Accounting for physicians in Quebec

By the JeanKali Santé Comptabilité team · Updated October 27, 2026 · 10-min read

The 2026 guide, and an accountant for physicians who handles it all

What an accountant for physicians does in Quebec

A physician's books aren't those of an ordinary small business. Most income comes from a public payer, RAMQ, under agreements negotiated by your federation; you often pay overhead to a clinic; and you may practise alone, in a group or through a professional corporation governed by a Collège regulation. In practice, we handle:

• bookkeeping: RAMQ and non-RAMQ income, clinic overhead and practice expenses, as often as suits you;
• reconciling RAMQ statements with the deposits received, so your income is complete and accurate;
• your personal T1 (federal) and TP-1 (Quebec) returns and, if you're incorporated, the corporation's financial statements and T2 and CO-17 returns;
• payroll for you and your staff, T4 and RL-1 slips, or T5 and RL-3 slips for dividends;
• a yearly pay plan and an estimate of the tax to set aside, so April holds no surprises;
• coordinating your incorporation if it pays off: a partner notary or lawyer prepares the legal documents, and we handle the rest of the file.

How RAMQ pays you, and what it means for your books

Physicians' fees and payment methods are set by agreements between the government and the federations: the FMOQ for family physicians and the FMSQ for specialists. RAMQ applies those agreements and makes the payments, with a statement of account. Depending on your practice, your pay can combine fee-for-service, flat fees, hourly rates and premiums.

The framework is changing. In August 2026, the FMOQ and the Quebec government reached an agreement on a new payment model for primary care. According to the FMOQ, it isn't operational yet: the amounts still have to be set and RAMQ has to adapt its systems. For your books, the essentials stay the same: each payment must be matched to its statement, and the gap between what was billed, paid and refused must be tracked.

If you're incorporated, RAMQ pays your fees to the corporation through a collective administrative account opened with form 4552; RAMQ indicates 4 to 6 weeks of processing (ramq.gouv.qc.ca). Non-RAMQ income (expert opinions, reports, teaching, non-insured services, work for an organization) is tracked separately, because its tax and sales tax treatment can differ. Billing agency fees, if any, are a practice expense.

Self-employed or incorporated: two different sets of books

A physician who isn't incorporated reports practice income as self-employment income on the personal return. No tax is withheld from fees: you pay the tax yourself, both shares of QPP contributions and, past a certain amount of tax, instalments.

An incorporated physician practises through a business corporation that meets the Collège's regulation on practising within a company: voting rights are held by physicians, directors are physicians, and the Collège must authorize the corporation ($500 per physician, about 14 business days, according to the Collège des médecins). The corporation has its own books, bank account and T2 and CO-17 returns, and pays you a salary or dividends. The legal documents (articles, resolutions, minute book) are prepared by a notary or lawyer; our role is to advise you, run the numbers and coordinate the file.

Incorporating usually pays off when your income clearly and consistently exceeds your personal needs, because the main benefit is deferring tax on what you leave in the corporation. Our Incorporation page and our guide to physician incorporation in Quebec cover the rules, steps and fees.

Corporate tax rates in 2026

Federally, the net rate is 9% on income eligible for the small business deduction (SBD) and 15% on general business income (CRA). In Quebec, the general rate is 11.5%; Quebec's SBD lowers it to 3.2%, then to 2.2% for taxation years that begin after April 29, 2026 (Revenu Québec).

Two points matter for physicians. First, Quebec's SBD requires at least 5,500 paid hours in the year; it shrinks between 5,500 and 5,000 hours and disappears below that. A physician alone in a corporation with no employees often doesn't qualify in Quebec, while keeping the federal SBD. Second, the $500,000 limit shrinks when the corporation and its associated corporations earn more than $50,000 of passive investment income, and it disappears at $150,000 (CRA). Investing surpluses inside the corporation needs a plan from the start.

Salary or dividends: how to pay yourself

Salary is deductible for the corporation, creates RRSP room (18% of earned income, up to $33,810 for 2026, according to the CRA) and triggers QPP contributions, which increase your retirement pension. It also means payroll, source deductions and T4 and RL-1 slips.

Dividends aren't deductible for the corporation and create neither RRSP room nor QPP contributions, but they're taxed at a lower personal rate thanks to the dividend tax credit, and the paperwork is simpler (T5 and RL-3 slips). Dividends paid to family members are sharply limited by the tax on split income rules, in force since 2018 (CRA).

Most incorporated physicians use both. The right mix depends on your needs, your plans (a home, retirement, parental leave), whether you qualify for Quebec's SBD and what should stay in the corporation. We review it with you every year, before year-end.

GST and QST: most of your services are exempt

Health services provided by a physician for health purposes are exempt from GST and QST. An often-missed consequence: since you don't collect tax, you generally can't recover the tax you pay on expenses (no input tax credits or refunds). It's part of your costs.

Some services are taxable, though, including examinations, reports and certificates made solely for non-health purposes, for example for an insurer, an employer or a lawsuit, according to the CRA, and cosmetic services that aren't medically necessary. As long as your taxable sales don't exceed $30,000 over four consecutive quarters (or in a single quarter), you're a small supplier and don't have to register (CRA). Past that, you must register and collect the taxes. We track that threshold for you.

Expenses you can deduct

An expense is deductible if it's incurred to earn practice income and is reasonable. The ones we see most often for physicians:

• clinic overhead or cost-sharing fees, and office rent;
• Collège dues and your federation or association dues;
• professional liability coverage (CMPA or a private insurer), taking any reimbursement you receive into account [treatment to confirm for your situation];
• continuing education and conventions (the law limits the deduction to two conventions a year);
• medical equipment, computers and software, depreciated under the capital cost allowance classes;
• phone and internet, for the business portion;
• vehicle costs for travel between practice locations, backed by a mileage log;
• a home office, if it meets the CRA and Revenu Québec conditions;
• billing fees, business bank fees and accounting fees;
• meals and entertainment, generally 50% deductible.

Personal expenses aren't deductible, even if the corporation pays them. Keep your receipts for at least six years: our secure portal stores them for you.

Residents and new physicians

During residency, you're an employee: the institution withholds tax, and that salary generally can't be paid to a corporation. It's the time to claim credits for eligible student loan interest, save your RRSP room for years when your tax rate will be higher, and prepare for what comes next.

The first year of independent practice is the year of surprises: no tax is withheld from your fees, and the full balance comes due the following spring. In Quebec, instalments become required when your net tax owing is more than $1,800 for the year and for one of the two previous years (CRA). If incorporating makes sense, start a few months before residency ends, to allow for the Collège and RAMQ lead times. Our guide for medical residents covers each step.

A physician's tax calendar

• March 15, June 15, September 15 and December 15: personal tax instalments, if required.
• End of February: T4 and RL-1 (salary) and T5 and RL-3 (dividend) slips for the previous year.
• April 30: personal tax balance due; June 15: filing deadline for the T1 and TP-1 of self-employed people and their spouse.
• 2 or 3 months after the corporation's year-end: corporate tax balance due (3 months for an eligible Canadian-controlled private corporation, according to the CRA).
• 6 months after year-end: T2 and CO-17 filing (CRA).
• Every year: annual update with the Registraire des entreprises and annual declaration to the Collège.

Day-to-day bookkeeping

Good physician bookkeeping comes down to a few habits: a bank account and credit card used only for the practice (required for a corporation), RAMQ statements and invoices uploaded to the portal every month, and a monthly or quarterly reconciliation. You see your real income, the tax to plan for and what can stay in the corporation, without waiting for year-end. Everything is done remotely, by video or phone, in English or French.

What does an accountant for physicians cost?

The price depends mostly on four things: do you have a corporation (and a holding company)? How many transactions a month? Do you have staff to pay? Are your books already up to date? A non-incorporated physician with few expenses doesn't have the same needs as an incorporated physician who employs an assistant.

At JeanKali Santé Comptabilité, incorporated physicians retain our annual Incorporated Professional package: bookkeeping, financial statements, T2 and CO-17, your T1 and TP-1, slips and a pay plan. The price is given to you in writing after the free call, before any commitment, with what it includes and what it doesn't. The fractional CFO for clinics is a separate service, published at about $1,500, $3,000 or from $5,000 a month depending on the level, plus taxes (details).

Free incorporation, start-up fees included, plus a business plan for your bank if you're opening your practice or clinic, in return for a 12-month engagement to the annual package. Full terms

How to choose an accountant as a physician

• They know RAMQ, the payment agreements and the Collège's rules on practising through a corporation.
• They prepare your personal and corporate returns together, for a single picture.
• They tell you plainly when incorporating isn't worth it.
• Their price is in writing, with what's included.
• They protect your information: secure portal, no SIN or banking details by email, a policy that complies with Quebec's Law 25.
• They answer in your language, and you can switch accountants at any time of year.

Frequently asked questions

General information only, not advice. This content is not tax, legal or accounting advice; your situation needs an individual review. Free incorporation, start-up fees included, plus a business plan for your bank if you're opening your practice or clinic, in return for a 12-month engagement to the annual package. Full terms