Locum tenens often introduces multi-state income, travel reimbursements, and business expenses that do not show up in a single W-2 hospital job. The goal is not “tax tricks”—it is clean documentation and predictable quarterly planning.
Why bookkeeping discipline matters
- Keep receipts and itineraries for flights, lodging, mileage, and rental cars when applicable.
- Track licensing fees, DEA renewals, and board maintenance separately from personal expenses.
- Separate accounts can reduce end-of-year reconstruction stress (even if not strictly required).
Common discussion topics with a CPA
- Entity choice (if any) and whether it matches your liability and admin tolerance.
- State residency rules and sourcing of income across states.
- Per diem vs actual expense methodologies where relevant.
- Estimated tax timing to avoid underpayment penalties.
Compare offers on after-tax outcomes
Two weekly rates can converge after tax and expenses—especially if one assignment requires expensive travel or longer unpaid credentialing gaps. A simple spreadsheet with conservative assumptions often clarifies the decision faster than intuition.