In modern conditions of the functioning and development of the Russian economy, as well as modernization in many aspects of the work of medical budgetary institutions, requirements are imposed regarding the reliability, relevance and objectivity of economic information. The relevance of the research topic is due to the need for changes in the healthcare sector, the success of which is impossible without the use of accounting and management accounting and effective planning and budgeting systems. Management of the healthcare sector is the focus of special attention of the government, whose decisions ultimately determine the features of the forms and methods of management, regulation and budgetary support that have developed today. This article is devoted to current issues of accounting and management accounting in medical budgetary institutions. The following methods were used in the research: analysis and synthesis, comparison, logical approach, systematic approach, method of analogies. As a result of the research, this article examined the need to develop management accounting in medical budgetary institutions along with accounting and revealed the main stages of its organization. It is concluded that for the effective operation of the institutions under consideration in modern economic conditions, a well-functioning management accounting system is necessary. The research results will be of interest to a wide range of readers and practitioners in the field of accounting and management accounting, as well as the scientific community involved in health research. Also, the results reflected in this article can be used in the educational process of higher educational institutions and in the practical work of accounting departments of all modern organizations (including healthcare). In modern conditions of the functioning and development of the Russian economy, as well as modernization in many aspects of the work of medical budgetary institutions, requirements are imposed regarding the reliability, relevance and objectivity of economic information. The relevance of the research topic is due to the need for changes in the healthcare sector, the success of which is impossible without the use of accounting and management accounting and effective planning and budgeting systems. Management of the healthcare sector is the focus of special attention of the government, whose decisions ultimately determine the features of the forms and methods of management, regulation and budgetary support that have developed today. This article is devoted to current issues of accounting and management accounting in medical budgetary institutions. The following methods were used in the research: analysis and synthesis, comparison, logical approach, systematic approach, method of analogies. As a result of the research, this article examined the need to develop management accounting in medical budgetary institutions along with accounting and revealed the main stages of its organization. It is concluded that for the effective operation of the institutions under consideration in modern economic conditions, a well-functioning management accounting system is necessary. The research results will be of interest to a wide range of readers and practitioners in the field of accounting and management accounting, as well as the scientific community involved in health research. Also, the results reflected in this article can be used in the educational process of higher educational institutions and in the practical work of accounting departments of all modern organizations (including healthcare).