Which legal structure should a private doctor choose in France in 2026?
Which legal structure should a private doctor choose in France in 2026? 2026 analysis for private medical practices: choices, risks, evidence to keep, watchpoints and Hayot Expertise internal resources.
Expert note: This article was written by our chartered accountancy firm. Information is current as of 2026. For a personalised review of your situation, contact us.
Quick answer. For a French private doctor, the useful 2026 choice narrows to three main options: continued individual BNC practice with form 2035, SELARL practice with a majority manager under the self-employed regime, or SELAS practice with a salaried-equivalent president. Moving from BNC to a SEL becomes economically relevant from roughly 150,000 to 180,000 euros of annual profit and when the doctor does not need to draw the entire result to live on. Ordinance no. 2023-77 of 8 February 2023, in force since 1 September 2024, overhauled the professional company framework and confirmed that SEL partners technical income falls by default within the non-commercial profits regime (BNC).
The 2026 framework: what the SEL reform changes for doctors#
Ordinance no. 2023-77 of 8 February 2023 replaced the 1990 SEL act with a single text covering every regulated profession. For doctors, its entry into force on 1 September 2024 triggered an obligation to adapt existing articles within one year, i.e. before 31 August 2025 for SELs already incorporated. The Public Health Code further frames capital ownership (articles R4113-9 and following): a practising doctor must retain the majority of voting rights and operating control of the company.
Two changes drive 2026 decisions. First, the tax doctrine confirmed by the BOFiP since 2024 states that technical income earned by a SEL partner for medical activity is declared as non-commercial profit (BNC) on form 2035, no longer as salary. This change directly affects social contributions and the CARMF base. Second, medical SPFPLs may now hold shares in several SELs practising the same profession, which facilitates territorial groupings between practices and consolidation in specialties such as radiology, ophthalmology or outpatient surgery.
Which status: BNC, SELARL or SELAS?#
The choice reads along four axes: professional independence, taxation, social protection and patrimonial trajectory. The individual BNC remains relevant for a general practitioner or specialist who prefers simple management, has no heavy equipment investment and draws nearly all of the profit. The SELARL suits a solo doctor or a duo who wants to limit liability, capitalise part of the result inside the company and keep a more economical self-employed regime. The SELAS becomes necessary once a practice gathers three or more partners, when transmission through an SPFPL becomes likely, or when the doctor wants the unemployment and executive pension cover provided by the salaried-equivalent regime.
| Form | Liability | Default taxation | Doctor s social regime |
|---|---|---|---|
| Individual BNC | unlimited on personal assets | personal income tax (form 2035) | self-employed, URSSAF PL, CARMF |
| SELARL majority manager | limited to contributions | corporate tax by default, IR option under conditions | self-employed, URSSAF PL, CARMF |
| SELAS president | limited to contributions | corporate tax by default | salaried-equivalent, CARMF plus AGIRC-ARRCO executive pension |
The classic trap is to compare these forms only on the headline tax rate. The right reading combines profit before remuneration, the doctor s real lifestyle, the capitalisation need to finance equipment or hiring, and the prospect of bringing in a partner at three to five years. A ten-year comparison often gives a very different answer from a single-year view.
How does the BNC-to-SELARL conversion work in practice?#
The conversion is prepared five to eight months before effective registration. Recently, a Paris radiologist asked us to convert a 320,000 euro individual practice into a SELARL: the projection showed that a 90,000 euro annual manager s remuneration combined with 60,000 euros of dividends spread over three financial years, after social contributions on the portion exceeding 10 % of capital and current-account balance, financed the purchase of a 180,000 euro ultrasound machine without weakening CARMF cover or the personal lifestyle. The operating sequence is the following:
- Validate fit with a three-year comparative forecast (individual BNC vs SELARL vs SELAS).
- Value the patient base and elements contributed in kind: equipment, furniture, fittings, possibly the lease.
- Appoint a contribution auditor where in-kind contributions exceed 30,000 euros or represent more than half of the share capital (article L223-9 of the Commercial Code).
- Draft articles compliant with ordinance 2023-77 and the Public Health Code (capital, governance, voting rights, approval clauses).
- File the file with the departmental medical council for a compliance opinion (statutory deadline of three months).
- Register the SELARL with the trade and companies register, notify the health insurance fund, open the bank accounts and switch accounting from BNC to corporate tax.
- Activate the deferral of taxation under article 151 octies CGI and organise the annual filing of the tracking statement until the shares are sold.
The deferral mechanism of article 151 octies CGI parks the capital gain on the patient list (non-depreciable asset) until the shares are sold. The capital gain on depreciable equipment is spread linearly over five years. The mechanism is powerful, but its survival depends on the annual filing of the tracking annex with each tax return: missing it, common in practice, causes the deferral to lapse and the tax to become immediately due.
How to read social contributions and dividends in a medical SELARL#
The majority-manager doctor is self-employed. The doctor contributes to URSSAF for liberal professions on family allowances and CSG-CRDS, and to the CARMF for basic pension, supplementary pension, supplementary old-age benefits, disability and death cover, and daily allowances. Total contributions represent roughly 40 to 45 % of the net manager s remuneration, against roughly 65 to 75 % in a SELAS on the gross president s remuneration.
| Flow | Social contributions | Personal tax |
|---|---|---|
| SELARL manager s remuneration | URSSAF PL + CARMF, ca. 40 to 45 % of net | personal income tax after 10 % allowance or actual costs |
| SELARL dividends, share <= 10 % of capital + CCA + premiums | CSG-CRDS 17.2 % | 30 % flat tax or progressive scale option |
| SELARL dividends, share > 10 % of capital + CCA + premiums | URSSAF PL + CARMF (self-employed) | 30 % flat tax or progressive scale option |
| SELAS dividends | CSG-CRDS 17.2 % only | 30 % flat tax or progressive scale option |
The 10 % threshold is computed on the average partner current-account (CCA) balance plus share capital plus share premium. A majority-manager doctor with 10,000 euros of share capital and an average CCA of 30,000 euros triggers self-employed social contributions on the portion of dividends exceeding 4,000 euros (10 % of 40,000 euros). This mechanism, codified in article L131-6 of the Social Security Code, often drives the decision to capitalise the SELARL beyond the legal minimum of 1 euro.
Health insurance conventioning, underserved areas and aids: what stays with the doctor#
The 2024-2029 medical convention signed with the French health insurance is concluded by the doctor personally. The conventioning sector (sector 1, sector 2, OPTAM), authorised fee overruns, the per-patient flat fee for the chosen general practitioner (FPMT) and the public-health objective-based remuneration (ROSP) remain attached to the practitioner, not to the practice structure. The conversion to a SEL therefore triggers no convention renegotiation and no loss of acquired rights.
Aids linked to underserved areas work the same way. The territorial stabilisation contract (CSTM), the installation aid contract (CAIM) and the territorial solidarity contract (COSCOM) are granted to the doctor as a natural person when the practice is located in a priority intervention zone (ZIP) or complementary action zone (ZAC) identified by the regional health agency. These aids continue to be paid when the doctor practises within a compliant SEL. The health insurance fund must be informed of the SEL incorporation and of the new fee payment arrangements (the company bank details replace the personal account).
Edge cases: locum doctor, group practice, heavy technical platform#
- Locum doctor or liberal collaborator without own patient base. Converting to a SEL makes no sense: the replaced or hosting doctor s patient base cannot be transferred. The individual BNC, or the micro-BNC below the 83,600 euros 2026 receipts threshold, remains the right answer. A SCM may be considered to share resources with an established colleague.
- Group practice of general practitioners or specialists. Three partners or more often point to a SELAS: more flexible general meetings, governance tunable by statute amendment, possibility to bring in a minority SPFPL investor, executive pension for president partners. A multi-partner SELARL remains possible but its majority rules can freeze growth decisions.
- Specialty with a heavy technical platform (radiology, ophthalmology, gastroenterology). Equipment investment (ultrasound, MRI, lasers, fibroscopes) often justifies a SEL from day one: corporate-tax depreciation, loan financing borne by the company, ring-fenced operating risk. A seed SPFPL can ease equipment financing and organise transmission to a future buyer.
Our chartered accountant s view#
At Hayot Expertise we systematically compare three ten-year scenarios: keeping the individual BNC, converting to a SELARL with majority manager and optional SPFPL, converting to a SELAS with president and SPFPL. On the engagements we run, SELARL beats SELAS for solo doctors or duos who prioritise an optimised net income and accept the self-employed-CARMF cover. SELAS gains the upper hand from three operating partners onwards, when a future acquirer becomes a credible prospect or when the doctor wants AGIRC-ARRCO protection on top of the CARMF.
The most frequent tax trap is forgetting the 151 octies tracking annex. On the cleanup files we handle, around a quarter of doctors who contributed a patient base to a SELARL five to ten years ago have not attached the tracking statement to their annual returns. The consequence is mechanical: the deferral lapses, the capital gain on the patient base becomes immediately taxable under the professional capital-gains regime, and the additional tax often falls between 40,000 and 100,000 euros. This charge is not covered by professional liability insurance when the omission is attributable to the doctor.
Hayot Expertise tip. Launch the comparative BNC, SELARL and SELAS simulation as soon as BNC profit exceeds 150,000 euros annually and this trend stabilises over two consecutive financial years. Document in writing the chosen status, the articles compliant with ordinance 2023-77, the shareholders agreement when relevant, the three-year forecast and the 151 octies tracking statement. The structure is chosen for five to ten years: better invest three months of analysis upfront than convert a SELARL to a SELAS under pressure when a new partner enters or a transmission becomes urgent.
Key takeaways#
- Ordinance 2023-77 of 8 February 2023 overhauled the medical SEL framework as of 1 September 2024.
- The BNC-to-SELARL move becomes economically relevant from 150,000 to 180,000 euros of annual profit.
- Article 151 octies CGI defers the capital gain on the patient base, subject to filing the annual tracking annex.
- Dividends above 10 % of capital plus CCA plus premiums are subject to URSSAF and CARMF self-employed contributions.
- Health insurance conventioning and underserved-area aids remain attached to the doctor, not to the SEL.
- Plan five to eight months between the decision and registration, with prior review by the departmental medical council.
Go further#
- 2026 BNC form 2035 guide
- SELARL and BNC reform
- corporate tax expense deductibility
- 2026 value-sharing bonus
- cash levers without borrowing
- accounting support
- secure company setup legal work
- bookkeeping and review
- 2026 private doctor accounting guide
- accounting support for doctors
- medical accounting follow-up with Pennylane
Official Sources Used#
- impots.gouv.fr - Calendrier de la réforme de la facturation électronique
- Service-Public Entreprendre - Choisir la forme juridique de son entreprise
- Service-Public Entreprendre - SELARL, ce qu il faut savoir
- impots.gouv.fr - Formulaire 2035-SD, revenus non commerciaux
- Legifrance - Ordonnance n 2023-77 du 8 février 2023 relative à l exercice en société des professions libérales réglementées
- Legifrance - Article 151 octies du CGI, report d imposition des plus-values d apport en société
- BOFiP - BNC, plus-values d apport en société, régime de l article 151 octies CGI
- BOFiP - Imposition en BNC des rémunérations techniques des associés de SEL
- CARMF - Cotisations retraite des médecins exerçant en SEL
- Legifrance - Article R4113-9 du Code de la santé publique, conditions de détention du capital des SEL de médecins
Current as of 3 May 2026.
Frequently asked questions
À partir de quel niveau d honoraires un médecin a-t-il intérêt à passer de BNC à SELARL en 2026 ?
Il n existe pas de seuil légal, mais un seuil de pertinence économique. Sur les dossiers que nous accompagnons, le passage en SELARL devient intéressant à partir de 150 000 à 180 000 euros de bénéfice BNC annuel, lorsque le médecin n a pas besoin de prélever l intégralité du résultat pour vivre. En dessous, l économie d impôt est souvent absorbée par les coûts de structure (commissaire aux apports, expertise comptable renforcée, formalités) et par la sortie de trésorerie via dividendes. Au-dessus de 200 000 euros, la SEL permet de lisser la pression fiscale à l IR via une rémunération de gérance calibrée et une distribution mesurée de dividendes.
Que change l ordonnance n 2023-77 du 8 février 2023 pour les médecins en SEL ?
L ordonnance n 2023-77, entrée en vigueur le 1er septembre 2024, a refondu le statut des sociétés d exercice libéral et a imposé une adaptation des statuts existants dans le délai d un an. Pour les médecins, deux évolutions sont majeures. Premièrement, les rémunérations techniques perçues par l associé d une SEL au titre de son activité médicale relèvent par principe des bénéfices non commerciaux (BNC) déclarés sur la 2035, et non plus des traitements et salaires. Cette nouvelle doctrine est confirmée par le BOFiP depuis 2024. Deuxièmement, les SPFPL de médecins peuvent désormais détenir le capital de plusieurs SEL exerçant la même profession, ce qui facilite les regroupements territoriaux.
Comment fonctionne le report d imposition de l article 151 octies du CGI lors de l apport en SELARL ?
L article 151 octies du Code général des impôts permet, lors de l apport de la patientèle et des éléments de l activité individuelle à une SELARL ou SELAS, de placer en report d imposition la plus-value constatée sur les éléments non amortissables (essentiellement la patientèle). L imposition est reportée jusqu à la cession des titres reçus en rémunération de l apport. Pour les éléments amortissables (matériel, agencements), la plus-value est étalée linéairement sur cinq ans. Trois conditions doivent être réunies : apport de l ensemble des éléments de l activité professionnelle, option exercée dans l acte d apport et dépôt annuel d un état de suivi (annexe 151 octies) joint à chaque déclaration jusqu à la cession des titres. Le défaut d annexe entraîne la déchéance du report et le rappel immédiat de l impôt.
Quelles cotisations CARMF et URSSAF s appliquent à la rémunération et aux dividendes d un médecin en SELARL ?
Le médecin gérant majoritaire de SELARL est travailleur non salarié (TNS) et cotise à l URSSAF profession libérale (allocations familiales, CSG-CRDS) et à la CARMF (retraite de base, retraite complémentaire, prestations complémentaires de vieillesse, invalidité-décès). Les cotisations représentent globalement 40 à 45 % de la rémunération nette de gérance. Concernant les dividendes, la part qui excède 10 % du capital social, des primes d émission et du solde moyen du compte courant d associé est soumise aux cotisations sociales TNS (URSSAF et CARMF) au lieu des seuls prélèvements sociaux. Sous ce seuil, les dividendes ne supportent que le prélèvement forfaitaire unique de 31,4 % (12,8 % d IR et 18,6 % de prélèvements sociaux).
Le passage en SEL remet-il en cause le conventionnement Assurance maladie du médecin ?
Non. La convention médicale 2024-2029 signée avec l Assurance maladie est conclue avec le médecin à titre personnel, pas avec sa structure d exercice. Le secteur de conventionnement (secteur 1, secteur 2, OPTAM) reste donc attaché au praticien. La SEL doit en revanche être inscrite au tableau de l Ordre départemental des médecins, déclarer ses statuts et obtenir l avis de conformité avant immatriculation. Les aides liées aux zones sous-denses (CSTM, CAIM, COSCOM) restent attribuées au médecin personne physique et continuent d être versées lorsqu il exerce dans une SEL respectant les conditions d éligibilité.
Quels sont les avantages d une SPFPL pour un médecin libéral en 2026 ?
La Société de participations financières de profession libérale (SPFPL) permet de détenir les titres d une ou plusieurs SEL médicales. Elle perçoit les dividendes en quasi-exonération via le régime mère-fille (95 % exonérés, 5 % de quote-part réintégrée, soit une taxation effective d environ 1,25 % à l IS au taux de 25 %). Elle facilite la transmission familiale via le pacte Dutreil (75 % d abattement sur la valeur des titres transmis sous conditions de conservation) et permet de financer le rachat de patientèle d un confrère via les dividendes futurs de la SEL. L interposition d une SPFPL doit être étudiée avant que les réserves de la SEL ne deviennent significatives, car la valorisation des titres apportés détermine le coût fiscal de la mise en place.
Combien de temps faut-il prévoir entre la décision de passer en SEL et l immatriculation effective ?
Comptez en moyenne cinq à huit mois entre la décision et l immatriculation effective. Les étapes incontournables sont : évaluation de la patientèle et des éléments apportés (un mois), rédaction des statuts conformes au Code de la santé publique et à l ordonnance 2023-77 (deux à trois semaines), dépôt du dossier au conseil départemental de l Ordre pour avis de conformité (délai légal de trois mois, souvent deux en pratique), commissaire aux apports si la valeur des apports en nature excède 30 000 euros ou représente plus de la moitié du capital (trois à six semaines), puis immatriculation au registre du commerce et des sociétés et information de la CPAM. Anticiper cette durée évite de basculer en SEL en cours d année fiscale, ce qui complique la clôture du BNC final.
Article written by Samuel HAYOT
Chartered Accountant, registered with the Institute of Chartered Accountants.
Regulated French accounting and audit firm based in Paris 8, built to support companies across France with a digital and decision-oriented approach.
Sources
Official and operational sources cited for this page.
- impots.gouv.fr - Calendrier de la réforme de la facturation électronique
- Service-Public Entreprendre - Choisir la forme juridique de son entreprise
- Service-Public Entreprendre - SELARL, ce qu il faut savoir
- impots.gouv.fr - Formulaire 2035-SD, revenus non commerciaux
- Legifrance - Ordonnance n 2023-77 du 8 février 2023 relative à l exercice en société des professions libérales réglementées
- Legifrance - Article 151 octies du CGI, report d imposition des plus-values d apport en société
- BOFiP - BNC, plus-values d apport en société, régime de l article 151 octies CGI
- BOFiP - Imposition en BNC des rémunérations techniques des associés de SEL
- CARMF - Cotisations retraite des médecins exerçant en SEL
- Legifrance - Article R4113-9 du Code de la santé publique, conditions de détention du capital des SEL de médecins
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