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What Do Therapists Need to Know About Taxes in Iowa?

Iowa is transitioning from a progressive income tax to a flat rate — but therapists still need to navigate estimated payments, entity rules, and the state’s filing quirks. Whether you’re just launching your private practice or optimizing one that’s already profitable, here’s how to stay compliant and minimize your tax bill in Iowa.


Who this guide is for

This guide is for:

  • Licensed Iowa therapists (LMHCs, LISWs, LMFTs, psychologists, etc.)
  • Solo or group private practice owners
  • Clinicians working in person, online, or hybrid
  • Therapists looking to set up correctly and avoid tax headaches

Step 1: Pick the right structure for your practice

Your structure determines how you’re taxed and what paperwork you deal with each year.

Sole Proprietorship

  • Easy to start — no state filing required unless using a DBA
  • Income taxed personally, including self-employment tax
  • No liability protection

PLLC (Professional LLC)

  • Iowa allows licensed professionals to form PLLCs
  • Offers liability protection
  • Taxed like a sole proprietorship by default
  • Can elect S Corp status as income increases
  • Must register with Iowa Secretary of State and notify your licensing board

S Corporation

  • Can help reduce self-employment tax
  • Requires payroll, bookkeeping, and corporate filings
  • Worth it when net income exceeds ~$75K/year
  • Still subject to Iowa income tax

Professional Corporation (PC)

  • Allowed in Iowa
  • Can elect S Corp status for tax purposes
  • More complex structure — better for larger practices

Step 2: Know your state tax obligations

State income tax

  • Flat rate of 3.65% for 2025
  • Replaces Iowa’s older bracketed system
  • Applies to all pass-through income
  • File with Iowa Form IA 1040

Annual report

  • Required for PLLCs and PCs
  • Due every odd-numbered year (2025, 2027, etc.)
  • $60 filing fee (online)
  • Submit to Iowa Secretary of State

Local taxes

  • Iowa does not have city or county income tax
  • No business privilege or gross receipts tax

Step 3: Pay taxes throughout the year — not just in April

Estimated taxes

  • Required if you’ll owe $1,000+ to Iowa or the IRS
  • Due quarterly: April 30, June 30, Sept 30, Jan 31
  • Iowa uses Form IA 1040ES (or file/pay online)

Self-employment tax

  • 15.3% federal self-employment tax
  • Applies to net income from sole props and default PLLCs
  • S Corp reduces this if you pay yourself a salary

Filing requirements

  • Sole prop: Schedule C + Iowa 1040
  • PLLC: Biennial report + IA 1040 + federal return
  • S Corp: 1120-S + IA 1120S + payroll filings + biennial report

Step 4: Track and claim your deductions

Deductions reduce your taxable income — and that saves money on both federal and state returns.

Deductible expenses for therapists

  • Therapy software and tech subscriptions
  • Office rent or home office
  • Licensing, CEUs, supervision
  • Malpractice and liability insurance
  • Internet, phone, office supplies
  • Advertising and directory listings
  • Retirement contributions (Solo 401k, SEP IRA)
  • Health insurance premiums (if self-employed)

Step 5: When it’s time to consider an S Corp

An S Corp can lower your self-employment tax and support growth — but it’s only worth it at the right income level.

  • Pay yourself a reasonable salary
  • Take remaining income as distributions (not subject to SE tax)
  • Must run payroll and file corporate returns
  • Still pay Iowa income tax on total business income

Step 6: Common mistakes therapists make

  • Missing the biennial report filing in odd-numbered years
  • Not separating personal and business finances
  • Delaying S Corp election past the optimal income range
  • Skipping estimated payments
  • Not claiming CEU, supervision, or home office deductions
  • Using one account for both therapy and non-clinical income streams

Step 7: Our recommendations by income level

Net Income Range

Suggested Action

Under $50K

Stay sole prop or PLLC; file estimates; track every deduction

$50K–$100K

Evaluate S Corp election; run payroll; file biennial report

Over $100K

Full S Corp setup; automate taxes; work with a CPA quarterly

Need help figuring this out?

We help Iowa therapists choose the right entity, manage estimated taxes, and stay fully compliant year after year.

Book a consult or email us at david@leichtercpa.com

Disclaimer: This guide is for informational purposes only and does not constitute legal, tax, or financial advice. While we make every effort to keep the content accurate and up to date, state laws and regulations can change without notice. You should consult a licensed professional in your state before making any decisions based on this information. Leichter Accounting Services is not liable for any errors or omissions, or for any actions taken based on the contents of this guide.