Accountant for doctors in France: BNC, SELARL, 2035 and CARMF

Accountant for doctors in France: BNC, SELARL, 2035 and CARMF#

Accounting for a self-employed doctor in France is more than filing form 2035. It should secure revenue, expenses, CARMF, URSSAF, possible VAT exposure, vehicle costs, the choice between individual practice and SELARL, social protection, remuneration and long-term wealth planning.

This guide is for general practitioners, specialists, replacement doctors, sector 1 and sector 2 practitioners, collaborators, SELARL partners and medical practices considering a move from individual BNC to a company structure. It supports our pages for doctors and liberal professions.

Doctors must choose between BNC simplicity, SELARL structuring, social contributions, CARMF, VAT analysis, professional expenses and remuneration planning.

Self-employed doctors generally fall under BNC when practising independently. The controlled declaration regime uses form 2035 and records actual revenue and expenses. The choice should not be automatic. See our French 2035 guide.

Controls include: collected fees, bank reconciliation, retroceded fees, collaboration fees, mandatory social contributions, vehicle costs, rent, SCM allocations, fixed assets, mixed expenses and CARMF contributions.

Medical care is often VAT-exempt when the applicable conditions are met. However, some side activities may be taxable: expert reports, non-therapeutic services, rental income, teaching, products or specific services. Do not assume every flow is outside VAT.

Moving from individual BNC practice to SELARL may be relevant when profit is high, several doctors join, equipment is financed or a wealth strategy justifies a company. But SELARL adds commercial accounting, shareholder decisions, manager remuneration, corporate tax and social analysis. Read our French guide on moving from BNC to SELARL.

CARMF and social contributions are a major cash item. Provisional contributions can create timing differences when activity starts, grows quickly or declines. The official CARMF parameters for 2026 should be reviewed every year.

The underestimated risk for self-employed doctors is confusing profit, personal income and practice cash. Bank receipts may be high while social contributions, CARMF, income tax, equipment, replacements, rent and adjustments absorb a large share of cash.

Moving from individual BNC practice to a SELARL is a decision to take across several years, not a one-off comparison. It tends to make sense when profit is high, when the activity is expanding, when several practitioners join forces, when technical equipment is being financed, or when a wealth strategy justifies a company structure. None of these triggers is sufficient on its own, and none should push you toward a company automatically.

The trade-off is real. Individual BNC keeps things simple: under the controlled declaration regime you still deduct actual expenses, and remuneration is simply the BNC profit. A SELARL gives you more room to associate with other doctors and to structure remuneration between salary and distributions, but it lowers simplicity and introduces company accounting, shareholder decisions, corporate tax and a distinct social analysis.

The right answer depends on the level of profit, the role of replacements, planned investments, the family situation, social protection and any transmission plan. A SELARL should be compared to staying in BNC over several years rather than on a single good year, because the simplicity you give up is permanent while the benefit may be cyclical.

CARMF and social contributions weigh heavily on a doctor's cash position, and they are the most common source of unpleasant surprises. Provisional contributions are calculated on an earlier reference income, so they create timing differences: when you first set up, when activity grows quickly, or when it falls, the amount called bears little relation to the cash you have on hand right now. A strong year can produce a heavy adjustment the following year, landing exactly when income may have softened.

The underestimated risk here is confusing three figures that are easy to blur: profit, available personal income and the practice's cash. Bank receipts can look healthy while social contributions, CARMF, income tax, equipment, replacements, rent and adjustments quietly absorb a large share of that cash. A doctor who reads only the top line can over-commit on investments or personal drawings and then face a contribution call with no buffer.

In practice, the discipline that protects a medical practice is forward estimation. Once the flows are secured, the practice should estimate the year's result and the charges still to come: social contributions, CARMF, income tax, investments, rent, payroll, insurance, training and any loan repayments. Following the provisional calls, the regularisations and the estimated income side by side, against the cash actually available, is what turns CARMF from a recurring shock into a planned line. The official CARMF parameters change, so they should be read again every year rather than assumed to be stable.

Another risk is assuming that every medical revenue stream follows the same VAT or tax treatment. Side activities need individual analysis.

• impots.gouv.fr: 2026 form 2035-SD.
• impots.gouv.fr: taxable profit under IR or corporate tax.
• BOFiP: BNC controlled declaration.
• CARMF: doctor contributions 2026.
• Service-Public Entreprendre: medical practitioners.