GP and dental practices. You care for patients, we take care of the figures.
For GPs, locum GPs, dentists, orthodontists and dental hygienists, from sole practitioner to a practice with 25 people. Registration fees, patients who pay themselves, goodwill on a takeover and staff with or without a cao: Alvelion handles the accounting around it.
Request an introductory meetingWhat does a GP assistant cost? Work it outWhat matters in a GP or dental practice?
A GP practice receives a fixed amount per registered patient every quarter, plus consultations. A dental practice lives mainly on patients who pay themselves. Those are two very different money flows.
At the Chamber of Commerce, GPs and locum GPs are registered under SBI code 86.21.0, dentists and orthodontists under 86.23.0. Dental hygienists and denturists are under 86.99.3.
According to Statistics Netherlands, there were more than 15,000 GP businesses and almost 10,700 dental businesses on 1 October 2026. Among dentists, one in four is a legal entity, such as a BV. Among GPs, it is fewer than one in ten. If you take over or expand a practice, you deal with goodwill, staff and the choice between a partnership and a BV. That is where we help.
Where things go wrong in GP and dental practices
Do you recognise one of these situations? Then your accounting needs attention.
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A permanent locum, in the same practice for years
The LHV sees the permanent locum disappearing. If a locum works in the same practice for years, to your rota and your way of working, it looks more like employment. The model agreement for long-term locum work only helps if you also work as it describes.
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An emergency cover fee without VAT
Do dental practices pay each other a fee for being available for emergency cover? According to the Arnhem-Leeuwarden Court of Appeal (2025), that fee is subject to VAT. Only the treatment of the patient itself is exempt.
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Dental assistants without a pension
There has been no cao for dental assistants for almost twenty years. Even so, you must register them with the PFZW pension fund. That obligation is separate from any cao.
With your accounting in order, you know what your practice brings in per patient, what is still outstanding and what you set aside for tax.
Together or alone, locum or your own practice
Partnership or BV
How do you share the practice with colleagues?
In a partnership, each partner is a business owner, with the self-employed deduction and their own income tax return. In a BV, you receive a salary as DGA and the BV pays corporate income tax. The healthcare exemption does not work for a practice owned by doctors. GPs build up pension with the compulsory SPH fund in both forms.
Locum or your own practice
Do you keep working as a locum or take over a practice?
As a locum you work without practice costs and with less risk. Your own practice gives a fixed income per registered patient, but requires staff, premises and often goodwill. The LHV sees more GPs choosing employment or a partnership.
We work out both choices with your own figures, also for a dental practice that wants to move from sole proprietorship to BV.
How Alvelion handles the figures of your practice
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Getting to know you and setting up
We look at how your practice receives money: registration fees, consultations, integrated care or invoices to patients. We set up your accounting accordingly, with medical examinations and other taxable services kept separate.
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Keeping up to date
Claims, invoices, purchases and bank are processed continuously. Every month you see what has come in and what is still outstanding with insurers and patients.
Every month
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Payroll and tax returns
The payslips of assistants and practice nurses, with the right cao and the right pension fund, and your tax returns go out on time.
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Looking ahead
Taking over a practice, a new partner or a second chair? We work out in advance what it costs, how you pay for it and what it brings in.
You work with one dedicated contact who knows your practice, not a changing team or a general helpdesk.
Where Alvelion helps your practice
Claims and patient invoices in the books
Registration fees, consultations, integrated care and invoices to patients are processed continuously, with revenue in the right month.
Go to online bookkeepingStaff with and without a cao
In a GP practice the GP care cao applies, even if you are a sole proprietor. In dental care there is no cao. We process wages and pension correctly.
Go to payroll administrationPractice takeover and goodwill
What is the practice worth, how do you finance the takeover and what is left after interest and repayments? We work it out in advance.
Go to acquisitions and business transferVAT on examinations and emergency cover
Medical examinations, reports and treatments without a therapeutic purpose are subject to VAT. We keep them separate and file the VAT return.
Go to tax advicePartnership, BV and holding company
A partnership with colleagues, a practice BV or a holding company on top. We set up the structure properly, with agreements on partners joining and leaving.
Go to structure and controlAnnual accounts and annual reporting
Your annual accounts, the tax returns and the annual reporting in DigiMV, in time for 31 May.
Go to annual accountsCalculators and cao
What does an employee cost in your practice?
Make an employment contract, look up a salary or write a letter with the GP care cao tools. Work out what a doctor's assistant or practice nurse costs, with pension and holiday pay. If you have a dental practice, you calculate without a cao, using the statutory rules. In doubt between a sole proprietorship and a BV, or already have a BV? Also work out what you keep net.
Go to the GP care cao toolsYou buy a practice in one go. You write off the goodwill over at least ten years.
Your practice and your figures with one team
Knows the rules in healthcare
NZa tariffs, VAT exemption, locum work, the GP care cao and PFZW: we know the rules that apply to GP and dental practices.
Wages straight into your figures
Payroll and bookkeeping run side by side. That way you see every month what an assistant or practice nurse really costs you.
One contact
Bookkeeping, payroll and advice with the same dedicated team.
Frequently asked questions
Yes, there is no legal ban. The old ban disappeared in 2006 with the introduction of the Health Insurance Act. The LHV does oppose goodwill for GP practices. For a dispensing practice, goodwill for the pharmacy part is common. In dental care, the NZa does not include goodwill in the tariffs. So you earn it back from your own profit. For tax purposes you write off goodwill at no more than 10% a year.
That depends on how you really work. The LHV has a model agreement for long-term locum work that the Tax Administration has assessed. You may use it until the end of 2029, but only if you also work as it describes. The practice owner may say what you do, not how you do it. In 2023 a court ruled that a locum GP was not an employee: there was a separate agreement each time and the rate was agreed each time.
The GP care cao. It runs from 1 July 2025 to 30 June 2027 and is generally binding. It also applies to a GP with a sole proprietorship who employs an assistant or practice nurse. The pension runs through PFZW. There is a separate cao for salaried GPs. Under the negotiated agreement of July 2026, those wages rise by 3.5% on 1 August 2026 and by 4% on 1 January 2027.
No, not for almost twenty years. The KNMT's old employment terms scheme was withdrawn because the ACM found it legally untenable. So you agree the terms of employment yourself, within the statutory rules. Pension is compulsory, though: you register dental assistants and senior dental assistants with PFZW. You may join your other employees voluntarily.
For services without a therapeutic purpose. Examples from the Tax Administration: medical certificates, driving licence examinations, liability reports and a mouthguard. The fee between dental practices for emergency cover is also subject to VAT. If you hire a self-employed GP assistant or practice nurse, they often do charge VAT. As an exempt practice, you cannot reclaim that VAT.
On 30 June 2026 the NZa set new tariffs, backdated to 1 January 2026. Together, the basic services are 6.1% higher than in 2025. Registration for a patient under 65 is now €21.94 per quarter, a consultation of 5 to 20 minutes €13.40. So you are still owed a difference for the first half of 2026. How it is settled depends on your insurer. We make sure it is in your figures.
For children under 18, check-ups and treatment. For adults, only surgical dental care and X-rays. So most adults pay themselves or through supplementary insurance. The NZa sets maximum tariffs, and insurers hardly ever sign contracts. For your practice that means many invoices to patients and therefore good debtor management.
Since 2025, almost every practice with staff that provides care under basic health insurance needs a Wtza licence. A sole practitioner in a sole proprietorship does not. If you already provided care before 2025, you received the licence by operation of law, but you must meet the requirements. If your Chamber of Commerce number changes, for example with a new BV, you are a new care provider. If your dental practice mainly treats adults who pay themselves, have it checked whether the obligation applies to you.
Knowledge for your trade
All articles on GP and dental practicesReady to grow your practice further?
Tell us how your practice runs now. We deliberately work with a limited number of clients. That is why we first look together at whether we are a good fit. You'll hear back within one working day.
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