Q
Q - ATECO Codes Health and Social Work
Section Q covers healthcare and social assistance activities: medical and dental practices, psychologists, nurses, testing laboratories, physiotherapists, as well as care homes, residential communities and social services for the elderly, minors and people with disabilities. For healthcare professionals who register a VAT number, almost all codes in this section fall under the 78% profitability coefficient in the flat-rate regime. The social security picture varies considerably by professional category: those enrolled with a professional register pay into their own fund (ENPAM, ENPAP, ENPAPI, ENPAB), while others contribute to the INPS separate management.
- ATECO 2025 codes
- 32
- Flat-rate eligible
- 32 of 32
- Profitability coefficient
- 78%
- Prevalent INPS scheme
- Gestione Separata
86.10.00ATECO Code Hospital Activities86.21.00ATECO Code General Medical Practice Activities86.22.01ATECO Code Cosmetic Surgery Treatments86.22.02ATECO Code Other Specialist Medical Practice Activities Carried Out by Independent Specialist Physicians86.22.03ATECO Code Other Specialist Medical Practice Activities Carried Out at Clinics and Specialist Centres86.23.00ATECO Code Dental Practice Activities86.91.01ATECO Code Diagnostic Imaging Activities86.91.02ATECO Code Medical Laboratory Activities86.92.00ATECO Code Ambulance Transport of Patients86.93.00ATECO Code Activities of Psychologists and Psychotherapists, Excluding Physicians86.94.01ATECO Code Nursing Activities86.94.02ATECO Code Midwifery Activities86.95.00ATECO Code Physiotherapy Activities86.96.01ATECO Code Kinesiology86.96.09ATECO Code Complementary and Alternative Medicine Activities N.e.c.86.97.00ATECO Code Intermediation Services for Medical, Dental and Other Human Health Activities86.99.01ATECO Code Body Treatment Techniques86.99.02ATECO Code Dance Movement Therapy86.99.03ATECO Code Psychomotor Activities86.99.09ATECO Code Other Miscellaneous Human Health Activities N.e.c.87.10.00ATECO Code Residential Nursing Care Activities87.20.00ATECO Code Residential Care Activities for People with Mental Disorders or Substance Abuse87.30.00ATECO Code Residential Care Activities for the Elderly or People with Physical Disabilities87.91.00ATECO Code Intermediation Services for Residential Care Activities87.99.00ATECO Code Other Residential Care Activities N.e.c.88.10.00ATECO Code Social Work Activities Without Accommodation for the Elderly or People with Disabilities88.91.00ATECO Code Child Day-Care Activities88.99.01ATECO Code Counselling Services88.99.02ATECO Code Family Counselling88.99.03ATECO Code Cultural and Intercultural Mediation88.99.04ATECO Code Other Non-Residential Social Work Activities Provided by Educationalists88.99.09ATECO Code Other Miscellaneous Non-Residential Social Work Activities N.e.c.Frequently asked questions
What is the profitability coefficient for a doctor or healthcare professional in the flat-rate regime?
For healthcare and professional activities in section Q the profitability coefficient is 78%. This means taxes and contributions are calculated on 78% of turnover, while the remaining 22% is treated as a flat-rate expense allowance and is not taxed. On the income calculated in this way the substitute tax of 5% applies for the first five years of the activity, then 15%. You can see how much you would net using the simulator: calculate your taxes.
Does a doctor in the flat-rate regime pay contributions to INPS or to ENPAM?
A doctor enrolled with the Medical Register is automatically enrolled with ENPAM and pays contributions there (the fixed Quota A and the income-based Quota B on income from private practice), not to the INPS separate management. The same logic applies to other professionals with their own autonomous fund: psychologists to ENPAP, nurses to ENPAPI, laboratory biologists to ENPAB. The INPS separate management applies only to those without a category fund.
Where do social care workers, such as care assistants or educators, pay their contributions?
Social and residential care workers (divisions 87 and 88) often have no professional register or category fund: care assistants, educators, social workers and assistants without a professional register enrol in the INPS separate management, with a rate of 26.07% in 2025. The advantage is that there are no fixed minimum contributions: if you earn little, you pay little. The 78% profitability coefficient also applies to them when the activity is carried out as a professional service.