PEO or payroll service for a dental practice

You need someone to run payroll from your first paycheck. The question is how much else you hand over. For the payroll basics, including W-2 vs 1099 and the filing calendar, start with payroll for a new dental practice.

This page is general education. Benefits and employment law vary by state, so review any PEO contract with your attorney or CPA.

What a PEO is

A professional employer organization (PEO) enters a co-employment arrangement with your practice. You still hire, schedule and direct your team. The PEO runs payroll and payroll taxes, and typically handles benefits, workers’ comp and HR compliance under its own umbrella.

The appeal for a small office is benefits. The PEO offers its own group plans, such as medical, dental, vision and 401(k), so you don’t have to set them up yourself.

The trade-off is control and cost. You use the PEO’s benefit plans, HR policies and technology, and you pay for them.

Certified PEOs and your tax liability

The IRS certifies some PEOs as certified professional employer organizations (CPEOs). The difference matters if payroll taxes go unpaid.

• With a payroll service or a non-certified PEO, the IRS says employers “are ultimately responsible” for withheld income tax and both halves of Social Security and Medicare.
• With a CPEO, customers “are relieved of their liability” for those taxes “in certain situations,” per the IRS. Per the IRS, the CPEO is solely liable for employment taxes on wages it pays to worksite employees.

The IRS publishes a list of certified CPEOs. When we checked it on Sept. 26, 2026, it included entities of ADP TotalSource, Insperity, Justworks and TriNet. The IRS suggests your contract name the exact CPEO and its EIN, so match those to the list.

What providers say they charge (as of Sept. 26, 2026)

PEOs price in two ways: a flat fee per employee per month (PEPM), or a percentage of payroll. ADP says PEO administrative fees “may range from 2% to 12% of total payroll or about $40 to $160 per employee per month.” It depends on the provider and your workforce.

Provider	What it sells	Pricing, as the provider states it
Gusto	Payroll, benefits and HR software (not a PEO)	Simple $49/mo + $6 per person; Plus $80/mo + $12; Premium $180/mo + $22. Health insurance through its brokers: you pay premiums, “no Gusto administration fees”
Justworks	Payroll and a PEO	Payroll $8 per employee/mo + $50 base fee; PEO Basic $79 per employee/mo; PEO Plus $124 per employee/mo (adds medical, dental and vision administration)
TriNet	PEO	Flat PEPM fee, customized; “does not publish standard list pricing.” Requires a minimum employee count it doesn’t state
ADP TotalSource	PEO (ADP also sells payroll)	Quoted, not listed; ADP says workers’ comp is “included as part of the service fee”
Insperity	PEO	Quoted. Fee built from direct costs (payroll taxes, workers’ comp, benefits, liability coverage) plus a fixed per-employee HR fee

TriNet and Insperity both point out that their per-employee fee doesn’t rise when you give raises. Under percentage-of-payroll pricing, it would.

The math: a practice with eight staff

Example: two hygienists, three assistants, and three front-office staff, with $440,000 a year in total payroll.

• Gusto Plus: $80 + (8 × $12) = $176 a month, about $2,100 a year, before benefit premiums.
• Justworks payroll: $50 + (8 × $8) = $114 a month, about $1,400 a year.
• Justworks PEO Basic: 8 × $79 = $632 a month, about $7,600 a year. PEO Plus: 8 × $124, about $11,900 a year.
• ADP’s general PEO range: 2% to 12% of $440,000 is $8,800 to $52,800 a year. At $40 to $160 per employee per month, it’s $3,840 to $15,360.

Prices are the providers’ posted or stated figures as of Sept. 26, 2026. Your quote depends on your state, team and benefits.

Compare all-in, not fee to fee. A PEO invoice may bundle payroll taxes, workers’ comp and benefit premiums. You’d pay those anyway with a payroll service. Add up your payroll software, workers’ comp policy, broker and benefits under each option. Then compare totals.

When a PEO makes sense

A PEO is usually worth quoting if:

• You want to offer health insurance to keep good hygienists and assistants, but have no broker or office manager to run it.
• You’re adding a second location in another state and want help with multi-state rules.
• You’ve had HR trouble (a claim, a wage dispute) and want ongoing HR support.

A payroll service is usually enough if:

• You have a small team and no plan to offer group health yet.
• Your office manager already handles onboarding and benefits.
• You want to pick your own benefits broker and plans.

If you choose a PEO

1. Confirm it’s a CPEO on the IRS list, by exact name and EIN.
2. Ask what’s in the fee and what’s billed separately.
3. Ask how fees change with raises, overtime and new hires.
4. Ask about leaving: notice period, fees, and what happens to your team’s benefits mid-year.
5. Review the benefit plans your team would actually get, including dental coverage for your own staff.

Where to start

For a payroll service, Gusto is one option: see Gusto’s plans. If you want PEO quotes, get at least two, for example from TriNet and Justworks, and compare the all-in totals.

What to do next

1. Set up your entity and EIN first. See dental practice entity setup.
2. Classify every role and set up payroll. See payroll for a new dental practice.
3. Connect payroll to your books. See bookkeeping software for dental offices.
4. Revisit a PEO when you’re ready to offer health benefits, or when HR takes more time than you can give it.