Accounting for Doctors and Dentists in Poland

Accounting for Doctors and Dentists - A Complete Guide

Doctors and dentists running a private practice must combine medical competence with knowledge of tax and accounting regulations. The specifics of the healthcare sector - from VAT exemptions to special registration requirements - make accounting in this field significantly different from other industries. This guide covers all the essential topics.

Forms of Running a Private Medical Practice

A doctor in Poland can run a practice in several ways:

Individual Medical Practice

The simplest form - a sole proprietorship registered in CEIDG and the Register of Entities Performing Medical Activities (RPWDL). Requirements include: the right to practice medicine, registration with the regional medical chamber, professional liability insurance, and meeting sanitary and facility requirements (if you operate a clinic).

Individual Practice Exclusively at Patient Location

Does not require a clinic. The doctor provides services at the patient's location or at healthcare facilities under a contract.

Individual Practice Exclusively at a Healthcare Facility

The most popular form for doctors working on B2B contracts at hospitals and clinics. Does not require your own office - you provide services at the facility with which you have a contract.

Group Medical Practice

Several doctors can establish a civil, general, or professional partnership to run a practice together. Professional partnerships (spolka partnerska) are particularly popular as they limit liability for other partners' medical errors.

Choosing a Tax Form

Flat Tax at 19%

The most commonly chosen by doctors. A fixed rate regardless of income level. At typical specialist doctor earnings (15,000 - 40,000 PLN monthly on a contract), flat tax is usually more advantageous than the progressive scale.

You maintain a KPiR (Revenue and Expense Ledger) or, at larger scale, full accounting books.

Lump Sum Tax (Ryczalt)

Doctors may use the lump sum at a 14% rate for healthcare services (PKWiU section 86). Lump sum is cost-effective when practice expenses are low - for example, when practicing exclusively at a healthcare facility where you do not bear clinic maintenance costs.

On lump sum, you cannot deduct business expenses, but the health insurance contribution is fixed and often lower than on flat tax.

Compare different tax forms using our calculators.

Progressive Tax Scale (12% and 32%)

Less commonly chosen by doctors due to tax progression. It can be advantageous early in a career, at lower income levels, or when a spouse does not work.

VAT in Medical Services

Subject-Matter VAT Exemption

Medical care services aimed at prevention, preservation, rescue, restoration, and improvement of health are exempt from VAT under Article 43(1)(18-19) of the VAT Act. This applies to both doctors and dentists.

The exemption covers:

Medical and specialist consultations
Therapeutic and diagnostic procedures
Dental services of a therapeutic nature
Medical care under hospital contracts

Services Not Covered by the Exemption

Not all services provided by doctors are VAT-exempt. Subject to the 23% rate are:

Aesthetic medicine services (unrelated to treatment)
Issuing medical certificates on request (e.g., for driving licenses, firearms permits)
Expert witness services
Training and lectures

If you provide both exempt and taxable services, you must maintain separate records. When taxable services exceed 200,000 PLN annually, you register as an active VAT taxpayer.

Dentists and VAT

Dentists must be particularly careful when classifying services. Cavity treatment, root canals, and extractions are VAT-exempt. However, teeth whitening, purely aesthetic porcelain veneers, and smile corrections unrelated to treatment may be subject to taxation. Documenting the medical purpose of each procedure is critical.

Deductible Business Costs

Medical Office

If you run your own office, deductible costs include:

Premises rental and utilities (electricity, water, heating)
Office equipment (dental chair, dental unit, diagnostic equipment)
Disinfectants, gloves, disposable materials
Medical equipment (depreciation for items over 10,000 PLN)
Premises insurance and professional liability insurance

Professional Costs

Medical chamber dues (mandatory)
Professional liability insurance (mandatory for practices)
Specialization training and courses
Medical conferences and scientific congresses
Medical journals and knowledge database access
Medical clothing (lab coats, footwear)

Vehicle in Medical Practice

A doctor traveling to patients or between facilities can settle vehicle costs:

Company car - depreciation, fuel, repairs, insurance
Private car used for business - 75% of operating costs (without mileage log) or 100% (with mileage log)

Medical Equipment - Depreciation

Expensive medical equipment (CT scanner, dental unit, laser) is depreciated over time:

Computers and electronic devices - 30% annual rate
Medical equipment - 20% annual rate
Furniture and office fittings - 20% annual rate
Vehicles - 20% annual rate

Equipment worth up to 10,000 PLN can be expensed in full immediately.

ZUS Contributions for Contract Doctors

B2B Contracts and ZUS

A doctor on a contract runs a business and pays full ZUS contributions. The stages are the same as for other entrepreneurs: startup relief (6 months), preferential ZUS (24 months), then full ZUS.

Doctor Employed and on Contract Simultaneously

Many doctors combine hospital employment with a B2B contract at another facility. If you earn at least minimum wage on the employment contract, you only pay the health insurance contribution from your business. This represents significant savings.

Health Insurance Contribution

The health insurance amount depends on your tax form:

Flat tax: 4.9% of income
Lump sum: fixed amount depending on revenue
Progressive scale: 9% of income

Fiscal Cash Register in the Office

Cash Register Obligation

Doctors and dentists providing services to individual patients (private patients) are required to record sales on a fiscal cash register. Medical services are listed in the regulation as excluded from the cash register exemption - regardless of turnover amount.

This obligation applies only to sales to individual patients. B2B contracts with hospitals and clinics are documented with invoices, and a cash register is not required.

Online Fiscal Cash Register

Since 2021, doctors and dentists must use online fiscal cash registers that transmit data to the Central Register of Cash Registers (CRK).

Medical Documentation and Accounting

Medical and accounting documentation are two separate obligations, but they must be consistent. Every private patient visit should be reflected both in medical records and in revenue records (invoice or fiscal receipt).

Medical documentation must be retained for 20 years from the last entry. Accounting documentation must be kept for 5 years from the end of the year in which the tax payment deadline fell.

Industry Regulations Affecting Accounting

RPWDL Registration

Every medical practice must be registered in the Register of Entities Performing Medical Activities. The registration fee and updates are deductible business expenses.

Professional Liability Insurance

Mandatory professional liability insurance is a tax-deductible cost. The minimum guaranteed sum is 75,000 EUR per event and 350,000 EUR for all events during the insurance period.

Costs of implementing and maintaining the personal data protection system (software, training, data protection officer) are deductible business expenses.

Summary

Accounting for doctors and dentists has its unique characteristics - VAT exemption for therapeutic services, mandatory online fiscal cash registers, and special registration requirements. The choice of tax form (flat tax or 14% lump sum) should consider your individual situation - the scale of costs, practice form, and additional income sources. Working with an accounting firm familiar with the healthcare sector is advisable, as they can help correctly classify services for VAT purposes and optimize your tax burden.