Self-employed nurse (BNC) in 2026: fee retrocession and accounting

Quick answer. A self-employed nurse operates under the BNC (Non-Commercial Income) tax regime. She may elect micro-BNC (receipts ≤ 83,600 EUR with 34% flat allowance) or full filing (Form 2035). Fee retrocessions paid to the principal nurse during substitution work are a reduction of receipts, never an expense. Care acts are VAT-exempt. CARPIMKO manages mandatory retirement contributions. AGA (tax-compliance agent) membership offers a tax deduction on accounting fees but has not increased reported income since 2023.

A self-employed nurse is a regulated healthcare professional. Substitution is governed by a strict professional framework (Public Health Code): written substitution contract, authorization from the regional Nursing Board, and mandatory retrocession documentation.

In 2026, three shifts affect accounting:

1. Micro-BNC remains at 83,600 EUR: the threshold, revalued in three-year brackets, is set at this level for 2026-2028.
2. AGA (tax-compliance agent) no longer increases reported income: the 25% uplift for non-membership was phased out (20% in 2020, 15% in 2021, 10% in 2022, 0% since 2023). Only the tax deduction for accounting fees (max 915 EUR annually, two-thirds) persists for members.
3. VAT on nurse care remains exempt: no VAT billing on medical acts, regardless of structure.

Recently, a young substitute nurse in Île-de-France contacted us to organize her accounting. Her common mistake: classifying retrocessions as an expense rather than a reduction of receipts. This distorted her taxable income and created reconciliation gaps.

Micro-BNC: simplified, automatic up to 83,600 EUR#

Condition: gross receipts in prior year (N-1) or two years prior (N-2) ≤ 83,600 EUR.

Advantages:

• Flat 34% allowance deducted from receipts (minimum 305 EUR).
• Simplified cash-basis bookkeeping: receipt log, supporting documents.
• Simplified income tax return (Form 2035-S).
• No VAT collected or recovered (automatic exemption).
• Social contributions calculated on net income (after allowance).

Example: nurse with 70,000 EUR receipts in 2026.

• Allowance: 70,000 EUR × 34% = 23,800 EUR (minimum 305 EUR).
• Taxable income: 70,000 EUR − 23,800 EUR = 46,200 EUR.
• This nurse cannot deduct actual expenses; the flat allowance replaces them.

Disadvantages:

• No deduction of actual expenses: a practice with significant costs (rent, specialized equipment) loses flexibility.
• No depreciation: equipment investments do not generate progressive tax relief.
• Single-year overage does not trigger regime exit: calculation is N-1 or N-2 based.

Full filing (Form 2035 + schedules)#

Condition: receipts > 83,600 EUR or voluntary election.

Advantages:

• Deduction of actual expenses: rent, CARPIMKO/URSSAF contributions, supplies, training, laundry, accounting fees, collaboration fees.
• Depreciation of assets (medical equipment, IT, furniture).
• VAT reconciliation (though the sector is exempt, exemption status must be justified).
• Enhanced fiscal transparency in audit (all expenses supported).

Deductible expenses (illustrative):

• Mandatory contributions: CARPIMKO (base + complementary), CSG/CRDS.
• Professional fees: Nursing Board registration.
• Professional space rent or business share of home office (max 25% if mixed-use).
• Consumable nursing supplies (syringes, dressings, antiseptic, masks — regularly replenished).
• Office and billing supplies.
• Laundry and professional attire.
• Phone and internet (justified business percentage).
• Professional liability insurance.
• Continuing education and peer-group fees.
• Accountant and tax advice fees.
• AGA contribution (if member).
• Travel and mileage (2026 standard or actual costs).

Accounting: Form 2035 (income statement) + 2035-A (expense details) + 2035-B (depreciation and reserves).

This is where nurse practices make the most errors. Understanding the cash flow validates the accounting from first entry.

Cash flow: substitute collects, retrocedes#

A substitute nurse works under the principal's name but receives payments directly from patients or the health insurance fund.

Concrete example:

• Principal: Ms. Martin.
• Substitute: Mr. Dupont.
• Substitution contract: Mr. Dupont collects 100% of patient/insurance payments, then retrocedes 20% to Ms. Martin.

Accounting for substitute (Mr. Dupont):

Key point: retrocession is a reduction of receipts, deducted from account 706 "Nursing fees" (line 3 of Form 2035-A), never classified as an expense (e.g., account 6XX). The substitute recognizes 8,000 EUR of revenue, not 10,000 EUR.

Accounting for principal (Ms. Martin):

Ms. Martin receives the retrocession of 2,000 EUR as reportable income, entered in:

This may seem counterintuitive: retrocession increases the principal's reported receipts. But it is correct — the principal declares what she receives.

Retrocession rates and forms#

Common substitution retrocession rates range from 10% to 30%, depending on:

• Substitution duration (short-term = higher rate).
• Workload intensity (emergency/pediatric = lower rate).
• Local sector customs.

Mandatory formalization: the substitution contract must be written, dated, and signed, then filed with the regional Nursing Board. It must specify:

• substitution duration;
• retrocession rate (percentage or fixed amount);
• payment frequency (weekly, biweekly);
• shared costs (equipment, contributions);
• termination conditions.

Special case: partial retrocession of contributions#

Occasionally, a principal agrees to absorb part of the substitute's URSSAF/CARPIMKO contributions. This amount must be documented separately and treated as the principal's expense (account 645 "Personal social contributions"), never as a reduction of retrocession.

CARPIMKO structure (Healthcare auxiliary retirement fund)#

CARPIMKO manages mandatory retirement for self-employed nurses, physiotherapists, podiatrists, and speech therapists.

Base plan (2026 rates):

• T1 (mandatory contribution up to 1 PASS): 8.73% on the bracket 0–48,060 EUR (1 PASS = 48,060 EUR in 2026).
• T2 (mandatory contribution on the 2nd bracket): 1.87% from 48,060 EUR to 240,300 EUR (5 PASS).
• Overall rate: 8.73% on the 1st PASS, then 1.87% above through 5 PASS.

Complementary plan (2026 reform):

• Now proportional (the fixed-rate system has ended).
• Base between 0.5 and 3 PASS (approx. 24,030 EUR to 144,180 EUR), for an annual contribution of roughly 2,091 EUR to 12,544 EUR.

Disability-survivor plan:

• Annual fixed amount: 1,022 EUR (2026).

ASV (Supplemental retirement):

• Annual fixed amount: 671 EUR (of which 224 EUR is self-funded, 447 EUR covered by the public health fund).
• Supplement: 0.40% of conventioned income from N-2.

URSSAF contributions for self-employed nurse#

In parallel, the nurse must pay URSSAF for:

• CSG/CRDS (overall rate 9.7% of income).
• Family allowances (exempt below 110% of the PASS, then a progressive rate up to 3.10%).

Budget example for micro-BNC nurse (receipts 70,000 EUR):

These amounts are estimates — the annual social contribution declaration (DSI) determines final assessments.

Nursing care is VAT-exempt under Article 261, 4°-1° of the French Tax Code, which exempts "services provided by healthcare professionals… in the exercise of their profession."

Consequence:

• A self-employed nurse never collects VAT on care fees.
• She cannot deduct VAT paid on purchases (sterile supplies, equipment). This VAT adds to real cost.

Example:

• Purchase of digital blood pressure monitor 200 EUR net = 240 EUR gross (20% VAT).
• Because the nurse is exempt, she cannot recover the 40 EUR VAT.
• Real cost to the nurse is 240 EUR.

VAT registration threshold (for reference):

• Nurse exempt on care: no VAT threshold question.
• But if the nurse incidentally sells compression stockings, dressings, etc., those sales would be VAT-subject if the threshold (37,500 EUR) is exceeded. In practice, this is rare for a self-employed nurse.

Under full filing (Form 2035), the following expenses are deductible:

Watch-out: a nurse cannot deduct personal expenses (workplace meals, civilian clothing, union fees). The tax authority scrutinizes the boundary between professional and personal costs.

Annual retrocession declaration (DAS2)#

If you pay honoraria (retrocessions) to another nurse or healthcare professional above a certain annual threshold, you must file a DAS2 (Annual Salaries Declaration) — or more precisely, a declaration of "non-salaried contributors" if it is BNC income.

The DAS2 is required when payments to a single beneficiary (fees, retrocessions) exceed 2,400 EUR including tax over the year (CGI art. 240). It is filed electronically with the tax authority early in the following year.

Substitution and tax reporting#

The substitute reports net receipts (after retrocession) as BNC income in the year of collection. No deferral, no additional tax relief.

Mistake 1 — Classifying retrocession as an expense#

Most common error. Retrocession is never a 6XX (expense) account — it is a reduction of account 706 (revenue).

Mistake 2 — Forgetting CARPIMKO contributions#

The nurse must anticipate CARPIMKO calls: direct billing, any balance via the annual DSI. Oversight creates an unexpected shortfall.

Mistake 3 — Deducting personal expenses#

VAT on a work meal, gym membership, civilian clothing: not deductible. The tax authority detects this routinely.

Mistake 4 — Substitution without a written contract#

Unwritten substitution risks reclassification by URSSAF as "disguised employment." Employer contribution arrears, penalties.

Mistake 5 — Confusing micro and full regimes#

Transition from micro-BNC to full filing: plan ahead, validate transitional tax calculation.

We regularly advise self-employed nurses, from newly licensed substitutes to principals with staff. Three concerns recur:

1. Substitute accounting. Many young nurses think "I withdraw from my collections" suffices. Yet proper accounting isolates each substitution contract, traces retrocessions, and provides proof for audit. This is more critical if multiple principals are substituted concurrently: confusion is assured.

2. Regime choice (micro vs full filing). Below 60,000 EUR of receipts, micro-BNC is very advantageous (minimal paperwork, flat allowance). Above 70,000 EUR, a practice with major assets (equipment, rent) gains under full filing. We recommend a simulation before switching.

3. CARPIMKO and retirement. Rates change annually; contribution calls are complex. A nurse unfamiliar with CARPIMKO liability finds an unexpected balance. We advise regular income reporting to CARPIMKO to avoid large adjustments.

Recently, we resolved a substitute nurse's retrocession cleanup after three years — substantial tax impact. A structured start would have avoided penalty interest.

Hayot Expertise advice. From your first substitution or practice launch, formalize accounting: written contract, retrocessions via traced bank transfer (never cash), separate receipts by principal/contract. Invest in simple software (Pennylane, Qonto) for automated tracking. Engage a tax advisor specializing in healthcare professionals to validate your first year — 500 EUR of advice prevents 5,000 EUR of later adjustment.