How is a medical & dental practices business taxed across borders?

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Answer

A professional corporation is resident where it is managed, so a practitioner who moves leaves behind an entity that continues to be taxed where it was — and may now be a foreign corporation to them. The first foreign obligation in this sector is rarely income tax, which is why it is discovered late.

The rule for this sector

A professional corporation is resident where it is managed, so a practitioner who moves leaves behind an entity that continues to be taxed where it was — and may now be a foreign corporation to them.

The team at work in the open-plan office

The exception worth knowing

Our owner has moved abroad and the corporation has not.

How is a medical & dental practices business taxed across borders?
ItemAmount
Annual salaryC$159,000
Working days in the year240
Days worked in the other country77
Days worked at home163
Income sourced to the other countryC$51,013
Income sourced at homeC$107,987

C$51,013 is sourced abroad on this split, which is the figure the host country taxes and the figure the home credit is computed on. Reproduce this from a travel record, not from memory — it is the first thing an auditor asks for.

Treat these numbers as a worked example rather than advice — they exist to make the mechanics visible, and the rates and thresholds are assumed for the illustration. For a real filing, we verify each figure with the authority that publishes it, for your year.

What to do next

The full treatment — who it binds, the deadline, the penalty and the fixed fee — is on Cross-border tax for medical & dental practices. If you already have an adviser, we will tell you what they should be asking rather than replacing them.

Reviewed for the 2025 and 2026 filing seasons by Udit Gupta, Cross-Border Tax Expert, Legal Quotient Consultants. General information, not advice for your circumstances — call our 24-hour helpline to discuss your own position.

International tax practice, in practice

Read this page for international tax practice. It works through medical & dental practices from the beginning — whether it applies to you at all, what has to be filed if it does, and what the engagement costs, priced up front.

Cross-border tax case studies

Case study 1

Establishing where a professional corporation is managed after the owner emigrates

A practitioner had relocated and carried on as sole director of the corporation left behind, signing everything from the new country. Nobody had considered whether the company had moved with them. We reviewed the minute book, the signing arrangements, and where decisions on hiring, banking and clinical policy were actually being taken, then set the position out against both countries' residence rules and the treaty. The engagement produced a documented residence conclusion, a corrected minute book, and a governance arrangement for future decisions so that the conclusion continues to match what the company does.

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Case study 2

Putting cross border associate agreements on a consistent footing

A clinic engaged associates who lived on one side of a border and worked sessions on the other, with some treated as contractors and some run through payroll for no recorded reason. We compared each agreement against what the associate actually did, how sessions were rostered, and who supplied premises, staff and equipment. The work produced a single set of terms applied to every associate on the same basis, a written analysis supporting the classification, and payroll registration in the country where the sessions are performed. Inconsistent treatment of comparable people was the exposure, and it has been removed.

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Case study 3

Valuing equipment and goodwill before a practice restructuring

A practice wanted to bring a younger partner in and had no idea what anything was worth beyond the book value of the surgery fittings. The patient list, the recall book and the site had never been valued. We scoped a valuation covering the tangible assets and the goodwill separately, gathered the operating records it needed, and set out how the transfer would be measured in each country the parties were resident in. The engagement produced a dated valuation report, and a transaction structured and documented around it rather than around a price agreed across a table.

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Case study 4

Resolving a dual resident practice company under a treaty

A dentist had emigrated years earlier and kept the corporation, which by then held investments rather than a running surgery. Both countries regarded it as resident. Returns had been filed in one and nothing in the other. We established the facts on where it was managed, applied the treaty mechanism that resolves a company resident in both states, and filed the years that remained open on that basis. The outcome was a single residence position supported by evidence, the outstanding years brought up to date, and the corporation's continuing obligations in each country written down for the client's file.

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Case study 5

Filing open years for a locum working either side of a border

A locum physician had taken sessions in both countries for several years and had filed properly in neither, on the understanding that tax deducted at source settled everything. We rebuilt the income by country from engagement letters, remittance advices and bank records, established which country had the first right to tax each session, and prepared returns claiming relief for tax already paid. The engagement produced a filed set of years in both countries, relief for the double taxation the client had been carrying, and a simple record to keep going forward so the position stays current.

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Case study 6

Separating a partner's shareholding when one owner moves abroad

A practice owned equally by its founding partners faced a change when one moved overseas and the other stayed to run the clinic. The shareholding, the directorships and the profit sharing had all been arranged on the assumption that both lived in the same place. We mapped what the departure changed for the company and for each individual, including where the board would now meet and what the departing partner's own position became. The work produced a restructured shareholding, a directors' arrangement that keeps management in one identified country, and written advice to each partner on their personal obligations.

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Case study 7

A US LLC Owned by a Canadian, Taxed Twice by Design

The two countries classify an LLC differently, so the credit relief that ought to apply frequently does not. The engagement looks at whether the structure can be changed, and where it cannot, at how to make the credit work.

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Case study 8

A Canadian Landlord With Property in the United States

Gross withholding on US rents takes no account of mortgage interest, tax or repairs, so a leveraged property can face tax on turnover. An election onto net basis fixes that, and it has its own timing and its own filing.

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All case studies — every published engagement in one place.

Core International & Cross-Border Tax Services

International Tax Planning & Advisory

Strategy and compliance for income, assets and families spread across borders.

One coordinating team: filings on every side of the border are sequenced so treaty relief and foreign tax credits are claimed once — and in the right country.

U.S. & Cross-Border Tax Returns

Dual filers: U.S. citizens in Canada and Canadians with U.S. income run two parallel systems — we prepare both, in the right order, every year.

Expat & Emigration Tax

The move year is its own project: the elections and valuations filed that year decide the next decade of both countries’ returns.

Non-Resident Canadian Tax

Default withholding is 25% of gross: elective returns routinely turn over-withheld rent and pensions into refunds.

Transfer Pricing & BEPS

Documentation prepared with the return is the cheapest insurance in international tax; reconstructing it during an audit is the most expensive.

Cross-Border Estates & Trusts

Wills drafted for one country routinely misfire in the other — deemed disposition here, estate tax there, credits in between.

Cross-Border Corporate Tax

Expansion raises the same four questions every time — entity, PE, repatriation, payroll. We answer them before the tax authorities do.

India Tax for NRIs & Returning Residents

The deduction is taken on the sale price, not the gain — which is why an NRI property sale strands cash unless the certificate is applied for before closing.

Canadian Tax with a Foreign Element

Residency is decided on facts, not on a form — and the year you arrive or leave is the one where the largest amounts turn on the smallest details.

UAE Tax for Expats & Their Home Country

A zero-tax country is only half the answer — the question that decides the bill is whether the country you came from still treats you as resident.

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Cross-Border Real Estate

Foreign property income and sales are taxed in both countries by default; Section 216, FIRPTA and treaty credits are the standing toolkit.

Property is taxed where it sits, which is the one rule no treaty overrides. What the treaty does decide is the credit, the rate on the rent and what happens on the sale — and the clearance certificate on a disposition is applied for before closing, not after the buyer has already held the money back.

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Remote Workers & Digital Nomads

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Investment Funds & Holding Companies

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Questions that come up on Medical & dental practices

I moved abroad but my medical corporation stayed here — what now?

You now have two tax positions to manage instead of one, and they interact. The corporation does not stop being your problem because you left the country: it carries on filing where it has always filed, keeps its obligations for anyone still working in it, and keeps whatever year end and instalment pattern it had. What changes is that the person directing it is no longer in that country, and that you are now resident somewhere with a view of its own about a company you control abroad. Both halves move on the same date, the date you leave, and the answers to them sit in two different countries' rules. Settle them together in the first year. Fixing one and leaving the other is what creates the expensive version of this.

Where is my medical corporation resident if I direct it from overseas?

Residence for a company follows management, and management means the place where the real decisions are taken, rather than the registered address or the address on the letterhead. If you have moved and you are the sole director, board decisions are being taken where you now live. That can make the corporation resident in your new country while it remains resident in the country of incorporation under that country's own rules. Where a treaty applies there is normally a mechanism to resolve a company with two residences, but it has to be applied deliberately and evidenced. The evidence is your minutes, your signatures, and where meetings actually happen.

Can I keep billing through my dental corporation after I emigrate?

Often you can, but the corporation may no longer be the right vehicle, and the answer turns on where the clinical work is now being performed. If you are treating patients in your new country, that income arises there, and the professional licensing rules there usually govern how it may be billed. A corporation left behind that invoices for work done elsewhere tends to attract questions from both tax authorities. Take advice on the structure before the first invoice is raised under the new arrangement. Unwinding a billing pattern after a year of it is harder than choosing one at the start.

Are my associates employees or contractors when they cross the border?

The two countries may answer that differently on the same facts, which is how practices end up treating comparable associates inconsistently. The tests generally look at control over how the work is done, who provides the premises and equipment, who carries the financial risk, and whether the associate may send someone else. A clinic supplies the surgery, the equipment, the staff and the patient list, which is why associate arrangements so often look like employment when a tax authority examines them. Write the agreements to match how the practice actually operates, and apply the same treatment to every associate engaged on the same terms.

Do I need to value goodwill before restructuring my practice corporation?

Yes, and it is a step that is often skipped. A restructuring moves assets between people or entities, and each movement is measured at value for tax purposes whether or not money changes hands. In a practice the equipment is the easy part. The goodwill, meaning the patient list, the location and the recurring recall book, is where the value usually sits and where nothing has ever been written down. If the value is not established at the time, it will be established later by someone else, working backwards, without your evidence. Commission the valuation before the transaction, not when a query arrives.

Is my professional corporation a foreign company now that I have left?

From your new country's point of view it probably is, and that is a reporting question as much as a tax one. Most countries require a resident who controls or holds a substantial interest in a company abroad to disclose it, and some tax part of that company's income in the shareholder's hands before any dividend is paid. The obligation usually starts with your residence, not with a payment out of the company. So the first year abroad is often the first year something is due, even though you received nothing. Establish what the disclosures are in the year you arrive.

Would a state exit tax even be constitutional?

A levy imposed purely for leaving would face serious challenge under the constitutional protections for interstate commerce and the right to travel, which is part of why proposals stall. But that is not what most states are doing. Taxing income that was earned or sourced within the state before you left is conventional, long upheld, and where almost all real disputes sit — which is why the useful question is sourcing and domicile, not constitutionality. See state non-resident returns.

What is double tax relief and how is it given?

Three mechanisms, and which one you get depends on your residence country's law and the treaty. Exemption leaves the foreign income out of the residence-country base. Credit taxes it and then subtracts the foreign tax, capped at the residence-country tax on that income. Deduction merely reduces taxable income by the foreign tax, and is usually the weakest. Canada and the United States lead with credit; several treaties give exemption for specific income types. See claiming the credit.

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