Physiotherapist setup grants in France: 2026 amounts
CACCMK €49,000, CAIMK €34,000, CAMMK €4,000 a year: the three setup grants in very under-served areas, their conditions and how they are paid.
Three contracts, three situations, and amounts ranging from €4,000 a year to €49,000 over five years. If you are setting up, creating or taking over a practice in a "very under-served" area, the Assurance Maladie (French national health insurance) pays a flat-rate grant. People often speak of a setup bonus; the official term is "contract", and the nuance matters, because it is a reciprocal commitment and not an unconditional payment. Here is which of the three applies to you, what you will actually receive, and what you sign in return.
The condition that governs everything: the area
None of these three contracts exists outside the areas classed as "very under-served" by the ARS (regional health agency). This is not one criterion among others, it is the entry point. A practice located a few kilometres from an eligible area opens no rights.
There are three ways to check your municipality, and none of them is a private directory:
rezonekine.ameli.fr, the zoning map published by the Assurance Maladie for physiotherapists: you search for your municipality there;
the website of your region's ARS, which publishes the zoning order;
your health insurance fund, that is, your CPAM (local health insurance office).
One clarification that avoids a disappointment: each contract applies in a region only from the publication of the zoning order issued by the director general of the ARS, under Article L. 1434-7 of the French Public Health Code. Being in a very under-served area and being able to sign are therefore not exactly the same thing. Your fund settles this point in one phone call.
Which contract for your situation
The three contracts cannot be combined with one another. The right reflex is to start from what you do, not from the amount. The conditions and amounts that follow are those published by the Assurance Maladie on its page "aides à l'installation et au maintien de l'activité en zones très sous-dotées".
You create or take over a main practice in the area: this is the CACCMK (contrat d'aide à la création de cabinet, practice creation grant contract), up to €49,000. You may practise alone or in a group. A takeover only opens entitlement to the contract in the event of the complete cessation of activity of the previous holder.
You join an existing practice in the area: this is the CAIMK (contrat d'aide à l'installation, setup grant contract), up to €34,000. Note that this one requires group or multi-professional practice: it is not open to a solo setup.
You already practise in the area and want to stay: this is the CAMMK (contrat d'aide au maintien d'activité, activity retention grant contract), €4,000 a year. It is the only one of the three that is renewable.
| Contract | Your situation | Amount | Duration | Group practice |
|---|---|---|---|---|
| CACCMK | you create or take over a main practice | up to €49,000 | 5 years, non-renewable | not required (alone or in a group) |
| CAIMK | you join an existing practice | up to €34,000 | 5 years, non-renewable | required |
| CAMMK | you already practise in the area and you stay | €4,000 a year | 3 years, renewable | required, or regular use of a locum |
The three contracts cannot be combined. For the CACCMK and the CAIMK, the amounts shown are ceilings, reached from a given volume of procedures: see the proration rule below. The CAMMK is not prorated. Some ARS also increase these amounts in the areas they judge to be the most under-served: ask your fund for the regional model contract.
CACCMK: up to €49,000 to create or take over a practice
The practice creation grant contract lasts 5 years, non-renewable. The grant is paid in four instalments:
€30,000 on signature (year N);
€9,000 in year N+2, for year N+1;
€5,000 in year N+3, for N+2;
€5,000 in year N+4, for N+3.
To join, you must have created or taken over a main practice in a very under-served area in the year preceding your application, or have been a collaborator or self-employed assistant established in such an area in the previous three years. If you practise alone, you undertake to use a locum regularly to ensure continuity of care. If you practise in a group, you need a contract validated by the Ordre des masseurs-kinésithérapeutes (the physiotherapists' professional body), with at least two physiotherapists covered by the national agreement practising in the same premises.
The official booklet on amendment 7 published by the Ordre specifies that this contract is also open to physiotherapists whose activity is carried out exclusively at patients' homes. Have your fund confirm this point if it applies to you.
CAIMK: up to €34,000 to join an existing practice
The setup grant contract also lasts 5 years, non-renewable, and follows the same payment rhythm, with a smaller first instalment:
€15,000 on signature (year N);
€9,000 in year N+2;
€5,000 in year N+3;
€5,000 in year N+4.
Two conditions clearly distinguish it from the CACCMK, and they determine your eligibility: the setup must take place in an already existing practice, and you must practise in a group or in multi-professional practice. Joining takes place within the year following the setup.
CAMMK: €4,000 a year to stay in the area
The activity retention grant contract pays €4,000 a year for 3 years, and it is renewable by tacit renewal. It is the only one of the three that assumes neither a setup nor a creation: it is aimed at the practitioner already in place.
Here too, group or multi-professional practice is required. If you practise alone, the condition is met by regularly using a locum for continuity of care. In return, you undertake to continue your activity in the area for at least 3 years and to carry out 50% of your activity there.
What "€49,000" really means: the proration rule
This is the point that changes your calculation, and it applies only to the CACCMK and the CAIMK. The announced amounts are ceilings, reached at a given volume of procedures.
The rule is twofold:
between 1,500 and 3,000 procedures a year, the grant is prorated on the basis of 100% for 3,000 procedures;
for the first year, it is prorated between 1,000 and 2,000 procedures, on the basis of 100% for 2,000 procedures.
In practical terms, a practitioner who starts a practice and carries out 1,500 procedures in the first year does not receive the full €30,000 of the first instalment. The reasoning to apply before signing is therefore not "how much is the grant worth", but "what volume of procedures can I sustain, from the first year and over five years". Your fund calculates the amount due on this basis, and there is no room for discretion.
This is also why the time you spend on anything other than care is not neutral in this scheme. The threshold is crossed in patients seen, not in hours spent.
The student trainee supplement: €300 a month
All three contracts give entitlement to the same supplementary payment: €300 a month for hosting a full-time student trainee, for the duration of their placement in the fourth or fifth year of study, under the conditions of Article L. 4381-1 of the French Public Health Code. The amount is prorated for part-time hosting.
Over five years, regularly hosting a trainee is worth several thousand euros: €300 for each month of placement, added to the contract amount without reducing it.
What you commit to
The grant is not a subsidy without anything in return. By signing, you undertake to:
practise in the area for 5 years from the date of joining, or 3 years for the CAMMK;
carry out 50% of your self-employed activity under the national agreement in the area and, for the CACCMK and the CAIMK, demonstrate a minimum of 2,000 procedures in the first year, then 3,000 procedures a year in the following years. The CAMMK, for its part, imposes no procedure threshold;
meet the conditions allowing you to receive the forfait d'aide à la modernisation et à l'informatisation du cabinet (FAMI allowance);
inform your fund of your intention to stop practising in the area before the contract expires.
The second commitment deserves to be read twice: it covers both a volume and a geographical split. A practitioner who reaches 3,000 procedures but carries out a majority of them outside the area does not meet the condition.
When the money is paid
The first instalment of the CACCMK and the CAIMK is paid on signature of the contract. Subsequent payments are made before 30 April of the year concerned, for the previous year, according to the official booklet on amendment 7 published by the Ordre. For the CAMMK, the amount due is calculated at the end of each calendar year.
The delay matters in a cash-flow plan: after the signature instalment, the second instalment arrives in year N+2. Year N+1 gives rise to no payment.
What has changed: the CIMK has disappeared
Many articles still online describe the "contrat incitatif masseur-kinésithérapeute" (physiotherapist incentive contract), the CIMK, created by amendment 3 in 2011. The three contracts above replaced it as early as amendment 5, in 2017; amendment 7 abolished annex 8, which still carried it, raised the amounts and reserved the contracts for "very under-served" areas only, where amendment 5 also opened them to "under-served" areas. If you read a page that still talks about a single incentive contract, or that announces these grants in simply "under-served" areas, it describes a scheme that has closed.
Existing contracts signed under amendment 5 are not cancelled for all that: an amendment taking the revaluation into account can be concluded, provided the area remains classed as "very under-served".
How to join, in practice
There is no dedicated online service, and no online form to fill in alone: joining goes through your CPAM, which you contact directly. It is the CPAM that checks the classification of your municipality, the publication date of the zoning order in your region, and your practice situation.
Three things to prepare before the call: the exact date of creation, takeover or setup, the form of practice (alone, in a group, in a multi-professional structure, with the contract validated by the Ordre where applicable), and an estimate of your annual volume of procedures, since that is what determines the amount actually paid.
And the rest of amendment 7
The amounts above are only one part of amendment 7. The fee codes, the nomenclature redescribed in 80 procedures and the revaluation timetable, including the postponement from 1 July 2025 to 1 January 2026, are detailed in our article on amendment 7 for physiotherapists in 2026. If you are equipping a practice that is starting up, our comparison of physiotherapist software sets out the selection criteria.
The volume of procedures is time
This scheme rewards a sustained volume of activity over five years, in an area where the demand for care exceeds the supply. The friction point is not the number of patients available, it lies elsewhere: in the assessments, reports and letters that pile up in the evening.
This is exactly where Markus comes in. The session is transcribed, the assessment is drafted according to your template, and you review it. Markus drafts, it does not decide, and it does not replace your billing software: the modernisation allowance depends on your approved equipment, not on us. Try Markus for free and judge on your first assessment.
