An accountant for medical professions
General practitioners and specialists, dentists, physiotherapists, nurses, psychologists, midwives: you care for patients, your accountant handles VAT exemption, your hospital fee transfers, your INAMI/RIZIV social status and a possible move into a company.
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What difficulties do self-employed healthcare professionals face?
Income split across several sources
Fees collected at your practice, payments from health insurance funds, fee transfers (rétrocessions) from a hospital or medical centre, on-call duties: your income arrives through different channels. The tax slips you receive must match your accounts. A gap often triggers questions from the tax administration.
VAT that does not apply to everything
Most care is exempt from VAT, but some services are not, for example certain aesthetic procedures. Mixing the two without knowing can force you to register for VAT and regularise.
High social contributions and tax
With incomes often above average, you quickly reach the top bracket of personal income tax (IPP). Provisional contributions are calculated on your income from three years ago, then adjusted: a sharp rise in income creates unpleasant surprises.
Setting up, shared practice, company: many decisions
Buying or renting a practice, sharing costs with colleagues, creating a medical company: each choice has tax and professional-ethics consequences. They are easier to weigh before you sign.
What your accountant does for your practice
Income and fee transfers
Reconciling your fees, health insurance fund payments and fee transfers with your tax slips, tracking the practice's deductible costs (rent, equipment, software, training, vehicle).
VAT and INAMI/RIZIV social status
Analysis of your exempt and taxable services, monitoring of your INAMI/RIZIV social status and its allocation to a pension or guaranteed-income contract, and optimisation of your supplementary free pension.
Group practice and company
Organising shared costs between partners, simulating a move to an SRL (BV), and supporting the incorporation with your notary in line with the rules of your professional Order.
What should you know about VAT, INAMI/RIZIV and a medical company?
VAT (TVA/btw). Care provided by recognised medical and paramedical professions is in principle exempt from VAT (article 44 of the VAT Code). One practical consequence: transactions exempt under article 44 are not subject to the structured e-invoicing obligation that took effect on 1 January 2026. Since 2022, only services with a therapeutic purpose are exempt, including those of osteopaths, chiropractors, homeopaths and acupuncturists. Still taxable are notably: purely aesthetic procedures, medical expert reports, medical certificates, occupational medicine and medical-control work.
INAMI/RIZIV social status. Doctors bound by the agreement who meet the activity conditions receive an annual allowance from the INAMI/RIZIV. For the 2025 premium year, it is €6,078.26 for a fully agreement-bound doctor reaching the maximum activity threshold. It must be paid into a pension or guaranteed-income contract concluded by 31 December of the year concerned at the latest. Comparable schemes exist for dentists and other providers.
Social contributions. As a main-activity self-employed person, in 2026 you pay 20.50% on income up to €75,024.54, then 14.16% up to €110,562.42. Beyond that, there is no further contribution: the quarterly maximum is €5,103.05.
Company. An SRL (BV) needs no minimum capital, but it does require a financial plan and a notarial deed. For doctors, the articles of association must also comply with the Code of Medical Ethics. Since the end of 2022, the Order accepts, for example, a non-doctor spouse becoming a partner, but professional independence and the ban on fee-splitting remain the rule. Have the draft articles reviewed from that angle before the deed.
Checklist: setting up as a self-employed healthcare professional
The steps not to forget before your first consultation: company number, social insurance fund, VAT, insurance, INAMI/RIZIV social status, business account.
Get the guideDoes a self-employed doctor have to charge VAT?
In principle no for healthcare, which is exempt (article 44 of the VAT Code). Taxable items include purely aesthetic procedures, expert reports, medical certificates, occupational medicine and medical-control work. Your accountant reviews your services one by one.
Do I have to send e-invoices to my patients?
No. The obligation covers invoices between VAT-registered businesses, and transactions exempt under article 44 are not subject to it. You still receive supplier invoices, though: your accountant organises how you receive them.
How much does the INAMI/RIZIV social status pay?
For the 2025 premium year, €6,078.26 for a fully agreement-bound doctor who reaches the maximum activity threshold, and €2,867.26 for a reduced threshold or partial agreement with maximum threshold. The amount is paid into your pension or guaranteed-income contract.
What conditions apply to benefit from the INAMI/RIZIV social status?
Join the doctors-health insurance agreement for the whole year, hold a suitable INAMI/RIZIV number, reach a minimum activity threshold and conclude the insurance or pension contract by 31 December of the year concerned at the latest.
How much social contribution does a self-employed doctor pay?
In 2026, 20.50% of income up to €75,024.54, then 14.16% up to €110,562.42. The quarterly contribution is capped at €5,103.05. Management fees from your social insurance fund come on top.
When should I set up a medical company?
When your profit durably exceeds your personal needs, an SRL (BV) can reduce the overall tax burden. You must however consider structure costs, the Order's rules and your investment plans. A figures-based simulation is needed before deciding.
How do I declare fee transfers from a hospital or medical centre?
They are professional income. The amounts on the tax slips you receive must match those in your accounts. Your accountant reconciles the two before your return.
Can I deduct my practice located at home?
Yes, for the part actually used for the professional activity, with a justifiable allocation key (surface area, use). Watch out for possible consequences on the cadastral income and property tax.
I am starting as a physiotherapist on the side. What contributions apply?
In 2026, no contribution is due if your supplementary self-employed income does not exceed €1,922.16. Above that, the same rates apply, with a quarterly minimum of €98.51.
Can you help a group practice?
Yes. The accountant helps you choose the structure (cost-sharing association, company), split shared costs and formalise the rules between partners.
Let's talk about your practice
Book a 20-minute video call with an accountant who already supports doctors and paramedical professionals.