Starting a Therapy Practice in Flanders: Administrative Checklist

Step 1: KBO Registration

Every self-employed person in Belgium must be registered in the KBO. Registration takes place via an accredited business counter (Acerta, Liantis, Securex, Xerius, Partena). Cost: approximately 100 euros, one-time. You choose your main activity (NACEBEL code) and business name. For somatic work, you often use NACEBEL 86.909 (other human health activities) or 88.991 (social work activities without accommodation).

Step 2: Self-Employed Social Status

Affiliation with a social insurance fund for the self-employed is mandatory within 90 days of starting. You pay social contributions based on your professional income, in four quarterly installments. The minimum in 2026 is approximately 875 euros per quarter (total 3,500 euros per year) for those earning less than 16,861 euros net. For higher incomes, the percentage increases to approximately 20.5 percent.

Step 3: VAT Exemption Article 44

Therapeutic and medical activities in Belgium are exempt from VAT under Article 44 of the VAT code. For somatic therapists without recognition as a clinical psychologist, this is a gray area: the exemption strictly applies to recognized healthcare professions. Many somatic therapists therefore opt for the small business regime (exemption if turnover is under 25,000 euros per year) or regular VAT-obligatory status with 21 percent on coaching turnover. Seek advice from your accountant; this is a common pitfall.

Step 4: Professional Liability Insurance

Not legally mandatory for non-recognized therapists, but highly recommended. Insurers like AG Insurance, Belfius, Ethias, and specialized providers offer policies from 250 to 600 euros per year for solo practices. Cover at least: professional liability (client claims), operating liability (incidents in your practice space), and legal assistance.

Step 5: Mutualiteit

As a self-employed person, you remain insured for statutory healthcare costs through your mutualiteit (health insurance fund), but the rate and coverage change. Report your new status to your mutualiteit within three months. Consider supplementary hospitalization insurance and guaranteed income insurance (from approximately 30 euros per month) in case you are unable to work for an extended period.

Common Mistake

Starting without an accountant. For solo practices, an online accounting package (Yuki, Teamleader, Billit) starting from 30 euros per month may suffice, but have a tax specialist check your declaration once a year. The gray zone around VAT exemption Article 44 is the most common pitfall during an audit.