Medical Practice and Contractual Physician Admission

1. General Information on Contractual Physician Admission

The admission to participate in outpatient care in the healthcare system – the so-called contractual physician admission – is a public-law authorization. It entitles and obligates a physician to treat patients covered by statutory health insurance under statutory conditions. The regulations for this are found in §§ 95 ff. of the Fifth Book of the Social Code (SGB V) as well as in the Federal Framework Agreement – Physicians and the corresponding admission regulations. The admission is tied to a specific practice location and is a prerequisite for the exercise of medical activities. When taking over a practice in an oversupplied planning area, a separate approval procedure is required. When practices are sold, the admission can be advertised by applying to the Association of Statutory Health Insurance Physicians, which may allow the buyer to obtain the admission, even in oversupplied areas.

2. Tax Implications of Acquiring a Practice

2.1 Tax Treatment of Acquiring a Practice Value

When acquiring a medical practice, a price is usually paid for the practice value. This value includes tangible and intangible assets as well as the "advantage from a contractual physician admission" or the patient base. The practice value can be depreciated, with the useful life varying depending on the type of acquisition.

2.2 Tax Treatment of Payment for a Contractual Physician Admission

The payment for a contractual physician admission is treated for tax purposes by examining whether there is a single purchase price or separate contracts. According to the Federal Fiscal Court, a contractual physician admission is generally a component of the practice value and cannot be valued separately.

2.2.1 Practice Acquisition in a Non-Restricted Planning Area

In non-restricted areas, the costs of the contractual physician admission are added to the practice value and depreciated together.

2.2.2 Practice Acquisition in a Restricted Planning Area

In restricted areas, the contractual physician admission can constitute an independent asset. This is the case, for example, when payment is made separately for the admission and it is essential for the acquisition.

2.2.3 Depreciation and Deductibility

The depreciation of the contractual physician admission depends on whether the entire practice or only the admission was acquired. The value of the admission can be transferred and utilized within the framework of replacement procedures, and in some cases, a partial value write-down is possible.

Overall, tax aspects are of great importance when acquiring a practice and require a careful examination of the individual components and contracts.