Chartered accountant for hearing-aid specialists

An accountant for hearing-aid specialists masters the hybrid nature of your business: regulated health care and the sale of medical devices. In practice, this means 5.5% VAT on hearing aids listed on the LPP (not 20%), the 100% Santé Class I framework with its capped price, third-party payment management and the valuation of a device stock.

At Hayot Expertise, we support hearing centres, established specialists and projects to open or take over a business. This profession combines several constraints: an act of care framed by the public health code, the sale of medical devices at a reduced VAT rate, multi-payer reimbursements and a capped margin on the reference offer. Sloppy bookkeeping is costly, both in VAT reassessments and in strained cash.

A first feature, often misunderstood: there is no Order for hearing-aid specialists, unlike pharmacists or doctors. The profession is governed by Title VI of the public health code (art. L4361-1 to L4364-9), with no ordinal body. Article L4361-1 defines the specialist as anyone who fits hearing aids for the hearing-impaired, and you are the only professional authorised to deliver hearing aids.

Practising requires the State diploma in audioprosthetics, a three-year course (art. L4361-3). You must also be registered with the regional health agency (art. L4361-2). One recent point to reflect in your filings: since 5 June 2024, hearing-aid specialists have moved from the ADELI register to the RPPS, the shared register of health professionals, with a single national number. We make sure these identifiers are consistent across your invoicing and third-party payment documents.

This is the main technical point and the most common source of error. CE-marked hearing aids listed on the LPP (the official list of products and services) fall under the reduced 5.5% rate (French Tax Code, art. 278-0 bis, 2 of A, devices for disabled persons). This rate covers the whole chain:

• CE-marked hearing aids listed on the LPP;
• specific zinc-air batteries used exclusively for these devices;
• the fitting and follow-up service linked to the device.

The 20% rate only applies to what falls outside this scope: non-reimbursed accessories not intended exclusively for the device, such as a TV headset, an amplified phone or standard batteries for non-exclusive use.

Our reading. The error we see most is not taxing an aid at 20%, but the opposite: applying 5.5% to comfort accessories that do not qualify, or leaving the point-of-sale software wrongly configured. At high volume, a wrong rate turns into a VAT reassessment over several years. We lock the rule in at source, from the configuration stage.

100% Santé in audiology reshaped the economics of hearing centres. For an adult over 20, the Class I offer (zero out-of-pocket cost) follows a precise set of figures, per ear, in 2026:

Class II, at a free price, drives the centre's profitability, but you must always offer a quote including at least one Class I device. These flows run through third-party payment: the social security and insurer shares are collected with a delay, creating receivables to track and a collection period to manage.

For a patient under 20, or a person affected by blindness, cover is more favourable. The maximum selling price of a Class I device rises to 1,400 euros incl. tax per ear, the reimbursement base is raised to the same level (1,400 euros), and social security reimburses 60% of that base, i.e. 840 euros. The out-of-pocket cost stays nil with a responsible complementary insurer. This scale gap changes the margin calculation as soon as a centre fits children, and is worth isolating in your tracking.

In accounting terms, your centre is a mixed activity. On one side, a regulated act of care (assessment, fitting, adjustments, follow-up over the life of the device). On the other, the sale of medical devices, so a stock of devices, accessories and batteries. This dual nature has three direct consequences:

• Stock. It must be valued, its turnover monitored and obsolete models written down. It is an asset that ties up a real share of your cash.
• Multi-rate VAT. 5.5% on LPP items, 20% off-LPP: the split must be clean from invoicing onwards.
• Third-party payment. Social security and insurer receivables (41x accounts) are collected with a lag. Your collection cycle (DSO) depends directly on how fast reimbursements come back, and the capped Class I margin (950-euro PLV) limits your pricing leeway on the reference offer.

A hearing-aid specialist is not an optician. Both fall under 100% Santé and combine care with sales, but the framework differs: products, reimbursement bases, price caps and VAT rates do not overlap. If you are looking for the optics logic, our dedicated page for opticians covers it, and our shared health-sector reference points appear on the pharmacy and health page.

Here is what separates your accounting from an optician's, the other 100% Santé profession you are often compared with:

Here is a situation representative of the files we handle, without matching any identified client. A hearing-aid specialist opens a second centre and finds, after a few months, that cash is tighter than expected despite strong sales volume. On analysis, two causes combine: an over-broad device stock that ties up cash, and third-party payment reimbursements coming in late for want of regular reconciliation.

We rework the stock valuation, isolate slow-moving models and put in place a monthly review of DSO and third-party payment returns. In parallel, we check the VAT split, because the point-of-sale software applied 5.5% to a few comfort accessories that fell under 20%. The result: a real margin readable by class, anticipated cash and a VAT correction handled before any audit. This example illustrates a method, not a guaranteed outcome: every centre has its own cost structure.

In hearing-aid specialist files, the same sticking points recur:

• Applying the wrong VAT rate to accessories or batteries, in either direction, with a reassessment risk at high volume.
• Neglecting third-party payment tracking: unreconciled reimbursements, untreated rejections and a distorted result.
• Overvaluing stock by failing to write down older models, which artificially inflates taxable profit.
• Mixing health and trade flows in too basic a chart of accounts, which prevents measuring margin by class.
• Choosing a legal form by default without weighing pay against dividends in light of the hybrid activity and investment needs.

Hayot Expertise, in Paris 8, supports health professionals and businesses combining care with trade. Samuel Hayot, chartered accountant registered with the Order of Chartered Accountants of Ile-de-France and statutory auditor registered on the list drawn up by the Haute autorité de l'audit (H2A), supervises the files. We combine reliable multi-rate bookkeeping, third-party payment and cash management, and advice on structure and director's pay.

To go further, you can prepare your decisions with our director's pay simulator, explore our accounting services in Paris 8 or talk to us about your project to open or take over a centre. This page is informative and does not replace an analysis of your situation: a decision depends on your figures, your contracts and the law in force, which we review together.

Hayot Expertise, 58 rue de Monceau, 75008 Paris. Content up to date as of 19 June 2026, reviewed by Samuel Hayot, chartered accountant. Rates, thresholds and amounts should be verified as of the date of your transaction.