Every November, my phone starts to ring with a version of the same question. "Ace, should I buy the new CBCT before December 31 for the write-off?"

It is a fair question, and this year it deserves a careful answer. The federal tax rules changed in 2025, and for many independent endodontists, 2026 is one of the most generous years in a long time to invest in the practice.

But here is what I tell every doctor who calls. A deduction is a discount. It is not a reason.

If you spend $150,000 on equipment and save $50,000 or so in taxes, you are still out about $100,000. Unless that equipment helps you see more patients, work more efficiently, or deliver better care, the tax savings only soften a decision that did not need to be made.

So let's look at what changed, and then at the conversations worth having before the year closes.

The One Big Beautiful Bill Act, signed in July 2025, made several changes that matter to practice owners:

• 100% bonus depreciation is back, and it is now permanent. Qualifying equipment placed in service this year can generally be deducted in full in the first year, rather than spread out over several years.

• The Section 179 limit more than doubled. It rose to $2.5 million and is indexed for inflation, which puts the 2026 limit at about $2.56 million.

• The 20% qualified business income (QBI) deduction is now permanent. Income thresholds still apply, which is one reason owner salary planning matters.

• Employer student loan repayment is now permanent. Through a qualified educational assistance plan, a practice can help pay a team member's student loans, up to $5,250 per year, tax-free to the employee.

One detail matters more than all the others. To count for 2026, equipment generally has to be placed in service by December 31. Ordered is not enough. Delivered and still in the box is not enough. It needs to be installed and ready to use.
That means the real deadline is earlier than the calendar suggests. Vendors, installers, and CPAs all get busy in December.

Five conversations to have with your CPA before December 31

1. Equipment that earns its keep. Bring your list of possible purchases and ask how each one would be treated this year. Then run the productivity test below before you sign anything.

2. Retirement plan contributions. A 401(k) with profit sharing, or a cash balance plan for higher earners, can shelter significant income and help you keep great team members. Some plans need to be set up before year-end, so ask early.

3. Owner compensation. If your practice is an S corporation, review your salary before the last payroll of the year. The right number balances reasonable compensation, payroll taxes, retirement contributions, and the QBI deduction.

4. Timing of income and expenses. For cash-basis practices, prepaying certain expenses or adjusting when receipts are deposited can shift taxable income between years. Your CPA can tell you whether 2026 or 2027 is the better year to recognize it.

5. Team benefits that work twice. A student loan repayment benefit or a stronger retirement match costs the practice less after tax and gives your assistants and front office one more reason to stay. In today's hiring market, that is worth a lot.

Before any major purchase, I ask three questions:

• Will it help us complete more cases, or the same cases in less time?

• Will it improve diagnosis, case acceptance, or the patient experience in a way patients and referring doctors will notice?

• How many additional cases per month does it take to pay for itself?

That last question clarifies everything. In a well-run endodontic practice, most of the fee from each additional case flows straight to the bottom line. If a new microscope or CBCT helps you add two or three cases a month, it can pay for itself quickly. If it simply replaces something that works fine, the tax savings are the only return.
When the answer is yes, the tax rules make this a wonderful year to invest. When the answer is unclear, that money may do more for you in a retirement plan or in your reserves.

Tax planning saves a percentage. Practice planning changes the number.
The practices we coach use these last weeks of the year to set next year's goals: cases, collections, referral targets, team development, and the days the doctor wants to work. When the plan is clear, the tax decisions get easier, because you already know which investments support it.

If you would like a second set of eyes on your numbers before the year closes, Christine Hoxha, our Director of Coaching, would be happy to walk through them with you. A complimentary discovery call is an assessment, not a commitment. No obligation. No pressure. We promise.