How should Contract Practitioners and Medical Assistants (PamCs) report their activity?

Verified 17 June 2026 - Entreprendre Service Public / (Prime Minister)

To exercise a medical activity or medical auxiliary as a liberal professional certain steps must be completed. All the necessary steps for installation are presented below.

A « WFP » is a self-employed who carries out an activity as a health profession covered by the social system of medical practitioners and auxiliaries under contract (PamC).

The following occupations fall under the category of practitioners :

  • Doctors (general practitioners and specialists)
  • Dental surgeons
  • Medical students replacing a medical doctor
  • Medical Analytical Laboratory Directors and who are also doctors

The following occupations fall under the category of medical auxiliaries :

  • Midwives
  • Nurses
  • Massage physiotherapists
  • Pedicures-Podiatrists
  • Speech therapists
  • Orthoptists

Several steps must be taken for the installation and exercise of the liberal activity:

  • Registration of diplomas to obtain a number RPPS: titleContent
  • Registration to the CPAM: titleContent the place of practice to inform him of the installation
  • Professional indemnity insurance (RCP)

1Registration of the diploma to obtain an RPPS number

Registration of the diploma is required to obtain an identification number.

The Shared Directory of Health System Professionals (SHSP) is the single repository of reference for identifying health professionals.

The professional must apply for registration on the roll of the Order. This registration is mandatory to legally practice medicine.

The application for registration is addressed to the president of the departmental council of the Order of Physicians of the place of professional residence.

The request may be submitted directly to the departmental council of the Order concerned or be sent by registered mail with a request for acknowledgement of receipt:

After registration, the departmental council registers the diploma. It issues a certificate of registration with the Order with a RPPS number (shared directory of health professionals) and one (more) place(s) of practice.

This number is assigned to the professional for his whole life.

The health professional card (CPS) is automatically sent by the Shared Health Information Systems Agency (ASIP Santé) responsible for the manufacture and issuance of CPS cards.

2Registration at the French primary health insurance fund of its place of practice

The professional must contact the Health Insurance to register his private practice.

Who shall I contact

The CPAM registers the professional in the National Health Professional Register (FNPS).

3Professional indemnity insurance (RCP)

All health professionals practicing in a private capacity, as well as the businesses they can train, must take out civil liability insurance covering all the acts they perform.

Failure to comply with this insurance obligation may result in criminal and disciplinary sanctions.

The procedures for declaring the activity vary depending on whether the activity is carried out as a holder or a substitute.

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Holder/Installed

The rules applicable to the creation of any liberal activity apply to the creation of a medical activity or medical auxiliary.

THEprofessional practice can be carried out under 2 main categories of legal forms: either individual business (EI) or business (civil, capital, etc.). 

The application for registration must be made on the site of the Window formalities of the companies in the 8 days which follow the start of activity.

Window of company formalities

The Urssaf provides a handy sheet to carry out the procedures for declaring the start of activity.

This declaration makes it possible to inform all the organizations concerned by the launch of the activity (Insee: titleContent, social organizations, Urssaf: titleContentpublic finance center, etc.).

Following registration, the Insee assigns a Siret number. It is a unique national identification number that identifies the establishment. It is composed of Siren (first 9 digits) which identifies the company and the Nic (last 5), modified in particular when changing the address of the establishment.

When registering the company, the Insee also assigns a APE code corresponding to the activity of that company.

FYI  

Obtaining the Siret number allows the user to carry out his activity even in the event that his registration with the social organizations is not carried out.

Substitute

Alternate physician

To practice as a substitute or regulatory doctor, the Urssaf offers a " simplified offer » which allows the declaration of the activity, the retrocessions of fees or remuneration and the payment of the related social contributions directly from a personal online space.

Under this scheme, the declaration and payment of contributions are simplified. They will be to be carried out quarterly (or monthly according to the initial choice) and only in the event of replacement and therefore effective collection of fee retrocessions, and without cash mismatch.

This device is reserved exclusively for doctors acting as substitutes and in the following cases:

  • Alternate physicians (general practitioner or specialist)
  • Student Doctors
  • Employed doctors
  • Retired Doctors
  • Medical Regulators
  • Doctors participating in a vaccination campaign

To subscribe to this simplified offer, it is necessary to gather the following conditions :

  • Perform replacements only
  • Have a surrendered fee not exceeding €19,000 by calendar year
  • Not to engage in any other activity as a self-employed person

The registration process is done on the following portal:

Simplified Device for Replacement Physicians (RSPM)

Other replacements

The substitute healthcare professional is required to follow the same formalities as all healthcare professionals.

It must therefore be registered as soon as it is 1er replacement day.

If he does not have a fixed practice address, he must enter his home address as a business address.

On the declaration of commencement of activity, the box « replacement » must be ticked to be exempted from the contribution to the Regional Unions of Health Professionals (URPS).

Thus, you must apply for your registration on the website of the Window formalities of the companies within 8 days of starting your activity.

Window of company formalities

Support for the creation and recovery of a company (Acre)

Acre is a scheme to promote company creation. It results in a partial exemption from social security contributions.

Warning  

The creators, liberal professionals, who opted for thesimplified offer (doctors and medical students substitutes), cannot benefit from this device.

When creating a business, an exemption from certain contributions can be applied for 12 months, subject to conditions. The creator did not benefit from the Acre during the previous three years.

The exemption covers sickness and family allowances, as well as basic pension and invalidity-death contributions.

This exemption applies first to provisional contributions and is then adjusted after the tax return.

3 cases may occur:

  • Where income is less than 75% the annual social security ceiling (PAS), i.e. less than €36,045 : the amount of the exemption is capped at 25% of these contributions
  • Where income is between €36,045 and €48,060 : a degressivity applies
  • When revenues exceed €48,060 : there is no exemption, it is withdrawn.

The creator or the buyer must make a request for exemption from Urssaf, by filling in the form of demand.

The Urssaf provides a handy sheet for carry out the step-by-step approach.

CPAM aid

Many financial aid measures are proposed by the CPAM: titleContent and may be assigned according to the health professional’s situation.

At the same time, there are also lump-sum payments paid by the health insurance (support for teletransmission, compensation for continuing training, installation premium, etc.).

The support portal for healthcare professionals (paps.health) contains all the useful information, from training to stopping the activity.

Please note

This aid must be declared and is therefore reinstated in the basis for calculating the compulsory social security contributions.

To be a practitioner, the professional must adhere to the national convention specific to his profession, which impose tariffs and entitles him to benefits (including coverage by the Health Insurance of part of its social contributions).

In some cases, the CPAM may decide to « deconvene » the liberal practitioner, for a maximum duration of 3 months. This means that it can decide to suspend the effects of the agreement with regard to the health professional.

The unloading may take place in the following cases:

  • Repeated application of tariffs higher than conventional tariffs outside the cases provided for by the texts, or non-compliance with the nomenclature of professional acts
  • Failure to comply with the rules concerning the establishment of care sheets
  • Misuse of excess fees for special requirements.

If the spouse (married, entered into a civil partnership or cohabiting) regularly participates in the company's activity, it must have a status.

It exists 3 statutes possible, depending on the legal status of the company: associate spouse, collaborating spouse, salaried spouse.

The chosen status must be declared on the website of the company formalities window.

If the spouse's professional activity is not declared, it is automatically considered to be carried out under the status of employed spouse.

To learn more about the social consequences of each status, consult the sheet Practitioners and medical assistants under contract (PamC): affiliation and social regime.

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Associated spouse

Associated spousal status is only possible if the activity is carried out in a business.

The spouse of the majority manager of the SELARLU must be associated (own shares) and participate in the company's activity.

He must have the necessary qualifications to practice the same profession.

Collaborating spouse

In order for the spouse to choose this status, the practitioner must practice either as an individual business (EI) or as a majority manager of SELARLU.

The spouse is not paid for his participation in the activity.

Employed spouse

This status can be chosen regardless of the legal status of the company and the spouse is considered as any employee of the company.

Any change of situation health professionals must be declared on the website of the company formalities desk.

For example, a transfer of head office for a business, a change of address for an independent professional.

Window of company formalities

The delisting formalities are different depending on whether it is a individual business or a business.

They must be carried out on the website of the companies' formalities office, within one month (30 days) of the cessation of the activity.

Window of company formalities