If you work as a medical specialist through your own company (bv), you are an owner-director (dga). You pay yourself a salary at least equal to the salary of the most comparable salaried job, and in 2026 at least € 58,000. The company pays corporate income tax on the remaining profit. If the company pays a dividend, you pay box 2 tax.
An owner-director (dga) is someone who holds at least 5% of the shares and works for the company. Box 2 is the part of income tax for income from such a substantial interest, such as dividends.
In short
- In 2026 the customary salary is at least the highest of: the salary from the most comparable employment, the salary of the best-paid employee, or € 58,000.
- The company pays 19% corporate income tax up to € 200,000 of profit and 25.8% above that. Dividends fall in box 2: 24.5% up to € 68,843 and 31% above (2026).
- As an owner-director you are a compulsory member of SPMS. According to the CIBG, a company providing medical specialist care needs a Wtza licence. A new Chamber of Commerce number may mean a new licence.
In this article
- What is a personal practice company alongside the MSB?
- What salary must you pay yourself from the company?
- How is the profit in the company taxed?
- What happens to your pension with SPMS?
- Does your practice company need a Wtza licence?
- When is a company more advantageous than being an entrepreneur in the partnership?
What is a personal practice company alongside the MSB?
A personal practice company is a company in which a medical specialist places their own practice. The company makes the arrangements with the MSB and receives the fee. The specialist works for their own company as an employee. There is often a holding company above it, a company that holds the shares.
The MSB is the medical specialist enterprise in which a hospital's independent specialists work together. In a cooperative, the specialists or their companies are members. Whether you are an entrepreneur in the MSB or work through a company has major consequences for your tax.
What salary must you pay yourself from the company?
As an owner-director you must receive a customary salary: a salary that is normal for the level and duration of your work. In 2026 this is at least the highest of three amounts: the salary from the most comparable employment, the salary of the highest-earning employee of the company or an affiliated company, and € 58,000 (Belastingdienst, Salary and substantial interest (in Dutch)).
For a medical specialist, the most comparable employment is that of a salaried specialist. What amount that is depends on your specialty and your work. A lower salary is only allowed if you can make it plausible that others earn less for the most comparable work (Belastingdienst).
Many owner-directors choose a salary exactly at the limit. Research using Dutch tax data for 2007 to 2011 showed that the salary of owners of small companies peaks sharply at the minimum of the rule (Bettendorf, Lejour and Van 't Riet, 2017). How the rule works for an adviser is explained in sole proprietorship or company as an adviser: what salary do you pay yourself. You can work out the salary with the owner-director salary calculator.
How is the profit in the company taxed?
The company pays corporate income tax on the profit after your salary. In 2026 this is 19% on the first € 200,000 and 25.8% above that (Belastingdienst, Corporate income tax rates (in Dutch)).
If the company pays a dividend, you pay 24.5% in box 2 up to € 68,843 and 31% above that (Belastingdienst, Box 2: explanation and rates (in Dutch)). If you leave the profit in the company, for now you only pay corporate income tax.
For comparison: salary in box 1 above € 78,426 is taxed at 49.50% in 2026 (Belastingdienst, Box 1 (in Dutch)). Because of that difference, a company can pay off at a high income. The benefit depends on how much you take out and when. Work it out with the salary or dividend calculator.
The 2027 Tax Plan contains proposals for entrepreneurs that have not yet been adopted as at 1 November 2026. The House of Representatives votes on 12 November 2026. So for 2027, calculate with the law as it is then adopted (2027 Tax Plan bill).
What happens to your pension with SPMS?
As an owner-director you are a compulsory member of SPMS, the pension fund for medical specialists. SPMS explains that as an owner-director you are employed by your own company and count as an employee for tax purposes. You build up pension on your gross salary from the company, excluding the SPMS premium (SPMS, Explanation of pension accrual 2025 for employees and owner-directors (in Dutch)).
Note the difference with the customary salary. If you deduct the pension premium privately, the tax authority calculates the customary salary including the premium. To SPMS you report the salary without the premium (SPMS). So a low owner-director salary also means less pension accrual.
Does your practice company need a Wtza licence?
According to the CIBG, yes. Self-employed professionals are not subject to the licensing requirement, but "a self-employed professional with a company (or other legal entity) providing medical specialist care does need a licence" (Toetreding zorgaanbieders, self-employed (in Dutch)). A legal entity can never be a self-employed professional.
The CIBG also mentions an exception for subcontractors, except in the case of an empty shell (Toetreding zorgaanbieders, Licensing (in Dutch)). If your company works as a subcontractor within the MSB, use the CIBG's licensing check to see which rule applies to you. The two CIBG texts do not point the same way here.
If you set up a new company or your Chamber of Commerce number changes, the CIBG regards you as a new provider and you may need to apply for a new licence. The application costs € 725 and the decision period is in principle 8 weeks (Toetreding zorgaanbieders, Applying for a licence (in Dutch)). So start well before the launch.
When is a company more advantageous than being an entrepreneur in the partnership?
A company pays off mainly if you can leave part of the profit in it. If you use all your profit privately, the benefit is smaller, because box 2 tax follows corporate income tax. As an entrepreneur in a partnership you do get the € 1,200 self-employed deduction and the 12.7% SME profit exemption (2026), but no corporate income tax (2027 Tax Plan bill, table of 2026 income tax parameters).
The choice of a company also depends on the MSB. The MSB's arrangements determine whether your company can become a member and how the fee flows. The steps for converting are explained in converting a sole proprietorship into a company: when does it pay off.
Distributing profit from healthcare may get new rules. Through the Integrity of Healthcare and Youth Care Providers Act (Wibz), the government wants all providers in insured care to be allowed to distribute profit under strict conditions, with a cap as a percentage of invested capital (Government of the Netherlands, 3 July 2026). That is a proposal. How high the cap will be and when the law takes effect is not known.
Sources
- Belastingdienst, Salary and substantial interest (in Dutch), accessed 1 November 2026. belastingdienst.nl
- Belastingdienst, Corporate income tax rates (in Dutch), accessed 1 November 2026. belastingdienst.nl
- Belastingdienst, Box 2: explanation and rates (in Dutch), accessed 1 November 2026. belastingdienst.nl
- Belastingdienst, Box 1, 2026 rates (in Dutch), accessed 1 November 2026. belastingdienst.nl
- SPMS, Explanation of pension accrual 2025, employee and owner-director (in Dutch). spms.nl
- CIBG, Healthcare provider admission: self-employed, Licensing and Applying for a licence (in Dutch), accessed 1 November 2026. toetredingzorgaanbieders.nl
- 2027 Tax Plan bill, 15 September 2026 (in Dutch). rijksoverheid.nl
- Government of the Netherlands, Government tightens rules on profit distributions and business operations in healthcare (in Dutch), 3 July 2026. rijksoverheid.nl
- Bettendorf, L., Lejour, A. & Van 't Riet, M. (2017). Tax bunching by owners of small corporations. De Economist, 165(4), 411-438. doi.org