Which tax regime for doctors who set up a PJ

Doctors are among the independent professionals who benefit most from setting up a company. Tax savings can exceed R$ 40,000 per year when the regime is chosen correctly. Vivian Sampaio explains the variables that define the best option.

Why are doctors setting up PJ companies?

The answer lies in the tax burden on income received as an individual. When a doctor is paid through an RPA (self-employed payment receipt), the payer withholds 11% of IRRF on the amount. On an annual basis, the progressive IRPF table can push the rate up to 27.5% on the highest earnings.

As an incorporated professional (PJ), the doctor pays tax on revenue — not on individual income. Under Simples Nacional (simplified tax regime), the effective rate on medical services ranges between 15.5% and 22.5% depending on the “fator r” (the ratio between payroll and revenue). Under Lucro Presumido (presumed-profit regime), the burden is roughly 11.2% of revenue, with no 11% withholding at source.

Tax advantages of incorporation for doctors

ISS as an operating cost: the service tax can be deducted as an expense.
Pró-labore as the INSS base: the doctor-partner sets their pró-labore (owner’s salary) and pays INSS on it — generally lower than contributing as a self-employed worker.
Profit distribution exempt from income tax: under Lucro Presumido, distributing profits to the partner after paying IRPJ and CSLL is free of income tax withholding.
Broad deductions: expenses on equipment, continuing education and clinic infrastructure can be deducted.

Tax planning: real annual savings

Example: a doctor billing R$ 60,000 per month (R$ 720,000 per year).

Receiving income as an individual (11% IRRF at source + annual IRPF):

IRRF withheld: ~R$ 79,200
IRPF due on annual reconciliation: ~R$ 35,000 to R$ 50,000 depending on deductions
Approximate total: R$ 114,000 to R$ 130,000

As a PJ under Simples Nacional (fator r > 28%):

Simplified taxation: ~16% on R$ 720,000 = ~R$ 115,200

As a PJ under Lucro Presumido:

IRPJ (15% on 32% of the base): R$ 34,560
CSLL (9% on 32% of the base): R$ 20,736
ISS (varies by municipality, ~5%): R$ 36,000
Approximate total: R$ 91,296 + ISS

The concrete difference appears when the doctor weighs pró-labore + profit distribution vs. payment via RPA. Planning, done annually, is what identifies the best configuration.

Comparison: Simples Nacional vs Lucro Presumido for doctors

Practical tax calculation under each regime

Simples Nacional — Medical services (Annex III or IV, depending on configuration)

The fator r is decisive: if payroll (pró-labore + any employees) is below 28% of revenue, the doctor falls under Annex III with higher rates. Above 28%, they fall under Annex IV with a heavier tax burden on services.

Lucro Presumido — Medical services

Calculation base = 32% of gross revenue.

IRPJ: 15% of the base = 4.8% of revenue
CSLL: 9% of the base = 2.88% of revenue
ISS: separate, per the municipal rate (2% to 5%)
Approximate total: 11.2% + ISS

Revenue range where each regime is worth more

Simples Nacional: recommended up to monthly revenue of R$ 60,000, when the fator r is favorable.
Lucro Presumido: more advantageous from R$ 60,000/month when the fator r does not exceed 28% under Simples.
Lucro Real (actual-profit regime): rare for self-employed professionals; it generally requires high documented deductible expenses.

Mandatory contributions for the PJ doctor

INSS, IRPF, municipal ISS

The PJ doctor must pay:

GPS (Social Security Guide): on the defined pró-labore, at a rate of 11% (partner’s INSS) or 20% (for those who opt for the standard regime).
IRPJ and CSLL: per the chosen regime (Simples or Lucro Presumido).
ISS: a municipal payment, usually monthly, at a rate set by the city where the clinic is located.

Ancillary obligations: SPED, ECF, ECD

SPED Fiscal: a monthly obligation to transmit tax ledgers to SEFAZ.
ECF (Tax Accounting Bookkeeping): annual, for companies under Lucro Real or Lucro Presumido with equity above R$ 4.8 million.
ECD (Digital Accounting Bookkeeping): annual, for companies required to keep full accounting records.
RAIS: an annual declaration of employee information (when there are employees).

Frequently asked questions

Can a doctor issue clinic invoices?

Yes. The doctor issues an NFSe (Electronic Service Invoice) through the city hall of the municipality where the clinic is based. The NFSe replaces the receipt and is the valid document for proving revenue. Many health plans and hospitals also require an NFSe to process payments.

Which CNAE code to use for a medical clinic?

The most common CNAE codes for medical activity are:

86.30-5: Outpatient medical activity (consultations and procedures)
86.40-2: Assisted reproduction clinic activity
86.50-0: Activity of other health professionals (specialties)

The choice depends on the specialty and the procedures actually performed.

How much does a doctor save per year with planning?

It depends on revenue. In cases documented by Vivian Sampaio, the annual savings from changing regimes and planning pró-labore/profit distribution range between R$ 30,000 and R$ 120,000 per year for revenues of R$ 50,000 to R$ 150,000 per month. The exact figure only emerges after a detailed analysis.

How to start tax planning

The first step is to consult an accountant who specializes in healthcare professionals — not a generic accountant. The complexity of the fator r, the correct CNAE and the ancillary obligations requires specific knowledge.

For doctors who already have a CNPJ (company tax ID), the analysis should begin by reviewing the previous year’s fator r. If the payroll/revenue ratio came in below 28%, Simples Nacional may have charged more than necessary — and the accountant can assess filing a refund request.

This kind of numbers-based comparison is what defines the editorial line of the Naprática hub: explaining tax regimes as a cash-flow decision — not as technical jargon — so the professional can assess the impact before signing any incorporation contract.

If you are still setting up your company, the choice of regime and initial pró-labore already sets the path. Talk to the VMAHUB team for a personalized analysis.

For other independent professionals, the path is similar. See how to set up a company as an independent professional and understand the basic rules that apply to all activities.

And if your question is how to pay less tax legally, check out this article on tax planning.

For independent professionals just starting out, it is important to understand how to set up a company as an independent professional before choosing a regime.

For independent professionals setting up a company now, check out the full step-by-step guide — the tax regime is one of the first decisions.