Discover the best small business accounting firms in the United States that combine expert bookkeeping, tax planning, and financial advisory services with industry-specific insight and hands-on support to help entrepreneurs streamline operations, optimize profitability, and achieve steady growth.
We Have Listed the Best US Small Business Accounting Firms For You
7 Companies-Rankings updated: September 14, 2026
All agencies are evaluated on DesignRush for demonstrated expertise and authentic client reviews to support your decision. Certain placements are paid.
FutureMD Solutions is a leading nationwide Revenue Cycle Management (RCM) firm providing end-to-end medical billing services to practices across the United States. While we have a strong footprint in the Texas healthcare market, our certified experts serve providers in all 50 states. We specialize in reducing...
Top Services:
BPO
Transcription Services
Business Consulting
Accounting
AI Development
Show more
Location
Houston, Texas
Number of Employees
Under 49
Average Hourly Rate
$20/hr
Minimal Budget
Under $1,000
Portfolios Count
12 Projects Listed
FutureMD Solutions Services
BPO
Transcription Services
Business Consulting
Accounting
AI Development
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Health Care Industry
Healthcare Practices
Dental Industry
Wellness & Fitness Industry
Medical and Diagnostic Laboratories
Medical Health Care
Medical Hospitals
Professional Services Industry
HR Industry
Software & IT Services Industry
Data sourced from the agency's DesignRush profile
FutureMD Solutions Reviews & Testimonials
Texas Medical Supply. Review from Google
5.0★
Texas Medical Supply.'s Review Sourced from Google
FutureMD Solutions is exceptional for compleating our credentialing process in 100 days 5/5 ! Now they are helping us with our DME billing for fast 5 monthes so far very satisfied . our denials are at an all-time low. Highly professional and efficient—highly recommended for any medical equipment supplier!"
Leandro Ansart Review from Google
5.0★
Leandro Ansart's Review Sourced from Google
"Switching to FutureMD Solutions completely transformed our medical billing process. Our claim approval rate increased, payments arrive faster, an their EHR system is very easy to use. If you're lookin for reliable medical billing and EHR services in the U this company delivers real results."
angelic lopez Review from Google
5.0★
angelic lopez's Review Sourced from Google
"As a new clinic, we needed an affordable EHR and medical biting iodTpartner. Futuremd set up talkEHR /EHR for us for very minimum setup fee, handled credentialing, and managed billing seamlessly. Great service, transparent pricing, and excellent customer support."
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
Gutsy Money is a bookkeeping and business advisory firm committed to empowering female founders & entrepreneurs to set solid business financial foundations in order to experience confidence, freedom, and exponential wealth...
Top Services:
Accounting
Location
Broomfield, Colorado
Number of Employees
Under 49
Minimal Budget
Under $1,000
Gutsy Money Services
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Your Finance Team Bookkeeping, Accounting & Strategy for One Monthly Price
CoCountant gives you a fully managed finance team that handles your books, reporting, and financial questions all for a fixed monthly fee. We work with startups and growing businesses that are tired of inconsistent freelancers, bloated firms, and DIY tools that only get you halfway there...
Top Services:
Accounting
Location
Cambridge, Massachusetts
Number of Employees
50 - 99
Average Hourly Rate
$25/hr
Minimal Budget
Under $1,000
Portfolios Count
3 Projects Listed
CoCountant Services
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Acuity is a technology-driven accounting and financial services firm that provides bookkeeping, tax, controller, CFO, and advisory solutions for entrepreneurs and growing businesses. The company combines dedicated financial experts, proven processes, and modern cloud-based accounting technology to help...
Top Services:
Accounting
Location
Atlanta, Georgia
Number of Employees
1000 & Up
Average Hourly Rate
$162/hr
Minimal Budget
Under $1,000
Acuity Accounting Services
Accounting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
Spanx
Greenlight
StudioHawk
Data sourced from the agency's DesignRush profile
Acuity Accounting Reviews & Testimonials
Cameron Weiss Review from Google
1.0★
Cameron Weiss's Review Sourced from Google
Extremely Disappointing Experience with Acuity Bookkeeping and Accounting ServicesI hired Acuity to help with bookkeeping and accounting, but the results were frustrating and unprofessional. Instead of properly categorizing transactions and providing accurate reports, almost everything was labeled as "uncategorized," making the books completely unreliable.They set up several automated apps that required me to pay extra subscription fees. None of these tools integrated correctly, and they only made the situation more confusing. Rather than helping me gain financial clarity, their system created more problems and wasted both time and money.I was hoping for experienced support and clean financial records, but what I received was a disorganized mess. I would not recommend Acuity to anyone looking for dependable accounting services.
Yonas Yemane Review from Google
5.0★
Yonas Yemane's Review Sourced from Google
Working with Acuity was an excellent experience. They truly understand entrepreneurs and delivered clear financial insights that helped us make smarter business decisions.
Krissy Zilli Review from Google
5.0★
Krissy Zilli's Review Sourced from Google
We we're in a predicament looking at cash-basis accounting to steer our decision-making at the risk of not understanding the true performance of our business. Abby is the BEST, most-knowledgable controller and so easy to communicate with regardless of your inherent accounting knowledge. Acuity has been transformational in moving our financial statements from super lumpy, cash basis to accrual. Amidst our work together, she's been willing to work through low-level transactional work with a smile as well as offering a high-level consultative look at our business, big picture. Can't recommend her enough for your ecommerce struggles!! She has made everything crystal clear and I've even developed my own skills as finance/ops director knowing her. @Acuity - do not lose this shining star!!
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
Compass CPA, PC, we provide top-notch Virtual Controller, Accountant, and CFO services for a fraction of the cost of in-house hires. Our dedicated team of virtual accountants, CPAs, and tax professionals helps you achieve business goals with comprehensive financial reporting, forecasting, and tax...
Top Services:
Accounting
Business Consulting
Location
San Rafael, California
Number of Employees
Under 49
Minimal Budget
Under $1,000
Compass CPA, P.C. Services
Accounting
Business Consulting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
KleerCard Inc
Rainmaker Games
Poplar Technologies Inc
Lifeboost LLC
Dive With Buddy
The Institutes for the Achievement of Human Potent
Serving clients who need Assistance in Accounting, Tax Preparation & Payroll Processing.
BusAcTa Advisors is a business consulting firm specializing in strategic growth and operational excellence for small to mid-sized enterprises. With a keen focus on tailored solutions, we offer expert guidance in areas such as financial planning, market expansion, and process optimization...
Top Services:
Accounting
Business Consulting
Location
New York City, New York
Number of Employees
Under 49
Average Hourly Rate
$10/hr
Minimal Budget
Under $1,000
BusAcTa Advisors LLP Services
Accounting
Business Consulting
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
ProfitWerx helps Oregon business owners gain clarity, consistency, and confidence in their finances and online presence. Based in Klamath Falls, we provide full-cycle bookkeeping services including setup, cleanup, and catch-up accounting, along with expert web design and SEO to help local businesses get found...
Top Services:
Accounting
Web Design
SEO
Location
Klamath Falls, Oregon
Number of Employees
Under 49
Minimal Budget
Under $1,000
ProfitWerx, LLC Services
Accounting
Web Design
SEO
Data sourced from the agency's DesignRush profile, its website, and other relevant accounts
TableRun
6th Street Grill
Once Famous Grill
Data sourced from the agency's DesignRush profile
ProfitWerx, LLC Reviews & Testimonials
Drew Patzke Review from Google
5.0★
Drew Patzke's Review Sourced from Google
ProfitWerx was great to work with. James helped us catch up on one year of bookkeeping and was very patient and clear in explaining everything, especially since we have no accounting or bookkeeping background. He communicated throughout the process to ensure everything was done correctly, and his services were thorough, timely, and affordable for our small business. We were so impressed that we’ve decided to keep him on as our bookkeeper going forward. Highly recommend!
Kaitlin Patzke Review from Google
5.0★
Kaitlin Patzke's Review Sourced from Google
We had a great experience working with James at ProfitWerx. He helped us build our website, improve our search engine optimization, and create a booking system that made our event rental business much more automated and efficient for customers. Since working with him, our online presence has grown and our revenue has increased. Pricing is affordable, communication was clear and consistent, and the entire process was smooth. Highly recommend ProfitWerx!
Tyler Pettigrew Review from Google
5.0★
Tyler Pettigrew's Review Sourced from Google
ProfitWerx completely improved our online visibility!We hired ProfitWerx for SEO, and the results have been outstanding. Our rankings jumped faster than expected, and we’re now showing up on Google for searches we never appeared in before. Traffic is up, leads are up, and the monthly reports make it easy to see exactly what’s working.They took time to explain everything, cleaned up our site, fixed technical issues we didn’t even know about, and built a smart strategy tailored to our business. If you want real SEO results from someone who actually cares about your success, ProfitWerx is the way to go. Highly recommend!
Reviews verified by DesignRush and sourced from the agency's profile View All Reviews
How much do small business accounting services cost in the United States?
Small business accounting services in the United States cost from $100 to $5,000, depending on the services and hired accountant. Accountants in major cities may charge up to $500 per hour.
The cost of accounting services for a small business will depend on the business size, industry, location, number of transactions, type and frequency of service, and the accountant’s experience level.
Can I get a free consultation from US small business accounting firms?
Yes, many US small business accounting firms offer a free initial consultation to discuss your business needs, review financial challenges, and explain their services. During this meeting you could assess whether the firm’s expertise, pricing, and approach align with your goals before committing to a paid engagement.
How do I choose the right small business accounting firm in the United States?
Choose the right small business accounting firm in the United States by following these steps:
Define whether you need bookkeeping, tax preparation, payroll, or advisory support services to make sure the accounting firm offers a matching scope
Look for firms with relevant client history in your sector and verify credentials like CPA licenses or other certifications
Ensure accounting firms you assess use modern accounting tools, can grow with your business, and offer clear, responsive interaction
Review reputation and pricing transparency by reading client reviews, asking for case studies, understanding their fee structure, and confirming they prioritize data security and customization
What certifications should US small business accounting firms have?
US small business accounting firms should have licensed Certified Public Accountants (CPAs), the most recognized credential for tax, audit, and financial reporting. Additional certifications like Certified Management Accountant (CMA) for financial analysis and Enrolled Agent (EA) for tax representation add further credibility.
Firms should also follow the ethical and continuing education standards set by the American Institute of Certified Public Accountants (AICPA).
Latest Trends Related to Small Business Accounting
Proposals