Doctor and dentist: SISA or MSP, taxation in 2026

Quick answer. The SISA, an interprofessional ambulatory care company, is the only structure that lets a multi-professional health centre receive and lawfully share the interprofessional agreement funding (ACI). For taxation, the SISA is a partnership: its profits are taxed in the hands of each partner, as non-commercial profits for doctors and dentists, as industrial and commercial profits for pharmacists, unless it opts for corporate tax.

You practise in a team, or you are setting up a grouping project, and one acronym keeps coming back: the SISA. You are told it is mandatory to receive the ACI, but no one really explains why, nor how this money is taxed. The confusion between a health centre and a SISA blurs the picture. Let us clarify the legal and tax framework of coordinated practice, a topic almost absent from accounting guides although it concerns thousands of practitioners.

People often use one for the other, and that is the first source of error.

The multi-professional health centre (MSP) is a collective and coordinated mode of practice, defined in article L6323-3 of the Public Health Code. It is a legal entity formed between medical professionals, paramedical professionals and, where relevant, pharmacists, who provide first-line care without accommodation, around a shared health project and a specification set by ministerial order. The MSP therefore describes a care organisation, not a tax-legal form.

The SISA is the legal form that carries this organisation when it comes to receiving and sharing funding. Created by law no. 2011-940 of 10 August 2011 and governed by articles L4041-1 and following of the Public Health Code, it is a civil company formed solely between natural persons practising a medical profession, a paramedical profession or as a pharmacist. It must include at least two doctors and one paramedic.

This is the heart of the matter, and it stems from a long-standing ethical rule.

Sharing fees between health professionals is in principle prohibited: a doctor cannot pay part of their fees to a colleague or a paramedic. Yet the ACI is collective funding that rewards teamwork: it must be shareable among the members. The SISA is precisely the legal exception that unlocks this. It can receive payments made by the health insurance fund for coordinated practice, then redistribute them among its partners, which no other structure allows without an ethical risk.

In other words, a health centre without a SISA can exist as an organisation, but it cannot receive the ACI into a common account and share it lawfully. The SISA is the vehicle that makes the collective money distributable.

The interprofessional agreement funding is paid by the health insurance fund to health-centre teams. It does not reward a care act, but the collective organisation: access to care, teamwork, and a shared certified information system.

Its amount is not fixed: it depends on the size of the patient base and on meeting indicators. The scheme changes in 2026. After the failed 2025 negotiations, the health insurance fund and the unions reached a new amendment, adopted on 22 May 2026, which reorganises the funding around a base that declines over several years in favour of complementary modules. As an indication, the base funding is around 50,000 EUR in 2026 and is intended to decrease in the following years, with the variable share rising in return. As the exact amounts depend on the structure and the indicators, they should be checked case by case with the fund.

This is where taxation plays out, and the logic is one of transparency.

The SISA is a partnership within the meaning of article 8 of the French Tax Code. It is not taxed as such: its profits are taxed in the name of each partner, in proportion to their rights in the company. For doctors, dentists and paramedics, the taxation falls under non-commercial profits; for pharmacists, it falls under industrial and commercial profits. The administrative doctrine confirms this in the official bulletin dedicated to SISAs.

In practice, the ACI received by the SISA, after covering common expenses, forms a result shared among the partners. Each practitioner takes their share into their own return and adds it to their liberal-activity fees. The subject ties into the practitioner's overall taxation, which we detail in our guide to the doctor's tax regime in 2026.

Since 1 January 2017, the SISA may opt for corporate tax. This option results from article 102 of law no. 2016-1918 of 29 December 2016.

In practice, the option remains rare. It removes transparency and introduces taxation at company level, then a second one on distribution, which often weighs more than direct income-tax taxation for shared ACI amounts. The option is mainly of interest if the SISA durably retains results without distributing them. Like any corporate-tax option exercised by a partnership, it becomes irreversible after a 5-year period: it is a decision not to take lightly.

The SISA keeps accounts, draws up the result for the year and shares this result among its partners according to each one's rights.

Each partner also keeps their own liberal activity, taxed in their own non-commercial profits. The SISA does not replace the practice: it overlays it for the collective share only. This articulation is essential so as not to mix care fees, which remain individual, with the ACI, which passes through the structure.

In most health centres, several structures coexist without merging.

The civil means company shares the common costs: rent, secretariat, equipment, with no revenue sharing at all. The SISA carries the collective share of coordinated practice and the ACI. And each practitioner keeps their care activity in their own name, with their patient base and their fees. You can therefore have, within a single health centre, an SCM to pool costs and a SISA to receive and share the ACI, without one replacing the other. On a departure or a transfer, this distinction also matters, as we discuss for the valuation and sale of a liberal practice.

In the grouping projects we support, the order of decisions saves time. You first build the health project and the organisation, which define the health centre. You then create the SISA, essential as soon as the team wants to receive and share the ACI. Finally you keep the SCM, or set one up, for the common costs.

On taxation, we leave the SISA under income tax in almost all cases: transparency is simpler and cheaper to share the ACI. The corporate-tax option is justified only in particular retention situations, and its irreversibility after 5 years requires long reflection before lifting it.

Four practitioners, two doctors, a nurse and a physiotherapist, ask us to structure their health centre. They already had an SCM to share a secretariat and rent of 36,000 EUR per year, but thought they could route the ACI through it. Yet the SCM cannot receive this funding nor share revenue. We created a SISA bringing together the four partners, meeting the requirement of at least two doctors and one paramedic. The first ACI grant, of around 50,000 EUR, was received by the SISA, allocated to a shared information system, then the balance shared among the partners on the agreed pro rata, each declaring their share as non-commercial profits. The SCM kept carrying only the common costs.