Short answer. A foreign company can bring a health platform to Brazil through a Brazilian company that it controls. What is different from other digital businesses is the healthcare layer: registration with the regional medical council, a medical technical director when there is telemedicine, physicians registered with the regional council, and patient data that the law treats as sensitive. The tax result depends on how the money flows between patient, platform and physician.
General information as of October 2026, it does not replace the analysis of each case. Healthcare is among the most regulated sectors in Brazil. Requirements vary by activity and by council, and some are confirmed with the council before launch.
First, understand the business model
Before structure and taxes, these questions decide almost everything:
- Is the platform only scheduling and marketplace, or does it also deliver teleconsultations, prescriptions and medical certificates?
- How does the platform earn: a fee per consultation, a percentage, or a subscription paid by the physician?
- Who receives the payment from the patient, and how does the physician receive his or her share?
- Which company abroad will be the partner in Brazil, and will the Brazilian company pay it a licence or a service fee?
- How many physicians and consultations do you expect in the first year?
The answers separate three very different cases: a technology intermediary that does not provide medical care, a platform that delivers telemedicine itself, and a clinic or laboratory operation. Each has its own registrations and its own tax base.
The structure
The usual vehicle is a limited liability company (Ltda.) in Brazil with the foreign company as partner. It needs a manager who lives in Brazil, a representative for the partner before the federal tax authority and the Central Bank, and a registered address. In a platform that delivers telemedicine, it also needs a medical technical director registered with the regional council. Because the partner is a foreign company, the Simples Nacional does not apply, and the company is normally taxed under presumed profit. The full path, with documents and timeline, is in our step-by-step guide.
| Piece | In a health platform |
|---|---|
| Partner | The foreign company, with documents apostilled and translated |
| Brazilian company | A Ltda. or S.A., under presumed profit or actual profit, headquartered in the city of operation |
| Manager | Lives in Brazil and signs for the company |
| Representative (power of attorney) | Acts for the foreign partner before the tax authority and the Central Bank |
| Technical director | A physician registered with the regional medical council, when there is telemedicine |
| Registered address | Headquarters and basis of the municipal registration |
Foreign capital in healthcare
The Brazilian Constitution restricts foreign companies and capital in healthcare, except in the cases provided by law. Law 13,097/2015 created broad exceptions: foreign companies and capital can take part, directly or indirectly, in healthcare services, including clinics, hospitals and laboratories. The constitutionality of that law has been challenged before the Supreme Court. The activity operates normally today. We check the current status of those cases in the diagnosis and take the risk into account when we structure your investment.
The medical council and the technical director
A company that provides medical services registers with the regional medical council of the place where it operates, and names a technical director who is a physician registered with that council. A platform has the same requirement: it must be registered with the medical council and follow the council's rules, and the technical director must also be reported to the council. The exact requirement of the council of the state, such as the São Paulo council, is confirmed before launch, and the council may ask for the clinical staff and documentation within a deadline after the company starts.
Telemedicine itself is regulated by the Federal Council of Medicine, including how remote consultations, records, prescriptions and certificates must be handled. The platform has to be designed around those rules, not adapted afterwards. If your software qualifies as a medical device, it may also need registration with the national health surveillance agency.
Physicians
- Physicians who see patients in Brazil must be registered with the regional medical council (CRM). A diploma obtained abroad must be revalidated in Brazil before the physician can practice.
- An investor may own the company without being a physician, as long as the company has a technical director who is a physician qualified and registered with the regional council in Brazil. Clinical care is provided only by professionals registered with the council.
- Physicians may provide services through their own company, as long as the contract reflects a real service relationship. When the relationship has the features of employment, it may be treated as employment.
Patient data
Health data is sensitive personal data under the Brazilian data protection law (LGPD), with stricter conditions for processing, consent and security. For a foreign platform, three points matter in practice:
- A data protection officer. The company appoints a person in charge of data, who communicates with patients and with the data protection authority.
- Sending data abroad. If patient data is processed by the parent or by servers in Europe or elsewhere, the transfer has to follow the international transfer rules of the law and of the authority's regulation, which include contractual clauses and other mechanisms. Design the data flow before the first patient.
- Security and records. Medical records have retention and confidentiality rules that apply on top of the data law.
Because the parent will also be subject to its own regime (for example, the GDPR in Europe), the data flow should be mapped by specialists on both sides. Our team coordinates with them on the accounting and tax side.
How money flows: patient, platform and physician
This is both a regulatory and a tax question. In a typical marketplace, the patient pays through a payment provider, the payment is split, the physician receives his or her share and the platform receives its fee. For this type of operation, use a partner: a payment gateway authorised by the Central Bank to operate in Brazil, which receives the payment and splits it between the physician and the platform.
When the platform acts only as an intermediary, its revenue is its fee. The physician's share goes through the split and does not become the platform's revenue, so it does not enter the platform's tax base. Document it clearly in the contracts and in the accounting, because the tax authority looks at who is the real provider of the service.
Taxes
For a service company under presumed profit, the tax on the platform's own revenue is roughly:
| Tax | How it is calculated | Effective rate |
|---|---|---|
| Service tax (ISS) | On the platform fee, set by the city | 2% to 5% |
| PIS and Cofins | On revenue (cumulative regime) | 3.65% |
| Corporate income tax (IRPJ) | 15% on a presumed profit of 32% of revenue | 4.8%, plus 10% on the presumed profit above R$ 20,000 a month |
| Social contribution on profit (CSLL) | 9% on a presumed profit of 32% of revenue | 2.88% |
| Total | About 13% to 16% of the platform's revenue |
If the company itself provides medical services, the presumption can be different, because some health services use a lower presumption percentage when they qualify as hospital services. That classification depends on the structure of the facility and is analyzed before the company is set up. The consumption tax reform also gives health services a reduced rate in the new tax, which is phased in until 2033. We model it in the diagnosis rather than relying on a single percentage.
Presumed profit or actual profit?
A Ltda. or S.A. owned by a foreign company can be taxed under either regime. They differ in how the income tax base is built and in how PIS and Cofins work:
| Presumed profit | Actual profit | |
|---|---|---|
| Income tax base | A percentage of revenue (32% for services in general) | The accounting profit, adjusted by the tax rules |
| IRPJ and CSLL rates | IRPJ 15%, plus 10% on the profit above R$ 20,000 a month, and CSLL 9% | The same rates, applied to the adjusted profit |
| PIS and Cofins | Cumulative: 3.65% of revenue, with no credits | Non-cumulative: 9.25% of revenue, with credits on eligible purchases |
| Costs and losses | Do not reduce the income tax | Deductible within the rules, and losses can be carried forward |
| Bookkeeping | Simpler | More detailed, with the tax adjustments |
| Annual revenue | Available up to R$ 78 million | Mandatory above that, and optional below |
Presumed profit tends to fit a platform with a high margin and few deductible costs. Actual profit tends to fit a company with a low margin, losses in the first years or large deductible costs. The right choice is a calculation with your own numbers. We do the tax planning to find out which regime is best for your company.
Check the cost of getting money back. The remittance calculator compares dividends, software licences and capital returns for a health platform, with the Brazilian rates of 2026.
Getting the money back to the parent
If the parent licenses the software to the Brazilian company, the tax cost on the way out is much higher than if the parent receives dividends.
Tax cost on the way out, in our model, for the parent to receive R$ 85,000
Under presumed profit, the licence also does not reduce the Brazilian company's income tax.
Simulate with your own numbersRead the details in our guide to sending money out of Brazil. A tax treaty between Brazil and the parent's country may change the withholding.
Timeline
For a simple structure, we plan 45 to 90 days from the start until the company operates. The timing depends mainly on the apostille, the sworn translation and the medical council. Plan the council registration in parallel with the incorporation, not after.
Checklist for a foreign health platform
- A clear description of the business model and the money flow.
- Structure and tax regime calculated for the platform and, if applicable, for the clinical activity.
- Medical technical director identified and registered with the council.
- Confirmation of the council's requirements for your type of telemedicine.
- Physician contracts and council registrations checked.
- Data protection officer, data flow to the parent and transfer mechanism mapped.
- A payment partner authorised by the Central Bank for the split.
- Central Bank registration of the investment before funds enter.
- A decision on how the parent will be paid: dividend, licence or capital return.
How we work
Move Advisory is the advisory arm of Move Online, an accounting firm founded in 2017 with a focus on healthcare professionals and companies. We start with a diagnosis, then handle the incorporation and the Central Bank registration, and then run the accounting, local representation and registered address. Regulatory questions in healthcare, such as telemedicine rules and contracts with physicians and payers, are handled with our tax lead and your own advisers. See the services page.