Accountant for doctors in France: BNC, SELARL, 2035 and CARMF

Accounting for a self-employed doctor in France is more than filing form 2035. It should secure revenue, expenses, CARMF, URSSAF, possible VAT exposure, vehicle costs, the choice between individual practice and SELARL, social protection, remuneration and long-term wealth planning.

This guide is for general practitioners, specialists, replacement doctors, sector 1 and sector 2 practitioners, collaborators, SELARL partners and medical practices considering a move from individual BNC to a company structure. It supports our pages for doctors, self-employed doctors and liberal professions.

Doctors must choose between BNC simplicity, SELARL structuring, social contributions, CARMF, VAT analysis, professional expenses and remuneration planning. The right answer depends on activity, replacements, profit level, investments, family situation, protection and future transfer.

Freshness note: updated on 2 May 2026.

Self-employed doctors generally fall under BNC when practising independently. Micro-BNC may apply under conditions, but it does not allow real expense deduction. The controlled declaration regime uses form 2035 and records actual revenue and expenses.

The choice should not be automatic. A doctor with premises, collaboration fees, equipment, secretarial costs, vehicle expenses, insurance and social contributions may need real expense tracking. See our French 2035 guide.

Form 2035 reports taxable BNC profit under the controlled declaration regime. It must be consistent with accounting records, fixed assets, social contributions, fees and retrocessions.

Controls include collected fees, bank reconciliation, retroceded fees, collaboration fees, mandatory social contributions, vehicle costs, rent, SCM allocations, fixed assets, mixed private/professional expenses and CARMF contributions.

The underestimated risk is deducting expenses without sufficient evidence or missing revenue collected through several channels.

Medical care is often VAT-exempt when the applicable conditions are met. However, some side activities may be taxable depending on their nature: expert reports, non-therapeutic services, rental income, teaching, products or specific services. Do not assume every flow is outside VAT.

The practical approach is to identify main medical activities, list ancillary revenue, qualify each flow and document invoices and agreements.

Moving from individual BNC practice to SELARL may be relevant when profit is high, several doctors join, equipment is financed, a technical platform is created or a wealth strategy justifies a company. But SELARL adds commercial accounting, shareholder decisions, manager remuneration, corporate tax and social analysis.

Read our French guide on moving from BNC to SELARL.

CARMF and social contributions are a major cash item. Provisional contributions can create timing differences when activity starts, grows quickly or declines. The official CARMF parameters for 2026 should be reviewed every year.

Good management includes forecasting contribution calls, estimating income after charges, adjusting instalments where relevant, provisioning regularisations and separating personal remuneration from practice cash.

The practice structure drives accounting. A solo doctor tracks own revenue and expenses. Collaboration requires correct treatment of retrocessions and fees. SCM structures require shared cost allocation. Group practices and SEL structures require stronger governance and agreements.

Professional expenses must be necessary, documented and correctly allocated. Mixed expenses such as car, phone or home office require a rational split. Medical and IT equipment may be capitalised and depreciated depending on its nature.

The underestimated risk for self-employed doctors is confusing profit, personal income and practice cash. Bank receipts may be high while social contributions, CARMF, income tax, equipment, replacements, rent and adjustments absorb a large share of cash. Without a forecast, the doctor may make personal decisions using cash that will later be needed for professional charges.

Another risk is assuming that every medical revenue stream follows the same VAT or tax treatment. Medical care may be VAT-exempt when the conditions are met, but side activities need analysis: expert reports, non-therapeutic services, teaching, rental income, products, collaboration arrangements or company flows. The accountant should qualify revenue, document agreements and avoid automatic treatment.

The doctor must decide the practice model over several years: individual practice, collaboration, replacement, SCM, association, SELARL, technical platform or transfer. The choice is not only an annual tax calculation. It affects governance, responsibility, remuneration, investments, retirement, wealth protection and the ability to bring in other practitioners.

The doctor must also decide the level of financial monitoring required. Preparing form 2035 at year-end may not be enough to secure tax instalments, social contributions, CARMF and investments. Hayot Expertise recommends a regular review of receipts, expenses, provisional contributions, estimated profit, personal drawings and practice investment capacity.

Each month or quarter, receipts should be reconciled with bank statements, medical software, retrocessions, replacement fees and direct payments. Expenses should be classified between current costs, fixed assets, mixed expenses, travel, rent, SCM, insurance and training. This classification makes the 2035 return easier and avoids rebuilding the year under pressure.

Once a year, the practice structure should be reviewed. If profit rises, associates join, significant equipment is financed, premises are acquired or a transfer is approaching, BNC versus SELARL should be modelled in detail. The model should include tax, social contributions, CARMF, legal costs, remuneration and wealth objectives.

The first thirty days should secure flows: bank accounts, medical software, possible invoicing, reimbursements, retrocessions, fees, SCM arrangements, expense evidence and contracts. The doctor should be able to separate personal receipts, practice flows, shared costs and mixed expenses.

Between thirty and sixty days, the practice should estimate annual profit and upcoming charges. The forecast includes social contributions, CARMF, income tax, investments, rent, staff, insurance, training and loan repayments. The goal is not to freeze the result, but to avoid cash surprises.

Between sixty and ninety days, the practice model should be reviewed: individual BNC, collaboration, SCM, SELARL, association or transfer project. The right choice depends on income, activity stability, investments, partners, wealth objectives and the doctor's personal plans.

Doctors should keep bank statements, revenue evidence, collaboration contracts, SCM agreements, equipment invoices, training evidence, allocation keys for mixed expenses and CARMF documents. Robust accounting is not a pile of receipts: it is a file that can explain each significant amount.

Hayot Expertise recommends particular attention to atypical flows: replacements, practice fees, premises, shared secretarial costs, patient list acquisition, share transfers, expert reports or teaching. These items deserve qualification before accounting entry.

Each quarter, the doctor should compare cash receipts, expenses, personal drawings, provisional contributions, estimated tax, planned investments and available cash. This prevents confusion between practice performance and immediately available personal income.

The doctor should also monitor commitments that are not visible in the bank balance: CARMF, social adjustments, tax, ordered equipment, rent, SCM charges, replacement costs and works. These items explain why an apparently profitable practice can still face cash pressure.

For group practices, the checklist should include shared costs, cost allocation keys, associate agreements, staff costs, equipment use and patient flow. Accounting becomes a governance tool because it shows whether the economic arrangement between practitioners remains balanced.

For doctors approaching retirement, the same data supports transfer planning. Recurring income, equipment condition, premises, staff, contracts, CARMF position and tax consequences should be reviewed before negotiating with a successor or joining a SELARL.

For recently established doctors, the same review prevents personal cash decisions from being based on early receipts alone. Contributions and tax adjustments may arrive later, when the initial cash has already been used. A conservative forecast is often the safest management tool.

For established practitioners, accounting becomes a strategic discussion. Should the practice invest in equipment, welcome another doctor, buy premises, join a group, create a SELARL or prepare a transfer? Each decision has accounting, tax, social and personal wealth consequences, so it should be reviewed before contracts are signed.

The purpose is not to make medical practice more administrative. It is to protect professional independence with clear numbers, documented decisions and cash visibility.

This is also why medical accounting should be discussed before major commitments. A lease, equipment financing, collaboration agreement or SELARL project may look operational at first, but it creates tax, cash and governance effects. Reviewing those effects before signature protects both the doctor and the practice.

For non-French doctors practising in France, the accounting review also clarifies local concepts: BNC, controlled declaration, CARMF, SCM, SELARL, VAT exemptions and professional expense evidence. Understanding these rules early avoids treating French practice like the system of another country.

The review should be practical rather than theoretical. It should end with clear decisions: what to pay personally, what to keep in the practice, which contributions are expected, which documents are missing and which legal or tax questions need review before the next commitment.

This practical output is what makes accounting valuable for a doctor. The figures are not produced only for tax filing; they help protect care time, professional independence and long-term financial choices.

The doctor can then speak with banks, associates, family advisers and legal counsel from a shared financial base. That shared base reduces rushed decisions and makes the practice easier to manage over time.

It also makes annual meetings more useful because the discussion starts from decisions, not from missing documents.

That is the practical value of timely accounting.

• Use the correct 2026 form 2035 version.
• Forecast CARMF contributions and adjustments.
• Do not assume every activity is VAT-exempt.
• Compare BNC and SELARL over several years.
• Document collaborations, SCM costs and retrocessions.
• Prepare e-invoicing for relevant professional flows.

Medical practices often mix replacements, collaboration agreements and shared costs. Each arrangement has a different accounting impact. Replacement fees, retrocessions, SCM cost allocations and shared equipment should be documented with signed agreements and consistent bank flows. Without this documentation, the annual tax return may be technically prepared but weak in case of questions.

When a doctor buys into a practice, joins a SELARL or prepares a transfer, the accountant should review recurring revenue, patient flow, premises, equipment, staff, software contracts, debt, CARMF impact and the tax treatment of the transaction. The goal is to separate the professional value of the practice from the owner's personal cash needs and retirement planning.

Read our doctor sector page, self-employed doctor page, liberal professions page, accounting service, bookkeeping service, tax service, legal advisory, wealth planning service, Pennylane, 2035 guide and SELARL remuneration.