Collaboration Agreements and Fee Sharing in a French Dental Practice

A liberal collaborator works in the practice on a lasting basis, may build a personal patient base, and pays the practice owner a fee for the premises and equipment made available: that fee falls under VAT at the standard 20% rate. A locum stands in for the absent owner and receives a share of care fees, which stays VAT-exempt.

This is the costliest confusion in French dental practices. Both contracts look alike on paper, both are settled as a percentage of fees, and yet they carry neither the same VAT regime, nor the same reporting duties, nor the same reclassification risk.

This guide is written for practice owners taking on a collaborator or a locum, and for practitioners about to sign a collaboration agreement. Everything else about running the practice, choice of structure, CARCDSF contributions, VAT on treatments, depreciation of clinical equipment and fee levels, sits on our dentist accountant page.

Freshness note: updated on 26 July 2026. Professional, tax and social rules should be checked at the date the agreement is signed.

In practice, dental vocabulary mixes the two words freely. Many agreements titled "rétrocession" actually organise a collaboration. The title of the contract does not decide the tax regime: what the payment actually rewards does.

The status of liberal collaborator is defined by article 18 of Act no. 2005-882 of 2 August 2005 on small and medium-sized businesses. Three points drive everything else.

The collaborator works in full independence, with no relationship of subordination. They are neither an employee nor a partner. They keep the social and tax status of a self-employed professional and answer for their own professional acts.

The agreement must be in writing and state its duration, how the collaborator is paid, the working conditions and in particular the terms under which they may serve their own patients, plus termination terms and notice. Since 1 January 2022 it must also provide for suspension during maternity, paternity or adoption leave.

Finally, the agreement must be filed with the departmental council of the professional Order. Article L. 4113-9 of the French Public Health Code requires dental surgeons to communicate agreements and amendments relating to the exercise of their profession, as well as those giving them the use of equipment and premises, within one month of signature. Any contract entered into with a dental surgeon must also be in writing.

Our view: this filing is not one more administrative formality. In the files we take over, an agreement never sent to the Order is almost always an agreement never re-read, whose clauses no longer match how the two practitioners have actually been working for years.

This is where the financial difference between the two contracts plays out.

The fee share paid to a locum is exempt. It rewards care provided to a patient by a practitioner holding the required qualifications, within the meaning of article 261, 4, 1 of the French Tax Code. The tax authorities have confirmed by ruling that the money passing through the replaced practitioner rather than being paid directly by the patient does not change the nature of the service.

The collaboration fee is taxable. It does not reward care but the provision of premises, equipment, staff and, often, access to a patient base. That is an ordinary supply of services, subject to VAT at the standard 20% rate, even though the practice's care activity is exempt.

Two practical consequences that many practices discover too late.

First, the owner becomes partly VAT-registered. The small-business VAT exemption must be assessed on taxable receipts only, meaning the fees collected from the collaborator, not on total practice income. The 2026 thresholds are 37,500 EUR, with an upper threshold of 41,250 EUR. Below those amounts the exemption applies and no VAT is charged. Above them, the owner charges VAT to the collaborator, reports it, and in return recovers input VAT on the corresponding share of costs.

Second, the agreement must state whether the fee is expressed excluding or including VAT. It is a one-line clause. Its absence is the most ordinary dispute we see between an owner and a collaborator: the exemption is lost mid-year, VAT is added, and nobody wrote down who bears it.

There is no scale, neither from the Order nor from any collective agreement. The percentage is freely negotiated. What matters is knowing what it rewards and documenting it, because that is exactly what an audit will look at.

The parameters that justify the level are always the same:

• the premises and their condition, and how many chairs are genuinely available to the collaborator;
• the clinical equipment made available: imaging, CAD/CAM, sterilisation;
• chairside assistance: a collaborator working four-handed with a dedicated assistant is not in the same position as one working alone;
• consumables and prosthetics, depending on whether they are recharged or included in the fee;
• front desk, appointment booking and practice software;
• access to the patient base, which is in practice the most debated item.

The agreement gains from setting out, item by item, what is included and what is recharged separately. A single global percentage is easier to write but far harder to defend the day one of the two practitioners disputes it.

The collaborator is a self-employed professional. They report fees as non-commercial profits (BNC), under the micro-BNC regime while annual receipts stay below 83,600 EUR, and under the controlled declaration regime above that, filing a form 2035. The fee paid to the owner is a deductible expense. They pay their own CARCDSF contributions and carry their own professional liability cover.

The owner records the fee as income. They must watch the VAT thresholds described above, and report sums paid on the DAS2 return once they exceed 2,400 EUR per beneficiary per year, which covers any sustained collaboration or locum arrangement. Missing the DAS2 is common and penalised, while the filing itself takes minutes.

The risk is not theoretical. A collaboration reclassified as employment triggers a social contribution reassessment over the period, paid holiday, and potentially the consequences of an unjustified termination.

The indicators that build subordination are concrete:

• the collaborator cannot set their hours or decline a patient;
• they have no real opportunity to build a personal patient base, even though the agreement says so;
• they have no clinical autonomy and no say on materials or suppliers;
• the owner sets them production targets;
• the pay is in fact fixed and disconnected from the treatments actually carried out;
• the collaborator invoices nothing, has no identified patients and bears no risk.

Our view: the weakest point is usually the personal patient base. The law makes it a mandatory clause. When the agreement provides for it but the way the practice is organised makes it impossible, the actual organisation prevails.

A non-compete clause, often called a non-reinstallation clause, is valid if it is limited in time and space and proportionate to the practice's legitimate interests. A clause barring the collaborator from practising across an entire city for several years is likely to be set aside, and a clause that is set aside protects nothing.

Two further points deserve to be written down: the notice period, which should match how long the collaboration lasted, and what happens to patient records when the agreement ends, in line with professional ethics and the patient's free choice.

A Paris practice takes on a collaborator four days a week. She bills 140,000 EUR of fees over the year and pays 40% to the owner for the premises, the chair, the assistant and the front desk, that is 56,000 EUR of collaboration fees.

That amount exceeds the 41,250 EUR upper threshold. The owner loses the small-business exemption on taxable receipts, must charge 20% VAT on the fee and report it. In return, input VAT is recoverable on the share of costs allocated to that taxable activity.

On the collaborator's side, 140,000 EUR of fees rules out micro-BNC: she files under the controlled declaration regime on form 2035, where the fee appears as a deductible expense. The owner reports the 56,000 EUR on the DAS2 return.

This example is modelled to illustrate the thresholds; it does not reproduce a real file. Amounts and percentages vary from one practice to another.

• agreement in writing, dated and signed by both practitioners;
• filed with the departmental council of the Order within one month;
• duration, notice and termination terms spelled out;
• collaborator's personal patient base provided for, and genuinely possible;
• fee percentage broken down item by item;
• fee stated as excluding or including VAT;
• allocation of consumables, prosthetics and laboratory costs;
• separate professional liability cover for each practitioner;
• holidays, absence, sickness and replacement;
• non-compete clause limited in time and space;
• consistency between the agreement and actual invoicing.

• Check the level of fees collected each year against the VAT exemption thresholds.
• Re-read the agreement whenever the setup changes: move to full time, a second collaborator, new clinical equipment.
• Do not forget the DAS2 above 2,400 EUR per beneficiary.
• Sign an amendment, and file it with the Order, rather than letting the agreement and the practice drift apart.
• Prepare for e-invoicing on the flows it covers, which include the collaboration fee.

The same mechanics apply in other French healthcare professions, with different rates and customs: see our analyses of fee sharing in physiotherapy and fee sharing for self-employed nurses.