance

While vendors are responsible for collecting sales tax, many may not yet be aware of the new rules—particularly if you work with out-of-state vendors. Here’s what you should do:

1.    Review your advertising invoices to verify whether sales tax is being charged.

2.    Contact vendors who aren’t charging sales tax to understand their reasoning. They may have a valid exemption (such as minimal presence in Washington) or may have inadvertently omitted the tax.

3.    Self-report use tax on your Combined Excise Tax Return if vendors legitimately cannot charge sales tax.

The Combined Excise Tax Return

Washington does not have a state income tax. Instead, businesses file a Combined Excise Tax Return that includes:

•       Business & Occupation (B&O) Tax – A gross receipts tax on business activities

•       Retail Sales Tax – Tax collected from customers on taxable sales

•       Use Tax – Self-reported tax on out-of-state or untaxed purchases

•       Other applicable state and local taxes

All registered Washington businesses must file this return, even if they had no business activity during the reporting period. This is known as a “no business activity” return.

Filing Frequencies and Due Dates

The Department of Revenue assigns filing frequencies based on your estimated annual tax liability:

Filing Frequency

Business Size

Due Date

Monthly

Higher volume businesses

25th of following month

Quarterly

Mid-range businesses

Last day of month after quarter

Annual

Smaller businesses

April 15 / January 31

Note: Due dates falling on weekends or holidays extend to the next business day.

Late Filing and Payment Penalties

Timely filing is crucial to avoid escalating penalties. Here’s what you can expect if you miss your deadlines:

Timing

Penalty

After due date

9%

After last day of following month

19%

After 2nd month following due date

29%

Interest (2025 rate)

7% annually

Additionally, interest accrues at approximately 7% annually (2025 rate) on unpaid tax balances.

Next Steps for Your Business

Staying compliant with Washington’s sales and use tax requirements requires ongoing attention, especially with the recent legislative changes. We recommend reviewing your current practices, auditing your vendor invoices for proper tax collection, and ensuring your bookkeeping processes capture any use tax obligations.

If you work with a bookkeeping team, make sure to notify them of any invoices requiring use tax treatment so they can properly record the expense and include the tax on your next excise tax return.

Disclaimer

This article is
for informational and educational purposes only and should not be construed as
specific accounting, legal, or tax advice. Tax laws and interpretations may
change, and specific situations may warrant different approaches. The
information provided herein does not create a client relationship and is not a
substitute for professional consultation. Please consult with a qualified
accounting professional to discuss how these requirements apply to your
specific circumstances.

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How to Complete Your 401(k) Annual Census: A Step-by-Step Checklist

If your company sponsors a 401(k) plan, submitting accurate annual census data to your Third-Party Administrator (TPA) is one of the most important tasks in your retirement plan administration process. This data drives everything from employer match calculations to required 401k compliance testing—and delays can lead to costly errors.

In this guide, we’ll walk you through exactly what information your TPA needs and how to ensure your TPA census submission is complete and on time.

What Is a 401(k) Annual Census?

A 401(k) annual census is a comprehensive report of employee data that your TPA uses to:

  • Perform required compliance testing (ADP, ACP, top-heavy tests)
  • Calculate employer matching contributions accurately
  • Determine participant vesting percentages
  • Identify highly compensated employees (HCEs) and key employees
  • Prepare your plan’s annual Form 5500 filing

The census includes data for all employees—not just those participating in the plan—because eligibility and testing requirements apply company-wide.

What to Include in Your 401k Census Checklist

While specific requirements may vary based on your plan document, most TPA census submissions require the following categories of information.

  1. Employee Identifying Information

For every employee on your payroll during the plan year, provide:

  • Full legal name
  • Social Security number or employee ID
  • Date of birth
  • Original date of hire (even if the employee was rehired)
  • Termination date and/or rehire date, if applicable
  • Current employment status (active, terminated, retired, deceased, on leave)
  1. Compensation Data

Compensation figures are critical for employer match calculations and compliance testing. Be sure to use the compensation definition specified in your plan document, which may differ from W-2 wages.

  • Gross compensation for the plan year
  • Bonuses, overtime, and commissions (if tracked separately per plan terms)
  1. Hours and Service Information

Hours worked are essential for determining eligibility and vesting. Even salaried employees may need hours tracked depending on your plan’s requirements.

  • Total hours worked during the plan year
  • Hours for part-time and salaried/exempt employees
  1. Ownership and Related Party Information

This information is used to identify highly compensated employees (HCEs) and key employees for 401k compliance testing.

  • Ownership percentage for each owner
  • Family relationships to owners (spouse, child, parent, grandparent)
  • Controlled group or affiliated service group details, if applicable
  1. Deferral and Contribution Data

Include payroll-related contribution information:

  • Pre-tax deferral amounts by employee
  • Roth deferral amounts by employee
  • Catch-up contributions for employees age 50 and older
  • Loan repayments processed through payroll (if applicable)

Common 401(k) Census Mistakes to Avoid

Even experienced plan sponsors can make errors in their retirement plan census submissions. Watch out for these common pitfalls:

  • Omitting terminated employees — They must still be reported for the plan year.
  • Using the wrong compensation definition — Always refer to your plan document.
  • Excluding hours for salaried employees — Many plans still require this data.
  • Outdated ownership percentages — Update after any business changes.
  • Late submissions — This delays compliance testing and contribution calculations.

5 Tips for a Smooth TPA Census Submission

  1. Request your TPA’s census template early — Each TPA may have specific formatting requirements.
  2. Coordinate with your payroll provider — Many payroll systems can export census data in the required format.
  3. Review data for accuracy before submitting — Double-check compensation figures and employee counts.
  4. Include all employees — Even those who didn’t participate or who terminated during the year.
  5. Submit as early as possible — This allows time for questions, corrections, and timely filings.

Why Timing Matters for Your 401k Plan Administration

Your TPA manages census data for many plans simultaneously during peak filing season. Submitting your 401(k) annual census promptly ensures your plan receives the attention it needs and helps avoid:

  • Delayed employer contribution calculations
  • Rushed compliance testing that may miss errors
  • Late Form 5500 filings and potential penalties
  • Additional stress during an already busy time

Next Steps

Completing your 401k census checklist doesn’t have to be overwhelming. Start by contacting your TPA to confirm their specific requirements, then work with your payroll provider to gather the necessary data.

If you have questions about preparing your retirement plan census or need assistance with your 401k plan administration, contact your TPA for guidance.

Disclaimer: This article is provided for general informational and educational purposes only and does not constitute legal, tax, or professional advice. Plan requirements vary based on individual plan documents and applicable regulations. Please consult with your TPA, legal counsel, or qualified retirement plan advisor for guidance specific to your situation. This content is intended to assist with understanding 401(k) census requirements but does not guarantee compliance with ERISA, IRS, or DOL requirements.

401(k) Annual Census Submission Checklist: Click Here to access a copy of the below checklist resource in PDF format.

Use this checklist to ensure you submit complete and accurate census data to your Third-Party Administrator (TPA). Timely submission helps ensure accurate contribution calculations, proper compliance testing, and on-time Form 5500 filing.

Section 1: Employee Identifying Information

Provide the following for ALL employees—not just plan participants:

 

Employee Identifying Information

☐

Full legal name

☐

Social Security number (or employee ID)

☐

Date of birth

☐

Date of hire (original hire date, even if rehired)

☐

Date of termination, if applicable

☐

Date of rehire, if applicable

☐

Employment status (active, terminated, deceased, retired, on leave)

Section 2: Compensation Data

Compensation must match the definition in your plan document, which may differ from W-2 wages:

 

Compensation Data

☐

Gross compensation for the plan year (per plan document definition)

☐

Bonus amounts (if tracked separately per plan terms)

☐

Overtime pay (if tracked separately per plan terms)

☐

Commissions (if tracked separately per plan terms)

Section 3: Hours and Service Information

Hours are required for eligibility and vesting calculations, even for salaried employees:

 

Service Information

☐

Total hours worked during the plan year

☐

Hours tracked for salaried/exempt employees (if required by plan)

☐

Hours for part-time employees

Section 4: Ownership and Related Party Information

Required for highly compensated employee (HCE) and key employee testing:

 

Ownership Information

☐

Ownership percentage for each owner

☐

Family relationships to owners (spouse, child, parent, grandparent)

☐

Any changes in ownership during the plan year

☐

Controlled group or affiliated service group information (if applicable)

Section 5: Deferral and Contribution Data

Provide payroll-related contribution information:

 

Contribution Data

☐

Pre-tax deferral amounts by employee

☐

Roth deferral amounts by employee

☐

Catch-up contributions (for employees age 50+)

☐

Loan repayments processed through payroll (if applicable)

Section 6: Before You Submit

 

Final Review

☐

Verify ALL employees are included (including terminated employees)

☐

Confirm compensation definition matches plan document

☐

Review ownership percentages for accuracy

☐

Use TPA’s preferred format or template

☐

Submit data to TPA ASAP to ensure timely filings

Helpful Tips

• Contact your TPA early to request their specific census template.

• Coordinate with your payroll provider to export data in the required format.

• Don’t forget terminated employees — they must be reported for the plan year.

• Submit early to allow time for questions and corrections.

Questions? Contact your TPA for assistance.

Disclaimer: This checklist is provided for general informational and educational purposes only and does not constitute legal, tax, or professional advice. Plan requirements vary based on plan documents and applicable regulations. Please consult with your TPA, legal counsel, or qualified retirement plan advisor for guidance specific to your plan. This document is intended to assist with compliance but does not guarantee compliance with ERISA, IRS, or DOL requirements.

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Understanding the IRS Math and Taxpayer Help Act

If you’ve ever received an IRS notice claiming there was a “math error” on your tax return—only to be left scratching your head about what actually went wrong—you’re not alone. For years, dental practice owners and other taxpayers have been frustrated by vague IRS notices that provide little explanation and even less guidance on how to respond.

That’s about to change.

What Is the IRS MATH Act?

On December 1, 2025, President Trump signed the Internal Revenue Service Math and Taxpayer Help Act (IRS MATH Act) into law. This bipartisan legislation passed unanimously in both the House and Senate, reflecting broad agreement that taxpayers deserve straightforward, transparent communication from the IRS.

The law, which takes effect on December 1, 2026, requires the IRS to provide specific, detailed explanations when it adjusts a tax return for a mathematical or clerical error. No more guessing games about what triggered the change or how much you owe.

What Changes Under the New Law?

When the IRS MATH Act goes into effect, math error notices must include:

Plain language explanations. The IRS must describe the error clearly, including the specific Internal Revenue Code section and the exact line on your tax return where the issue occurred.

Itemized calculations. You’ll receive a detailed breakdown showing exactly how the IRS computed the proposed adjustment and how it affects your return.

Prominent deadlines. The 60-day window to challenge the adjustment must appear in bold on the first page of the notice. This is critical because failing to respond within this timeframe typically means losing your right to contest the assessment in U.S. Tax Court.

Clear response procedures. The notice must explain how you can request an abatement—whether in writing, electronically, by phone, or in person.

Specific error identification. The IRS can no longer send you a list of possible errors. They must identify the exact issue on your return.

The law also establishes a pilot program to test whether sending these notices by certified mail improves delivery and response rates.

Why This Matters for Your Dental Practice

Math error notices are more common than many practice owners realize. According to IRS data, over one million of these notices were sent during the 2023 tax year alone. For busy dental professionals managing patient care, staff, and business operations, receiving a confusing IRS notice can be stressful and time-consuming.

Under the old system, many taxpayers simply accepted the IRS adjustment because they couldn’t figure out what had gone wrong or didn’t realize they had a limited window to respond. The IRS MATH Act levels the playing field by giving you the information you need to understand the situation and make an informed decision about whether to challenge it.

What Should You Do Now?

While this law won’t take effect until late 2026, here’s what you can do in the meantime:
If you receive a math error notice before the new rules take effect, review it carefully and contact your tax advisor promptly. Remember that you typically have only 60 days to dispute the assessment. Keep thorough records of all tax return documentation, which will make it easier to respond to any IRS inquiries. If you’re having difficulty resolving an IRS issue, the Taxpayer Advocate Service (TAS) is a resource that can help you navigate the process.

We’re Here to Help

At Dental Accounting Group, we monitor tax law changes that affect dental practices so you can focus on what you do best—caring for your patients. If you receive an IRS notice or have questions about how tax changes might affect your practice, our team is ready to assist.

Sources:

Disclaimer: This article is intended for general informational purposes only and does not constitute legal, tax, or professional advice. Every situation is unique, and tax laws are subject to change. You should consult with a qualified tax professional or CPA regarding your specific circumstances before making any decisions based on this information. This content is provided in accordance with AICPA professional standards and does not create a client relationship with Dental Accounting Group.

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ESSB 5814 Tax Guidance for Dental Study Clubs: What Dentists Need to Know Before October 1, 2025

Washington State’s Engrossed Substitute Senate Bill 5814 introduces significant changes to how professional services are taxed, particularly affecting dental study clubs and continuing education presentations. This article provides our interpretation of the new law and practical guidance for navigating these changes while protecting your interests.

Key Tax Changes Effective October 1, 2025

The new law extends retail sales tax to “live presentations,” defined in RCW 82.04.050(3)(l) as:

“Live presentations including, but not limited to, lectures, seminars, workshops, or courses where participants attend either in-person or via the internet or telecommunications equipment that allows audience members and the presenter or instructor to give, receive, and discuss information with each other in real time”

This creates three distinct scenarios for dental practices:

  1. Study Club Membership Dues: We advise these remain non-taxable (explained below)
  2. Speaking Fees Paid to Presenters: Must include sales tax
  3. Event-Specific Attendance Fees: Subject to sales tax

Our Position: Study Club Dues Are Not Subject to Sales Tax

The Dental Accounting Group takes the position that annual study club membership dues should not be subject to retail sales tax, based on careful analysis of ESSB 5814’s language and structure. Here’s our reasoning:

Legal Basis for the Dues Exemption

The statute specifically targets “live presentations” as discrete, identifiable services. Annual membership dues represent a fundamentally different transaction:

  1. Bundle of Rights Specific Service: Membership dues provide access to multiple benefits including networking opportunities, resource libraries, practice management support, and potential attendance at presentations. They do not constitute payment for any specific “live presentation.”
  2. Timing Distinction: The law contemplates real-time presentations with defined start and end times. Annual dues are paid without reference to specific events, often before any presentations are
  3. Allocation Complexity:
    • Many study clubs allocate dues across multiple purposes: Administrative costs (30-40%)
    •  Venue and hospitality (20-30%)
    •  Materials and resources (15-20%)  Speaker fees (15-30%)

Since only a portion relates to presentations, taxing the entire dues amount would exceed the statute’s scope.

Supporting Arguments

The statute taxes “charges for” live presentations, not general membership fees. Just as country club dues aren’t subject to sales tax despite members using taxable facilities, study club dues represent membership in an organization rather than payment for specific taxable services.

No Department of Revenue guidance contradicts this interpretation. Until specific regulations address membership organizations, reasonable interpretations favoring taxpayers should prevail.

Clear Taxable Transactions: Speaker Fees and Attendance Charges

While we defend the dues exemption, two scenarios clearly trigger sales tax obligations:

1.  Speaking Fees (Paid to Presenters)

Under RCW 82.04.050(3)(l), any dentist or professional receiving compensation for delivering a live presentation must charge sales tax. This includes:

  • Hourly or daily speaking fees  Flat-rate presentation charges
  • Travel stipends tied to speaking engagements
  • Any compensation for real-time educational delivery

Example: Dr. Smith receives $2,000 to present at your study club. She must invoice $2,000 plus applicable sales tax (6.5-10.5% depending on location).

2.  Event-Specific Attendance Fees

When charging non-members to attend specific presentations, sales tax applies:

  • Single-event registration fees
  • Guest attendance charges
  • Workshop-specific fees beyond regular dues

Example: Your study club charges $150 for non-members to attend a hands-on workshop. You must collect sales tax on this amount.

Compliance Strategies for Different Scenarios

For Study Club Operators

Current Approach (Until Further Guidance):

  • Continue collecting annual dues without sales tax
  • Maintain clear documentation showing dues cover multiple benefits
  • Segregate presentation costs in your accounting records

When Hiring Speakers:

  • Require all speakers to include sales tax on their invoices
  • If speakers fail to charge tax, self-report use tax on the untaxed amount
  • Document all speaker agreements specifying tax obligations

For Individual Events:

  • Any charges specifically for attending presentations must include sales tax
  • Create separate fee structures for “membership” versus “event attendance”

For Dentists Who Present

If You Receive Speaking Fees:

  • Register for Washington sales tax collection immediately
  • Add applicable sales tax to all speaking fee invoices
  • Specify on invoices: “Sales tax per RCW 82.04.050(3)(l)”

Calculation Methods:

  1. Add-On Method: Quote $2,000 + sales tax
  1. Inclusive Method: Quote $2,130 with tax included (must “back out” tax: $2,130 ÷ 1.105 = $1,927.60 taxable amount; $202.40 tax due)

Exemptions and Special Circumstances

What Remains Exempt

The following are NOT subject to the new retail sales tax:

  1. Telehealth Services: Patient consultations via video or phone (RCW 04.192(3)(b)(xi))
  2. Educational Institutions: Presentations by accredited colleges/universities to their students
  3. Internal Training: Employee education provided without charge
  4. Pre-Recorded Content: Asynchronous online courses without real-time interaction

Gray Areas Requiring Caution

  • Hybrid Events: Mixing business meetings with educational content
  • Sponsorship Payments: May avoid tax if not tied to specific presentations
  • Material Sales: Books and supplies remain subject to existing sales tax rules

Practical Implementation Timeline

Before October 1, 2025:

  1. Review Current Structure: Document how your study club operates and allocates funds
  2. Update Agreements: Revise speaker contracts to specify tax obligations
  3. Adjust Invoicing: Implement systems to collect tax on taxable transactions
  4. Communicate Changes: Inform members about new requirements

Ongoing Compliance:

  • Track Department of Revenue guidance for updates
  • Maintain clear records distinguishing dues from event fees  Report and remit collected taxes timely
  • Self-assess use tax on untaxed speaker fees

Risk Management Recommendations

Documentation Best Practices

Maintain records showing:

  • Membership benefits beyond presentations
  • Allocation of dues to various purposes
  • Clear separation between dues and event fees
  • Speaker agreements with tax provisions

Audit Defense Preparation

The Department of Revenue will likely scrutinize professional organizations. Prepare by:

  • Establishing written policies before October 1
  • Consistently applying your tax treatment
  • Documenting the business purpose of all transactions
  • Retaining professional tax guidance 

Conclusion and Action Steps

The Dental Accounting Group believes thoughtful structuring can minimize the tax impact of ESSB 5814 on dental study clubs. By distinguishing general membership dues from specific presentation charges, clubs can maintain their current dues structure while ensuring compliance on clearly taxable transactions.

Immediate Actions Required:

  1. Study Club Operators: Document your dues structure and update speaker agreements
  2. Presenters: Register for sales tax collection before accepting October engagements. No action is needed if you have historically accepted speaking fees through your dental practice entity, just make note to report speaking fees on your Sales Tax / B&O filing.

We will monitor Department of Revenue guidance and update our recommendations accordingly. This reasonable interpretation balances compliance with practical business operations while we await specific regulatory clarification.

Please contact our office to discuss your specific situation. As your trusted advisors, we’re committed to helping you navigate these changes efficiently and defensively.

Sincerely,

The Dental Accounting Group

Disclaimer: This article represents our current interpretation of ESSB 5814 based on the statutory language and existing Department of Revenue practices. Tax laws and interpretations may change, and specific situations may warrant different approaches. This article is for educational purposes only. Please reach out to your tax advisor accordingly. 

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Running a successful dental practice isn’t just about delivering exceptional patient care — it’s also about making smart financial decisions that protect and grow your business. That’s why choosing the right CPA for dentists can be as important as choosing the right lab or supplier.

For private practice owners, working with a private practice dental CPA offers clear advantages over large, corporate accounting firms. Much like the difference between an independent dental office and a corporate DSO, a private CPA delivers personalized service, aligned incentives, and independent decision-making. We specialize in dental accounting services designed for every stage of your career — from startup tax planning and dental practice growth strategies to retirement transitions — and we do it all with a USA-based dental CPA team that never outsources.

In this article, we’ll compare private vs. corporate CPA models, outline the benefits of partnering with a firm that shares your values, and show why independence matters for both patient care and financial success. Dentists go into private practice for a reason. You want control over your schedule, your patient care, your standards, and the way your business runs. 

The same logic applies to your finances. If you value independence, accountability, and outcomes that truly serve your interests, you need to work with a private practice dental CPA — not a large, corporate accounting machine that has private equity shareholders.  

1. We Care About Clients the Way You Care About Patients

When you run a private dental practice, you know every patient’s name and story. They’re not just a line item on a spreadsheet — they’re people you care about.

That’s exactly how we see our clients.

  • You care about successful treatment outcomes.
  • We care about successful financial outcomes.

And because we’re owners of our firm, our financial incentives are directly tied to your success. When your practice thrives, we thrive. That’s not just a marketing line — it’s our business model.

2. Private vs. Corporate: The DSO Analogy

In dentistry, you know the difference between a private practice and a corporate DSO:

  • In a DSO, decisions are often made far from the operatory by people who have never treated a patient.
  • In private practice, you make decisions with your patients’ best interests at heart.

Large, corporate accounting firms are the DSOs of the financial world. Their size can mean bureaucracy, turnover, and “one-size-fits-all” strategies that don’t fit your unique practice. They have outside investors and management layers whose priorities may not align with yours.

A private practice dental CPA, on the other hand:

  • Makes decisions in-house — no outside investor telling us what to do.
  • Customizes advice based on your goals, not corporate quotas.
  • Builds a long-term relationship with you, not a transactional engagement.

3. Independence Means Better Decision-Making

Because we own our firm outright:

  • We answer only to our clients, not shareholders or a board.
  • We can invest in tools, technology, and continuing education that serve your needs — not corporate cost-cutting measures.
  • We can be nimble — adapting to tax law changes (like the OBBB Act) or shifts in the dental market without waiting for “corporate approval.”

This independence mirrors your freedom as a practice owner to choose your labs, materials, and treatment approaches.

4. We Hire in the USA — Every Day. Never Outsourced.

You’d never outsource crown prep to someone overseas. So why would you let your financial work be sent halfway across the world?

We believe in quality at every step — which means:

  • Every team member is US-based.
  • Every report, forecast, and tax plan is created and reviewed by professionals who understand your business and your regulatory environment.
  • We protect your data and your trust by keeping your information in-house.

5. Quality of Care — From Graduation to Retirement

Your relationship with a private practice dental CPA isn’t just about “doing your taxes.”
It’s about having a financial partner through every stage of your career:

  • Startup: Entity choice, financing strategy, budget planning.
  • Growth: Overhead control, KPI benchmarking, tax optimization.
  • Maturity: Retirement planning, wealth transfer, practice sale strategy.

At each stage, the focus is on outcomes that align with your definition of success — not someone else’s quarterly targets.

6. The Result: Long-Term, Aligned Success

Corporate firms often work in volume. They can afford to lose a client because they’re chasing the next big account.

We can’t — and don’t want to — work that way.
Like you, we want a healthy, sustainable practice, built on trust and quality. That’s why we put in the work to understand your numbers, your vision, and your challenges.

Bottom Line

Private practice dentists choose independence because it delivers better patient care and better outcomes.
The same is true for your financial care. Working with a private practice dental CPA means:

  • Aligned incentives.
  • No outside control.
  • Uncompromising quality.
  • A partner for the life of your career.

Because when you win, we win. And that’s exactly how it should be. 

Questions? – Feel free to reach out to Ke***@******************os.com or Ke***@*****ds.com 

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Press Release

FOR IMMEDIATE RELEASE

Dental Accounting Group Named to Inc. 5000 List for Second Consecutive Year — Leading the Way in Specialized Dental Practice Accounting

Bellevue, WA — August 13, 2025 — Dental Accounting Group, a leading provider of specialized accounting, tax, and advisory services for dental practices, has once again been recognized on Inc. Magazine’s prestigious 2025 Inc. 5000 list of America’s Fastest-Growing Private Companies. This marks the second consecutive year the firm has earned this distinction, underscoring its position as the trusted choice for dentists nationwide seeking financial clarity, compliance, and strategic growth.

The Inc. 5000 list ranks companies based on percentage revenue growth from 2021 to 2024, spotlighting businesses that are driving innovation and resilience in their industries. Dental Accounting Group’s back-to-back recognition highlights not only consistent growth, but also its ability to deliver unmatched value in a highly specialized market.

“Making the Inc. 5000 list for the second year in a row is a direct reflection of our mission — to give dental professionals the financial confidence they need to grow,” said Kevin Bray, Partner & Client Advisor at Dental Accounting Group. “We’re unique in that we only hire full-time W-2 employees based in the United States. We never outsource overseas. Our clients know exactly who’s handling their financial data, and they can trust it’s secure, accurate, and managed by experts who understand the dental industry inside and out.”

Unlike general accounting firms, Dental Accounting Group focuses exclusively on the dental industry. Its services are designed to address the unique operational, regulatory, and financial needs of dental practices. From bookkeeping and tax planning to CFO-level consulting, payroll, bill pay, and cash flow forecasting, the firm’s subscription-style service packages scale with each practice’s growth.

“Our niche focus allows us to see trends and opportunities that others miss,” added Bray. “We pair this deep industry knowledge with an industry-leading technology stack that ensures both security and efficiency. Our clients aren’t just getting accounting — they’re getting a strategic partner invested in their success.”

Why Dental Accounting Group Leads the Industry:

  • 100% USA-Based Team — Every team member is a full-time W-2 employee located in the U.S.

  • Never Outsourced — Sensitive financial data never leaves the country.

  • Industry Expertise — Serving dental professionals exclusively for unmatched insight and guidance.

  • Cutting-Edge Technology — Secure platforms for efficiency and protection.

  • Scalable Service Plans — Flexible options to match any stage of practice growth.

Dental Accounting Group works with practices of all sizes — from solo dentists to multi-location groups — delivering the financial clarity, compliance, and proactive tax strategies that drive profitability and long-term success.

For more information on Dental Accounting Group’s services and to book an initial consultation, visit dentalaccountingpros.com/contact/.

Complete results of the 2024 Inc. 5000, including company profiles and rankings, can be found at Dental Accounting Group’s Inc. 5000 Profile.

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The OBBB (Oh-Triple-Bee as we are starting to call it) Act officially passed and signed into law on July 4th, 2025 by the President. We have been diligently reviewing source material to craft our tax planning approach for 2025 and future years. Please note that we are still waiting for additional IRS guidance, but in the interim, here is a short summary of the key tax provisions:

Key Takeaways for Dentists:

  • Tax rates from the 2017 Tax Cuts & Jobs Act made permanent
    • 10%, 12%, 22%, 24%, 32%, 35%, and 37%
    • Enhanced inflation adjustment for 10%/12%/22% brackets.
  • Qualified Business Income Deduction made permanent at 20%
  • State and Local Tax (SALT) limit raised to $40k ($20K MFS) with a phase-down over $500k of Modified Adjusted Gross Income. Reverts back to $10k in 2030.
  • SALT cap increases 1% per year starting in 2025 through 2029

The Pass-Through Entity (PTE) tax work around was on the chopping block, but in the final Senate version this tax saving strategy for business owners was saved, which will benefit high-earning practice owners in income tax states like California and Montana.

  • Child tax credit increased to $2,200 per child, adjusted for inflation thereafter. Phase out begins at $400k Modified Adjusted Gross Income (if filing jointly).
  • Trump Retirement & Savings Account (Trump Account) is introduced – Invest up to $5,000 per child per year until the child turns 18. Funds must be invested in US stock market index funds. The US Government will give $1,000 per baby born between 2025 – 2028.
    • Employers can make up to $2,500 in nontaxable contributions per employee. We need more guidance from the IRS regarding compliance.
    • Trump accounts grow tax-deferred until the beneficiary withdraws the money.
  • Expanding the use of section 529 tax-advantaged savings accounts for qualified higher education expenses, including “qualified postsecondary credentialing expenses” related to professional licensure. We believe CE programs like AGD, Spears and KOIS fall under this new definition. 
  • Charitable deductions: Under OBBBA, the deduction has been expanded to include a permanent “above-the-line” deduction for taxpayers who do not itemize their deductions. Beginning in 2026, taxpayers who do not itemize can claim a deduction of up to $1,000 ($2,000 for those taxpayers who are married filing jointly) for certain charitable contributions. Taxpayers who itemize are subject to a 0.5% floor of their modified adjusted gross income. For example, a household with $300k in MAGI would not be able to deduct the first $1,500 in charitable contributions. New carryover rules would also apply. OBBBA also makes the 60% contribution limit for cash gifts to qualified charities permanent.
  • Green energy tax credits are repealed including electric vehicle credits, installation of home EV charging equipment, and some residential energy credits such as insulation, windows, or energy efficient heating and cooling systems (including solar). Most Inflation Reduction Act (IRA) credits will terminate 2025-2027. 
  • Exemption for overtime pay up to $12,500 per year (2025 to 2028) via a tax deduction (above the line). Must be reported on Form W-2 (waiting on additional guidance).
  • Above the line deduction for auto loan interest up to $10,000 per year (2025 – 2028). The car must be new (not used) and be assembled in the United States.  EV cars are eligible. Debt must have been incurred after 12/31/24. Deduction is completely phased out when income is over $150k ($250k married filing jointly)
  • Senior Citizens aged 65 and older will get an additional $6,000 added to their standard deduction (in an effort to offer relief to those collecting Social Security (2025 – 2028).
  • Health Savings Account (HSA) changes – expanded coverage & eligibility.
  • Employer education plans paying student loan payments – extended permanently.
  • Increasing the filing threshold for Forms 1099-NEC and Forms 1099-MISC from $600 to $2,000, adjusted for inflation.
  • The 100% depreciation deduction is now permanent. This replaces the phase-down of 40% for property after January 19, 2025.
    • A temporary 100% expensing for qualifying structures that start construction in 2025-2028 will be granted.
  • The OBBB Act overhauls federal student loan repayment by eliminating all existing Income-Driven Repayment (IDR) plans and replacing them with the standard repayment plan and the Repayment Assistance Plan (RAP). While RAP caps monthly payments at 10% of discretionary income, it extends the repayment period to 30 years (360 payments) before any remaining balance is forgiven, compared to current plans that offer forgiveness after 10-25 years.
  • The temporary increase to the estate and gift tax exemption has been made permanent and increased further to $15 million.
  • Higher exemptions and phase-out thresholds for the Alternative Minimum Tax have been made permanent, meaning very few taxpayers will be subject to it.
  • Total itemized deductions are subject to a new phase-out for higher incomes. The otherwise allowable deduction is reduced by 2/37 of the lesser of (1) the amount of the itemized deductions or (2) the amount of the taxpayer’s taxable income that exceeds the start of the 37% tax rate bracket.

Impact for Dental Practice Owners:

Most of our clients will continue to benefit from key tax provisions passed in the original Tax Cuts and Jobs Act (TCJA) from 2017. We continue to review text from the One Big Beautiful Bill Act and participate in CPA industry group discussions. We will keep you updated as information becomes available from the IRS.

Any Questions? Feel free to reach out to our office.

-Your Dental Accounting Group

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2025 brings some notable changes to local taxes in Washington State. 

Capital Gains Tax 

The Washington capital gains tax has been in place for a few years now.  Washington taxpayers are subject to a 7% tax on long-term capital gains that exceed an annual threshold (currently $270,000).  An additional 2.9% tax is now being added for taxable gains above $1 million.  This retroactively applies to any gains realized as of January 1, 2025. 

With the annual exemption, this essentially means you must have long-term capital gains of $1,270,000 before the additional tax applies.  The first $270,000 is still exempt, and gains from $270,000 – $1,270,000 are still taxed at 7%.  Only the gains exceeding this amount are taxed at 9.9%. 

There are no changes to the existing exemptions and deductions, such as gains on real estate, retirement accounts, and qualified family-owned small businesses. 

Estate Tax 

Many are aware of the increased federal estate tax exemption.  When someone dies, they can leave assets to their heirs without paying any estate tax as long as the estate is under $13.99 million (or $27.98 for a married couple).  This effectively means that very few people need to worry about the federal estate tax.  (Note that this is currently scheduled to sharply decrease next year, although legislation is currently in the works that could extend it). 

However, many states also have a state estate tax, including Washington.  The state exemption is currently much lower, at $2.193 million and has been unchanged for several years.  It will increase to $3 million on July 1, 2025, and it will be indexed to inflation each subsequent year.  Note that unlike the federal exemption, this is not “portable” between spouses, meaning you cannot double the exemption to get $6 million per couple.  When the first spouse dies, everything can pass to the surviving spouse tax free.  But when the second spouse dies, they will only be entitled to a $3 million exemption, the same as someone who was never married. 

While the increased exemption will allow more people in the state to avoid the state estate tax, once you are above that exemption, the rate at which you pay the estate tax is increasing.  Similar to the federal income tax, the state uses progressive brackets where larger estates pay a larger percentage in taxes.  The rates currently range from 10%-20%, but the top bracket will now increase to 35%. 

Taxable Estate (amount above exemption) 

Current Rates 

Rate as of 7/1/25 

<$1m 

10% 

10% 

$1m – $2m 

14% 

15% 

$2m – $3m 

15% 

17% 

$3m – $4m 

16% 

19% 

$4m – $6m 

18% 

23% 

$6m – $7m 

19% 

26% 

$7m – $9m 

19.5% 

30% 

>$9m 

20% 

35% 

Business owners can also take advantage of another exclusion, if the value of the business owned makes up over 50% of the taxable estate and has been actively operated by the decedent or a family member for at least five of the previous eight years.  Currently, you can exclude $2.5 million of the business from your total estate value.  That amount is increasing to $3 million. 

However, if the business is later sold, or the business no longer qualifies within three years of death, the State can go back and assess tax on the business as if it had been included in the taxable estate. 

Should you have any questions on these tax changes, or how you can best plan to limit your exposure, please do not hesitate to reach out to us. 

 

 

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The PDF version of our formal letter can be found Here

January 29, 2025

RE:        Testimony in support of HB 1535 / SB 5351

Our firm specializes in working with dental practices, which we have been doing since 1989.  We understand the economics of the dental profession, how the current financial model dictated by large insurance carriers is threatening its financial health, and how this directly leads to less access to care and more expense for patients.

Here’s some background on the economics of a dental practice.  Dental graduates typically leave school saddled with $300,000 or more in student debt.  In addition to servicing that debt, they will require nearly $1 million in financing if they want to buy or open a basic clinic.  Once a clinic is up and operating, it faces economic challenges over which it has little control.  Post-pandemic, we have seen a decline in experienced dental office employees, a trend identified by the American Dental Association as a critical challenge for the dental profession nationwide.  Due to this acute shortage of experienced dental workers (especially hygienists), average dental employee wage rates have increased by at least 30% in the last five years alone across Washington (and up 40% in Seattle/Bellevue Metro).  Other expenses have also increased, if not as significantly.

Despite these rising costs and despite an overall increase in the general Consumer Price Index of more than 45% since 2010, dental benefit reimbursement rates have remained relatively flat.  Delta Dental of Washington (DDWA), by far the largest carrier in the state, unilaterally reduced its reimbursement rates by approximately 15 percent in 2011 and froze those rates for 10 years. More recently, DDWA has increased reimbursements by approximately 3% in 2024 and 4% for 2025 for select Current Dental Terminology (CDT) reimbursement codes.

These increases are insufficient to keep up with rising costs, much less make a dent in the gap created by more than a decade of frozen reimbursements.  They create a clear imbalance between the huge costs associated with obtaining a dental education and operating a dental clinic and the potential rewards for pursuing a career in dentistry.  In short, the current financial model is killing the future of the profession. It is a formula for a shrinking number of providers and a decline in the supply of dental care resources – reducing access, availability and quality of care. In the end, patients are the ones that will suffer.

We have seen this trend in the medical profession over the last 20 years, where changing economics have led to provider consolidation, private equity acquisition of health systems, and diminished access to care for patients. 

HB 1535 and SB 5351 can help prevent this from happening in the dental arena.  It will:

  • Support dentists in covering rising expenses like wages, equipment, and rent
  • Ensure parity of reimbursement between in-network and out-of-network providers, giving patients true freedom to choose their dentist and unrestricted access to the benefits they are paying for. 
  • Reduce anti-competitive practices by dominant insurers (For example, several insurers already provide relative parity for in-network and out-of-network reimbursements, but DDWA as the dominant player does not.).
  • Provide sufficient economic incentives for students to pursue dentistry, critical for maintaining an adequate dental workforce and appropriate access to care
  • Prevent rural and underserved communities from losing access to dental care
  • Mandate insurance plans spend 85% of premium revenue on care, not profits or administrative costs.

Everyone in Washington will benefit from a more competitive and better functioning market for dental benefits.  It will allow dentists to tailor their practices to compete for and meet the needs of their patients without insurance companies dictating how and how much they are reimbursed for the care they provide.  It will allow patients to pick the dentist they are most comfortable with and not be forced to accept a lower level of benefits because of that choice.  It will allow insurance companies to adjust their reimbursement rates to become more competitive.  Premera’s recently announced plan to increase its reimbursement rates 24% clearly shows how this can benefit consumers.  Most importantly, it will require that 85% of patients’ premium dollars are directed to their care, helping ensure that they – and the dental profession that cares for them – remain healthy in the years ahead.

We urge you to support this vitally important legislation.

ADDITIONAL BACKGROUND INFORMATION

  • Dental care is financed in large part by employer provided dental insurance.

  • Delta Dental of Washington (DDWA) covers the majority of insureds in Washington State. In some markets, it exceeds 80% of the patient population. Premera and Regence also have large insured populations. We refer to these as The Big 3.

  • Effective July 2011, DDWA reduced their reimbursement rates to providers by roughly 15% with some more frequently used CDT codes, such as those for preventive care, being cut even greater than 15%. DDWA froze those lower rates for 10 years

  • In 2024, DDWA increased a handful (around 20 of the over 800 CDT codes) of the CDT reimbursement rates by approximately 3%. For 2025, DDWA has increased some CDT reimbursement rates by approximately 4%, with an emphasis on selective hygiene CDT codes.  

  • Premera followed DDWA’s lead in 2018 with a significant cut to their CDT reimbursement rates. Premera and Regence have followed DDWA’s frozen reimbursement rate model in lockstep. Premera is one carrier that pays the same in-network reimbursement rate to out of network providers which allows insureds unrestricted provider choice and full access to their benefits.

  • Following Premera’s rate cut in 2018, based on experience with our clients, a substantial number of clinics dropped out of Premera’s PPO network. The out of network reimbursement rates for many carriers, with the exception of DDWA, are on par or nearly on par with in-network reimbursement rates without transferring an onerous financial burden to patients who choose to continue their relationship with their dental provider regardless of their PPO status. Delta, on the other hand, slashes reimbursement rates as low as 20% of in network rates, even for preventive care, and transfers the financial burden of dental care back to those patients who choose/desire to continue with their established dental provider. DDWA’s punitive financial terms for out of network providers (and patients that desire to continue working with their long-term provider that has dropped their DDWA PPO status) are so onerous that it forces most patients to transfer to an in-network provider. Dictating consumers (patients) to seek services solely from in-network providers due to DDWA’s control and influence in the market is anti-competitive and monopolistic, especially when you factor in the punitive outcome to both providers and patients that are out of network. It is a barrier to a patient’s choice and access to care.   

  • Market conditions (presumably Premera insureds complaining about difficulties to access care with in-network providers) must have come into play to trigger Premera to raise their reimbursement rates by 12% effective October 1, 2024 and another 12% effective March 1, 2025. Given the frozen reimbursement rate environment since 2011, Premera’s 24% rate increase within 5 months is a “drastic” reaction to presumably free market forces.

THE CURRENT PPO BASED FINANCIAL MODEL IS NOT SUSTAINABLE

  • The Big 3 carriers have monopolistic influence in the marketplace. They dictate what providers can charge for their services. They have influence over approving or disapproving insureds claims diagnosed by their providers. Because they “control” the majority of “customers,” they make it nearly impossible to compete for doctors who choose to drop out of the carrier’s PPO networks.

  • Between 2010 and 2024, the consumer price index (CPI) has increased by 45.65%. The CPI is a measure of increasing costs. Meaning how much the cost of delivering dental services has increased over the 10 plus years that reimbursement rates have been frozen. Post the 2020 pandemic, we have seen a decline in experienced dental office employees which has been identified by the ADA as a nationwide critical challenge for the industry. Combine the short supply of experienced dental workers with wage inflation in recent years, dental employee wage rates have increased by 30% just in the last five years alone across Washington on average (and up 40% in Seattle/Bellevue Metro).

  • The medium-term trajectory for this model threatens the economic viability of independent private practice and leads to a declining interest in the profession due to the miss-match with the financial reward relative to the huge investment (educational costs and student loans). The University of Washington’s current projected cost for an in-State student to complete dental school is approximately $432,000. We regularly see new dental grads saddled with student debt in excess of $300K at current interest rates in the 7% to 9% range. Currently it typically cost a dentist at least $1.0M in practice financing to buy or open a basic clinic. The long-term implications we are potentially faced with is a shrinking number of providers relative to a growing population which will stress insureds access to in-network dental care. The current financial model is killing the future of the profession. It is a formula for a decline in the supply of dental care resources – reducing access, availability and quality of care. In the end, patients are the ones that will suffer. Simply look at what has been going on with medical care over the last 20 years as a predictor of future dental care without needed structural changes with the financial model. Medicine has pivoted to a concierge model which is simply a pay for access model which has created financial barriers to accessing highly experienced and sought after providers. The concierge model, created out of the financial failings of the PPO model, allows providers to deliver quality care that is focussed on the patient’s needs and not dictated by a carrier’s claim approval or subsistence reimbursement rates. One could argue that the concierge model has created a two-tier health care system. One able to deliver unbridled high-quality care to those with financial resources and a second constrained by the financial model dictated by the carriers for everyone else. This can be avoided in dentistry with some needed structural changes in the financial arrangement between the carriers, the providers and patients.  

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COMPANY BIO

DG Accounting Professionals LLC dba Dental Accounting Group 

  • Washington Chapter of the Academy of Dental CPAs
  • We are a dental specific CPA firm that works with hundreds of dental practices.
  • We are a member of an exclusive organization of dental CPA firms (the Academy of Dental CPAs) nationally that serve over 11,000 practice units.
  • We understand the economics of the dental industry and the in-network or PPO financial model dictated by the large dental insurance carriers.

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LEADERSHIP BIOS

Brian F. Bray, CPA
Co-Managing Partner | Senior Client Advisor
Working with dentists since 1989

Brian has been a Certified Public Accountant and business advisor for over 40 years and is Co-Managing Partner of the Dental Accounting Group. Brian offers clients a business-minded perspective, sharpened by decades of practical experience, to help clients grow and improve their business. He is passionate about helping the next generation of dentists learn how to be financially successful in today’s challenging economic environment.

Affiliations:
Washington Society of Certified Public Accountants
American Institute of Certified Public Accountants
Academy of Dental Certified Public Accountants

Education:
University of Washington

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Margaret M. Boyle, CPA
Co-Managing Partner | Senior Client Advisor
Working with dentists since 1990

Maggie is the Co-Managing Partner of the Dental Accounting Group. She is a University of Washington graduate, a Certified Public Accountant (CPA) and a former Certified Valuation Analyst (CVA). Maggie has been providing tax, consulting and planning services to dental professionals since 1990. She served on the board of the ADCPA for 6 years and is the Washington representative for the Academy of Dental CPAs, a select group of 26 CPA firms throughout the US that provide progressive consulting, accounting and tax services to dental professionals. Maggie has guest lectured at the University of Washington Dental School, SKCDS and many local study clubs.

Affiliations:
Washington Society of Certified Public Accountants
Academy of Dental Certified Public Accountants

Education:
University of Washington

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Kevin J. Bray
Partner | Client Advisor
Working with dentists since 2014

Kevin has been working with Dentists since 2014, building a dental focused bookkeeping practice from scratch, that later merged with the Dental Group to form the Dental Accounting Group in 2022. DAG was recently honored as one of the Puget Sound Business Journal’s Best Places to Work in 2024 and was featured in the INC. 5000’s Fastest Growing Companies in America list. Kevin is passionate about building businesses, financial planning and education.

Affiliations:
Academy of Dental Certified Public Accountants

Education:
University of Washington
Washington Governors University