Opening a hearing-aid centre in 2026: diploma, status and steps

To open a hearing-aid centre, you first need the State Diploma of audioprosthetist (Diplôme d'État d'audioprothésiste), the only qualification that authorises you to dispense hearing aids. You then register with the Regional Health Agency (RPPS number), choose a legal form, and launch the activity of care and sale of medical devices.

The challenge is not only regulatory. A hearing-aid centre is a mixed activity, both care and trade, with VAT at several rates and an unusual collection cycle (third-party payment). In creation files in this sector, this mix is often what causes the first management mistakes. Here is how to frame it from the start.

Practising the profession requires the State Diploma of audioprosthetist, a three-year course (registered with the RNCP under number 36110). Without this diploma, you can neither practise nor dispense hearing aids.

The Public Health Code is clear: the audioprosthetist is the only professional authorised to dispense hearing-correction devices (articles L4361-1 and L4361-3). You can perfectly well be a non-qualified investor or director of a company that operates a centre, but the technical fitting act must be carried out by a qualified audioprosthetist. This is a point we systematically check when a project holder wishes to open several centres relying on salaried practitioners.

Unlike pharmacists or doctors, the audioprosthetist does not belong to a professional Order. This does not exempt you from any identification formality.

You must register with the Regional Health Agency (ARS) for your place of practice (article L4361-2 of the Public Health Code). Since 5 June 2024, audioprosthetists have been identified by an RPPS number (shared register of healthcare professionals), which replaced the former ADELI register. This number then governs your agreement (conventionnement) and your billing with the health insurance fund.

Our reading. The absence of an Order simplifies the ethical side, but should not make you overlook the rigour expected on the health side: registration, agreement, traceability of quotes. Treat these steps as blocking, not merely administrative.

Because it sells medical devices (a commercial act) in addition to the care service, and because the profession is not regulated by an Order, the audioprosthetist has access to a wide range of legal forms.

The right choice depends on your real project: single centre or network ambition, presence of partners, need to finance a heavy investment, level and nature of your remuneration. There is no universal answer. The legal form determines your social regime, your taxation and your ability to bring in a partner later: best to calibrate it before signing the lease, not after.

This is the accounting specificity of the trade. A hearing-aid centre invoices both a care service (assessment, fitting, follow-up) and sells products (devices, accessories, batteries). This means multi-rate VAT that must be set up correctly from the very first invoice.

The underestimated risk. A poorly configured till applying a single rate distorts VAT returns and complicates any later audit. We recommend mapping the product catalogue by rate from opening day, and linking the till to the accounting tool to avoid re-keying.

Since the 100 % Santé reform, every quote must include at least one Class I device (zero out-of-pocket cost for the patient). This is a presentation obligation, not just a commercial option.

On the management side, this mechanism works through third-party payment (tiers payant): you advance the reimbursed portion and then collect the receivables from the health insurance fund and the complementary insurers, with a delay. These receivables must be tracked in your cash flow as a full line item. A centre that is profitable on paper can face cash-flow tensions if third-party payment collection is not managed.

Opening a centre requires an accessible premises, measurement equipment (soundproof booth, audiometer), a stock of devices and accessories, and the fitting-out of the sales space. The amount varies greatly depending on the city, surface area and positioning: we never give a typical budget, but we build a costed forecast based on your real project.

This forecast serves to talk to the bank, to size the working capital requirement (stock + third-party payment) and to set the threshold from which the centre becomes profitable.

• Obtain the State Diploma of audioprosthetist (or surround yourself with a qualified practitioner for the technical side)
• Define the project: single centre or network, alone or with partners
• Choose the legal form and incorporate the company (or register the sole trader)
• Register with the ARS and obtain the RPPS number
• Set up the agreement with the health insurance fund
• Configure the till and accounting for multi-rate VAT (5.5 % / 20 %)
• Organise third-party payment tracking and the cash-flow forecast
• Secure the financing of the investment and the stock

The diploma and registration belong to your profession; the status, VAT, third-party payment and forecast belong to ours. These two sides are decided at the same time, because the chosen legal form affects your taxation and your remuneration from the very first euro.

Our firm supports project holders in the sector: you will find the detail of our approach on our page dedicated to accounting expertise for audioprosthetists, where we set out the accounting, tax and management obligations specific to hearing-aid centres. Before signing a lease or ordering your booth, let's talk about your project: it is the right time to arbitrate the status and frame the cash flow.