Expertise
Physicians & medical care centres
The medical professions follow tax rules of their own. We support physicians in private practice, dentists, joint practices and medical care centres – from ongoing support to the handover of the practice.
Sector knowledge for healthcare.
Professional (freelance) status needs protecting, the VAT exemption needs clean delineation, and health insurance billing needs correct mapping. We make sure your structures hold for tax and your numbers help run the practice economically – so you can concentrate on your patients.
Our services for physicians & medical care centres.
Practice formation, legal form & cooperations
Whether setting up in practice, taking over a practice, merging into a joint practice or founding a medical care centre – the chosen structure determines tax burden, liability and the flexibility for later changes.
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We advise you before these decisions fall and align the structure with your goals – in coordination with your lawyers and the licensing framework.
- Tax advice on setting up, buying and taking over a practice – including the treatment of practice goodwill
- Tax burden comparisons of the practice forms: solo practice, cost-sharing group, joint practice, medical care centre
- Tax evaluation of cooperation and partnership agreements and of profit distribution
- Safeguarding freelance status and avoiding commercial infection from ancillary activities
- Support with the tax side of formation formalities – tax onboarding, opening accounts, chart of accounts
- Tax support for investments in practice premises and medical technology including financing questions
- Coordinating the structuring with lawyers and notaries – the legal implementation is done by counsel
Ongoing support: bookkeeping, payroll & practice reports
A current, meaningful set of numbers is the foundation of every economically run practice.
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We take over your bookkeeping and payroll completely and digitally, map health insurance billing and private billing cleanly and prepare your numbers so that you always know where your practice stands.
- Ongoing bookkeeping with digital document flow via DATEV Unternehmen online
- Correct mapping of health insurance billing, private billing and other income types
- Payroll for medical assistants, employed physicians and casual staff
- Treatment of supplements, training and benefits in kind in payroll
- Monthly management reports with practice-relevant KPIs
- Target-actual comparisons and liquidity overviews as a basis for your decisions
- Review of tax assessments, deadline monitoring and correspondence with the tax authorities
VAT in healthcare
The VAT exemption for medical services is a privilege with sharp edges.
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Whether a service is therapeutically indicated and therefore exempt, or subject to VAT as a self-pay service, expert report or aesthetic treatment, is decided case by case – and must be separated correctly in the books from the start. We delineate your services cleanly and make sure you neither build up risks nor give away room for structuring.
- Delineating VAT-exempt medical treatments (sec. 4 no. 14 German VAT Act) from taxable services
- VAT classification of self-pay services, expert reports, aesthetic treatments and lectures
- Review and monitoring of the small business exemption for taxable revenue
- Clean separation of revenue accounts as the basis of audit-proof books
- Assessment of proportional input tax deduction for mixed revenue
- Advance VAT returns and annual returns where required
- Support during special VAT audits
Annual accounts, tax returns & practice succession
At year-end all threads come together: we prepare your cash-basis accounts or annual accounts on time, handle all tax returns and keep the practice owners' private affairs in view.
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And as the handover of the practice approaches, we plan the transition early – thought through for tax, from valuation to the reliefs on the capital gain.
- Cash-basis accounts (sec. 4 (3) German Income Tax Act) or annual accounts – depending on the practice form
- Separate and uniform profit determination filings for joint practices
- All business tax returns plus the owners' private income tax returns
- Tax planning of investments, depreciation and investment deductions
- Early tax design of the practice sale or handover
- Use of the reliefs for capital gains (allowance and reduced rate, secs. 16, 34 German Income Tax Act)
- Support during tax audits – from the audit order to the final meeting
Our understanding
The medical professions deserve advice that knows their particularities – from profit determination to practice succession.
What you may measure us by.
Industry-savvy.
Health insurance billing, private billing, the German medical and dental fee schedules, the typical KPIs of a practice – to us not jargon but daily practice. That is how we spot anomalies before they become problems.
Forward-looking.
The most important courses are set at formation, cooperation, investment and handover – not in the tax return. We think these steps through early and approach you when windows for action open.
Relieving.
You look after your patients, we look after deadlines and formal requirements. Bookkeeping, payroll and taxes run digitally and reliably – and we get in touch before anything is due.
The challenge
Hardly any profession combines so many special rules.
Protecting freelance status.
Medical practice is exempt from trade tax – but the privilege is fragile: product sales, ancillary services or insufficiently supervised employed colleagues can 'infect' income commercially, and in a joint practice the income of the entire partnership. These lines must be watched continuously – before the tax authorities draw them.
VAT in healthcare.
Medical treatments are VAT-exempt (sec. 4 no. 14 German VAT Act) – but only with a therapeutic aim. Self-pay services (IGeL), expert reports or aesthetic treatments without indication can be taxable. The delineation belongs in the day-to-day books, not first in the tax audit.
Structures in transition.
Solo practice, cost-sharing group, joint practice or medical care centre – each form has its own tax consequences, from profit distribution and practice value to the handover. Such courses should be set before contracts are signed – coordinated with your legal advisors.
Contact
Let's talk about your practice.
We see every engagement as a long-term relationship – and it begins with a personal conversation. Describe your matter and we will take the time to understand it before we discuss next steps together.