Chartered Accountant for Physiotherapists in France

A physiotherapy-focused accountant files your 2035 return (or runs your micro-BNC), secures locum retrocessions, provisions CARPIMKO and URSSAF at the right level, and structures the practice (SCM, SELARL, SCI for the premises) once your BNC level justifies it. That is the support Hayot Expertise offers liberal physiotherapists, in Paris and remotely, with a quote within 24 hours.

In 2026, liberal physiotherapists face increasingly complex accounting and tax challenges: strict management of BNC 2035 regime, CARPIMKO contributions rising annually, optimization of fee retrocessions for replacements, structuring via SCM (Cost-Sharing Company) to share expenses, and acquisition of practice premises via SCI (Real Estate Company) to secure assets.

Cabinet Hayot Expertise is the specialized chartered accountant for physiotherapists in Paris who secures your accounting, optimizes your taxation, and supports your asset development.

These figures drive your cash flow: the threshold sets your filing regime, the CARPIMKO rates set your contribution calls, and the PASS sets the brackets.

For physiotherapists trained abroad who practise in France, and for international patients or investors seeking to understand the French healthcare accounting framework:

BNC regime (Non-Commercial Profits): all liberal physiotherapists in France practice under the BNC tax regime, declaring income on the 2035 form. Unlike the UK where physiotherapists can freely incorporate as a limited company, French practitioners default to BNC personal taxation unless they specifically create a SELARL.

CARPIMKO: the mandatory retirement and disability fund specific to paramedical professions (physiotherapists, nurses, speech therapists, podiatrists, orthoptists). The 2026 rates are 8.73 % on the first PASS bracket plus 1.87 % on the wider bracket for the basic pension, and 8.70 % for the now fully proportional complementary pension, on top of flat disability-death and ASV contributions. They are fully tax-deductible, a key advantage over employment where pension contributions come from post-tax income.

Sector II convention: unlike doctors who can choose between sector 1 (regulated fees), sector 2 (variable fees), and sector 3 (no convention), physiotherapists in France practice under a single convention with the Assurance Maladie (national health insurance). Fee rates are set by the convention (tarif conventionné), making revenue forecasting predictable.

BNC Regime and 2035 Declaration: Strict Obligations

A liberal physiotherapist practices under the Liberal Profession status in the category of Non-Commercial Profits (BNC). Although exceeding €83,600 in revenues (2026 threshold) makes the 2035 declaration (controlled declaration regime) mandatory, the economic reality of the profession pushes even young practitioners toward the actual controlled regime.

Why opt for actual BNC regime (2035) from the start?

With the purchase of therapeutic equipment (electric tables €2,000, shockwave €8,000, tecar therapy €12,000, diagnostic equipment), practice rent (minimum €1,500/month in Paris, i.e., €18,000/year), vehicles for home visits, mandatory continuing education (DPC), and CARPIMKO contributions, your actual expenses far exceed the standard deduction of 34% of the micro-BNC regime.

Calculation example: A physiotherapist with €65,000 in revenues under micro-BNC pays tax on €42,900 (€65,000 − 34% = €42,900). Under actual regime with €30,000 in actual deductible expenses, they pay tax on only €35,000, i.e., €7,900 less taxable profit, corresponding to approximately €3,200 in tax savings (41% marginal rate).

Key lines of 2035 declaration for a physiotherapist:

• Line 1: Cash receipts (Assurance Maladie reimbursements + patient top-ups)
• Line 3: Fee retrocessions (amounts paid to the holder as a replacement, or received from a collaborator)
• Line 20: Rent and rental charges (rented practice or SCM share)
• Line 26: Purchases (gels, massage oils, consumables)
• Line 29: Other management expenses (DPC training, professional dues, subscriptions, RCP insurance)
• Line 31: Depreciation allowances (therapeutic equipment, furniture, IT)
• Line 35: Mandatory social contributions (URSSAF + CARPIMKO)

CARPIMKO Contributions: Understanding and Optimising

CARPIMKO covers 5 branches: basic retirement (section A), complementary retirement (section B), disability-invalidity (PMMR), death insurance, and professional expenses insurance.

What it costs in euros: for a physiotherapist on €70,000 of BNC, the basic pension is €4,196 (8.73 % of €48,060) plus €1,309 (1.87 % of €70,000), the complementary pension €6,090 (8.70 % of €70,000), disability-death €1,022 and ASV €224, so roughly €12,800 of CARPIMKO excluding the proportional ASV share. URSSAF contributions (health, family allowances, CSG-CRDS, training) follow their own scale on top.

The regularisation trap: CARPIMKO calls provisional contributions on your income from two years earlier, then trues them up. A physiotherapist moving from €40,000 of BNC to €70,000 sees CARPIMKO rise from about €8,970 to about €12,800, so close to €3,900 landing in one go.

Madelin law optimization: beyond mandatory CARPIMKO contributions, physiotherapists can deduct supplementary Madelin or PER premiums under article 154 bis of the CGI. The ceiling is the higher of two amounts: 10 % of taxable profit capped at 8 PASS, increased by 15 % of the profit fraction between 1 and 8 PASS, or 10 % of the PASS. The widespread "10 % of income" shorthand drops the 15 % uplift and understates what you can actually deduct.

Locum work is where most French physiotherapists first meet liberal taxation, and where the costliest mistakes cluster. A locum practises in their own right, under their own registration with the Ordre, and is taxed under BNC like an established practitioner.

Two set-ups, two treatments. In the arrangement most common in physiotherapy, the locum collects the patient fees and pays the principal an agreed percentage: the locum is the one paying the retrocession, reported on line 3 of the 2035 ("honoraires rétrocédés"). In the reverse arrangement, the principal collects and pays the locum a retrocession: that sum is then simply a receipt of the locum, with nothing to strip out.

The point almost everyone gets backwards. It is widely repeated that a retrocession paid is "lost" under micro-BNC because the 34 % flat allowance swallows it. That is inaccurate. French tax doctrine expressly provides that retrocessions of fees paid to a fellow professional are subtracted from the receipts retained under the micro regime, and that they are correspondingly receipts of whoever receives them. The tax authority's own illustration: a professional collecting €75,000 and retroceding €10,000 retains €65,000 of receipts. The consequence works twice over, on your taxable base and on the assessment of the €83,600 threshold.

Mind the definition. A retrocession of fees is a sum paid over by a liberal professional, on their own initiative and within the assignment entrusted to them by their patient, to a fellow professional. A sum paid in return for the use of premises, equipment or a patient base does not meet that definition and follows the logic of expenses, deductible only under the real regime. A locum contract and a collaboration contract are therefore not treated alike, and it is the contract that decides, not the wording of the transfer.

When to switch to the real regime. Micro-BNC holds up as long as your expenses excluding retrocessions stay below 34 % of your net receipts. Once equipment, a vehicle, premises and CARPIMKO settle in, the 2035 wins, and it is mandatory in any case above €83,600. We quantify the switch on your own figures before changing your regime.

Sole Proprietorship (the default start)

Most young physiotherapists start as sole traders under BNC. Simple to set up, no corporate formalities, but personal liability is unlimited and there is no income optimisation via salary/dividend split.

SCM: Société Civile de Moyens (Cost-Sharing Company)

The SCM is the most common structure for physiotherapists sharing premises. Key features:

• The SCM owns or rents the practice premises, equipment, and shared infrastructure
• Each associate physiotherapist is billed a share of costs (rent, utilities, secretary, equipment amortisation)
• Each practitioner remains professionally independent (separate practice, separate patients, separate BNC accounting)
• The SCM does not generate revenue: it only redistributes costs

Tax treatment: each physiotherapist deducts their SCM share payment as a professional expense on their 2035 declaration. We create SCMs, draft the articles, register with the relevant authorities, and handle the annual SCM accounting (separate from each member's individual 2035).

SELARL: Société d'Exercice Libéral à Responsabilité Limitée

For established physiotherapists earning above €80,000-100,000 BNC, transitioning to a SELARL (the liberal profession equivalent of an SARL, subject to corporate tax) can generate significant tax savings:

• IS rate: 15% up to €42,500 profit, then 25%, far below the 41%/45% IR marginal rates at this income level
• Modular remuneration: you set your salary (subject to social charges + IR) and distribute dividends (31.4% flat tax in 2026; the fraction above 10% of share capital bears TNS social contributions for a majority manager)
• Asset protection: liability limited to SELARL capital contributions

SELARL creation requirements: authorisation from the Ordre des Masseurs-Kinésithérapeutes (the professional regulatory body), specific articles of association approved by the Ordre, and a minimum of 50%+ of shares held by physiotherapists in active practice.

SCI: Buying Your Practice Premises

Once established, many physiotherapists choose to purchase their practice premises rather than remain a tenant. The standard structure is:

1. Create an SCI (real estate holding company), co-owned by you and/or your spouse
2. The SCI borrows to purchase the premises
3. The SCI rents the premises to your SELARL or to yourself as a sole practitioner
4. Rental income in the SCI is offset by loan interest deductions and depreciation

Benefits:

• Build real estate assets (practice premises can be worth €150,000-€400,000 in Paris)
• Deductible rent as a professional expense in your practice
• Transfer premises to heirs through gifts of SCI shares, using the €100,000 allowance per parent and per child (renewable every 15 years); the Dutreil pact does not apply to an SCI that simply lets premises
• Tax-efficient exit: selling an SCI with leverage is more tax-efficient than selling property directly

Management Accounting and Bookkeeping

We handle all your liberal BNC accounting:

• Automated import of your bank statements (professional account)
• Fee reconciliation: Assurance Maladie reimbursements (SNIR data), complementary mutual insurance, direct patient payments
• Deduction of retrocessions: if replacement, we isolate the retrocession paid to the holder (line 3 of 2035) to maximise your tax deduction
• Tracking deductible expenses: rent, equipment, DPC training, vehicle, professional dues, RCP insurance
• Depreciation calculation: electric tables, shockwave, tecar therapy, diagnostic equipment, furniture, IT
• 2035 declaration: preparation, verification, and electronic filing within deadlines

Real-time dashboard: via our Pennylane platform, you permanently view your cash flow, monthly collections, deductible expenses, and an estimate of your upcoming taxes and contributions.

Tax Optimisation Summary

Location Relief: ZFU Is Closed, QPV Replaces It

A point that still trips up practices opening in 2026. The profit-tax exemption attached to urban free zones (ZFU-TE) was not extended beyond 31 December 2025: an installation after that date no longer qualifies, whatever older guidance still says online. What replaces it is a scheme tied to priority urban districts (QPV), open to businesses created or taken over between 1 January 2026 and 31 December 2030. The relief is total for five years, then tapers to 60 %, 40 % and 20 % over the following three years, subject to a headcount below 50 and turnover or a balance sheet total below €10 million.

The practical consequence for a physiotherapist is a matter of timing, not paperwork: the benefit is decided by where you set up, so the zoning of the address has to be checked before the lease is signed. Once the practice is running, no filing can retrofit it. We check the zoning as part of the pre-installation review, together with the choice between micro-BNC and the real regime.

Cabinet Hayot Expertise is a chartered accountancy firm registered with the Ordre des experts-comptables of Île-de-France, based at 58 rue de Monceau in Paris 8.

• Secure your 2035 declaration: quality control before electronic filing, compliance with tax standards
• Optimize your deductible expenses: maximize tax deductions (equipment, vehicle, training, contributions)
• Anticipate your social contributions: CARPIMKO and URSSAF modelling, avoid brutal adjustments
• Structure your assets: SCM, SCI property, SELARL transition, PER and Madelin
• Responsiveness in less than 24h: answer your questions by email/phone within 24h, Pennylane platform accessible 24/7

Physiotherapy is a regulated healthcare profession in France requiring mandatory registration with the Ordre des Masseurs-Kinésithérapeutes (OMK). The recognition pathway depends on your country of origin:

EU/EEA-qualified physiotherapists: mutual recognition under EU Directive 2005/36/EC. You apply to the OMK in the département where you intend to practice. You must demonstrate French-language proficiency at a level adequate for patient interaction. In some specialty areas, the OMK may require an adaptation period or aptitude test to confirm your practice covers all aspects of the French qualification (masso-kinésithérapie).

Non-EU physiotherapists (UK post-Brexit, US, Canada, Australia): you must apply for an Autorisation d'Exercice (AE) from the Ministère chargé de la Santé. This involves submitting your diploma for evaluation, potentially a supervised practice period in a French hospital, and a language test. The process typically takes 6 to 18 months. We advise UK-trained physiotherapists who've faced delays in post-Brexit recognition and help structure their business affairs so they're operationally ready the moment authorisation arrives.

First steps on registration: immediately after OMK registration, you must register with URSSAF as a new self-employed professional, affiliate with CARPIMKO, open a dedicated professional bank account, and choose your tax regime (micro-BNC or réel 2035). Missing CARPIMKO registration in the first three months generates penalty contributions from your theoretical start date. We handle this onboarding end-to-end.

Background: a UK-trained musculoskeletal physiotherapist relocated from London to Paris in 2023. He obtained his OMK registration after completing the adaptation period process under post-Brexit rules.

Year 1: Individual BNC, réel 2035 regime. Patient base built slowly: month 1 to 6 at €2,000/month revenue, months 7 to 12 at €3,500/month. Year-1 gross receipts: €33,000.

• CARPIMKO year-1 minimum: €1,500
• URSSAF provisional: €2,000
• Practice rental share (SCM with 2 other physiotherapists): €5,400
• Equipment (treatment table, ultrasound, TENS unit amortised over 5 years): €1,200 depreciation
• Professional liability insurance: €1,100
• DPC continuing education and OMK dues: €800
• Taxable BNC: 33,000 − 12,000 = €21,000 → income tax ≈ €2,800

Result: modest but sustainable start. Net disposable income in year 1: approximately €15,700 (tight, but the catch-up contributions in year 2 had been provisioned).

Year 2: Receipts: €62,000 (full year established). The CARPIMKO true-up landed once the fund caught up with the real income, and it was expected because contributions had been provisioned monthly against the published 2026 rates rather than a rule of thumb. Year-2 taxable BNC: €38,500.

Year 3: The practitioner joined two colleagues in a formal SELARL structure. Combined practice revenue: €340,000. The SELARL allows the practitioner to manage remuneration at €45,000/year (salary) + €18,000 (dividends at flat tax 31,4%), accumulating cash in the SELARL to purchase equipment and eventually buy the SCM's practice premises via an SCI.

1. Not switching from micro-BNC to réel 2035 soon enough: once you have meaningful equipment, premises costs, and CARPIMKO contributions, the 34% micro-BNC flat deduction is always less than your actual expenses. The réel regime gives better results from year 1 in most cases.

2. Treating SECU reimbursements and patient co-pays as separate income sources: they are one combined receipt per patient session. Declaring them separately creates data reconciliation issues with the SNIR (CPAM data) and can trigger queries.

3. Not tracking vehicle expenses properly: physiotherapists doing home visits can claim mileage at the official rate or actual vehicle costs. Without a proper mileage log (carnet de déplacement) with dates, addresses, and patient codes, the entire vehicle deduction is at risk in an audit.

4. Missing CARPIMKO disability-death premium deadlines: CARPIMKO disability insurance relies on timely premium payment. Missing the deadline creates coverage gaps that can have catastrophic personal financial consequences.

5. Confusing personal and professional accounts: physiotherapists who use the same bank account for personal and professional transactions cannot easily demonstrate the professional nature of expenses. Open a dedicated professional account from day one.

SCMs are the standard cost-sharing vehicle for liberal professionals in France, including physiotherapists. An SCM is transparent for tax purposes (each member declares their SCM share in their own BNC) and does not generate income: it purely pools property rental, equipment maintenance, reception staff costs, and insurance.

For foreign physiotherapists joining an existing French practice, the SCM provides immediate access to shared overhead at a fraction of individual ownership cost. Entering a SCM typically requires a capital contribution (buy-in) and adherence to the shared cost allocation key (clé de répartition). We review SCM statutes for incoming members and ensure the allocation methodology is fair and documented.

SCM buy-ins in Paris typically range from €5,000 to €40,000 depending on the practice's equipment, location, and patient volume. This amount is capitalised on your personal BNC balance sheet (it is an investment, not a deductible expense). If the SCM owns assets with significant accumulated depreciation, your effective entry cost is partially offset by the lower future cost-share for equipment renewals.

CARPIMKO annual declaration: every year by 30 June, you must provide CARPIMKO with your prior-year income figure (drawn from your Form 2035). Late or missing declarations are penalised: CARPIMKO calculates contributions based on a national average rather than your actual income, which is almost always higher. We submit this declaration automatically as part of our annual BNC return service.

📍 Cabinet Hayot Expertise - 58 rue de Monceau, 75008 Paris 💼 First free appointment: let's discuss your tax optimisation and asset objectives

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