Nurses and “Partita IVA”

All the answers to the most frequently asked questions about self-employment as a nurse.

To open a Partita IVA you have to contact the “Agenzia delle Entrate” (Revenue Agency). Self-employed workers must fill the AA9 / 10 form available online at  or at any office of the Revenue Agency of their district.

Form AA9 / 10 must be submitted within 30 days from the start date of the activity in one of the following ways:

  • two originals, in person (or through a delegated person) to any office of the Revenue Agency
  • a single copy plus a copy of an ID, by certified mail to any office of the Revenue Agency. The declarations are considered submitted on the day they are mailed
  • electronically directly by the taxpayer or through the subjects in charge of telematic transmission. The declarations are considered submitted upon receipt confirmation from the Revenue Agency
  • Ordinary: it is opened by professionals who do not have the requisites to take advantage of the flat-rate scheme or who presume to have an income exceeding € 65,000.00 gross per year. Applied Taxation is at the same income bracket of employed nurses.
  • Flat-rate: advantageous fiscal plan based on a personal income tax and related additional taxes equal to 15%. For new economic initiatives, the Flat-rate tax is 5% for the first 5 years. It’s applicable to those who have the requisites and foresee a gross annual income not exceeding € 65,000.00

Individuals already in business and / or individuals who start a business, art or profession can access the flat-rate scheme, provided that in the previous year:

  • have incurred overall expenses not exceeding 5,000 euros gross for ancillary work, employee work and for remuneration paid to collaborators, also hired for the execution of specific projects
  • the total cost of capital goods, before depreciation, does not exceed 20,000 euros at the end of the financial year.

Cannot make use of the flat-rate scheme:

  • individuals who make use of special regimes for IVA purposes or flat-rate regimes
  • non-resident subjects, with the exception of those residing in one of the European Union Countries, or in a Country member of the Agreement on the European Economic Area, which ensures an adequate exchange of information, and generates in Italy at least 75 % of the total income
  • subjects who carry out, exclusively or mainly, operations for the sale of buildings and related portions or land that has been approved for building or intra-community transfers of new transports
  • subjects participating in partnerships, professional associations, as per Article 5 of the TUIR, or limited liability companies with a restricted ownership base who have opted for tax transparency
  • subjects who in the previous year have received income from employment and / or similar amounts exceeding 30,000 euros, unless the employment relationship in the previous year is terminated (provided that in that same year there is no retirement income or employment income deriving from other employment). This cause of exclusion was introduced by the stability law for 2016, which at the same time repealed the provision which provided, as a requirement for the application of the flat-rate regime, that in the previous year the income from the business, art or profession exercised was prevalent with respect to the salary or similar income eventually received. Therefore, it should be noted that the repealed provision continues to have effect only in respect of taxpayers, who adopted the flat-rate regime during 2015. Instead, those who intend to apply the 2016 favorable regime must comply with the new condition (they must not have received in the previous year an income from employment or similar larger than 30,000 euros).
  • The flat-rate regime ceases to be effective from the year following the one in which even one of the access requirements stated by law is no longer valid or one of the reasons for exclusion occurs.

The flat-rate scheme has no limits on either duration or age. The flat-rate regime ceases to be effective starting from the year following the one in which even one of the requirements provided by law is no longer valid.

Nurses and CME training credits

We answer all questions related to training and CME credits.

Continuing Medical Education, introduced with June 19th 1999 legislative decree no. 229 art. 16 et seq. serves to maintain, develop and increase the knowledge, skills and performance of healthcare professionals. The CME national program concerns all health personnel, medical and non-medical, employees or freelancers, operating in the health sector, both private and public.

The training credits provide a measure of the commitment and time that each health care operator has dedicated annually to updating and improving the quality level of their profession. The credit is recognized on the basis of both the quality of the training activity and the time dedicated to it.

Healthcare professionals can obtain CME credits through residential training events (congresses, conferences, seminars) and through distance courses (FAD) accredited by the National Commission for Continuing Education (NCCE), by the Regions or by the Autonomous Provinces. CME credits issued by FAD courses delivered by providers accredited by the Regions and Autonomous Provinces, are recognized only for professionals operating in the territory of the accrediting provider.

The training credits can be acquired by participating to FAD courses – distance learning, RES courses – residential courses, FSC courses – local training.

The Financial Maneuver of August 13th, 2011 Law Decree n. 138, art. 3, paragraph 5, letter b) establishes “provision of the obligation for the professional to follow continuous training courses prepared on the basis of specific regulations issued by the national councils, without prejudice to the provisions of current legislation on continuing medicine education (CME). The violation of the CME training obligation determines a disciplinary offense and as such is sanctioned on the basis of the provisions of the Professional Association that will have to integrate such provision”.

Individuals on maternity leave as per December 30th, 1971 law, n. 1204 (mandatory abstention) and subsequent amendments; health care personnel who attend, in Italy or abroad, training courses specific to the category to which they belong for the entire training period (year of attendance).

You want to open a ‘Partita IVA’ and need help?

Nursing Project provides consulting services to nurses who want to become self-employed or who simply want to be informed.

Nurses and ENPAPI registration

We answer questions regarding everything related to enrolling with ENPAPI.

All Nurses, Pediatric Nurses and Health Assistants enrolled in the IPASVI Provincial Registers, who works as freelancers in single or associated form without subordination constraint, even in the form of non-habitual service or coordinated and continuous collaboration in any form other than the subordinate one, must register to ENPAPI.
It also applies for freelancer working as employees (non-freelancer).

Enpapi members, in accordance with the provisions of art. 8, paragraph 3 of Legislative Decree 10/2/1996 n. 103 must apply a percentage increase on all gross incomes that forms the taxable income of the activity. Starting 2012 the increase is 4% and is collected directly by the freelancer. For work with Public Administration, this increase remains fix at 2%.

The annual members (of ENPAPI) mandatory subjective contribution is 12% of the professional net income deriving from self-employment. The taxpayer can also opt for higher rates.

All employees of public administrations, including those of the Health Sector and in particular nurses, cannot perform the so-called dual activity, neither on their own nor employed by third parties.
However, if the employee has a less than 50% part-time employment, or has been previously authorized by the administration they are employed with, even if hired full-time, they can perform another working activity, subordinate or independent, also by registering with professional registers.
In both cases the common assumption for the lawfulness of the jobs is the absence of a conflict of interest.

In performing any activity there is the possibility of causing damage to others. For nurses the risk is very high as they assist people, therefore it is necessary to have a third-party liability insurance.
There are several insurance companies that offer this form of insurance; FNOPI has stipulated an agreement in favor of the members.

The freelance nurse must submit, by registered letter with return receipt, the following documents: application form (downloadable from the ENPAPI website) and the front / back copy of a valid identity document. All documents must be sent no later than 60 days from the start date of the activity as freelancer, to the following address: ENPAPI Via Alessandro Farnese 3, 00192 Rome.

The application for registration with ENPAPI must be submitted no later than 60 days from the start date of the activity as freelancer, or else penalty. The Institution, after having verified all the requirements, communicates the confirmation of the registration, the registration number and the first information relating to the obligations required by the Pension Regulations.

The Pension Regulations in art. 9 establishes a penalty of 100.00 Euros for failure to send the application for registration within the term of 60 days. In the event of registration within the following 30 days, the penalty is reduced to 20.00 Euros.

All subjects registered with ENPAPI have to communicate to the institution, by September 10 of each year, the amount of the net income as well as the turnover, or gross amount deriving from professional activity, declared for the previous year for IRPEF purposes.

The pension regulation in art. 10 establishes a penalty for delayed income declaration equal to € 10.00 if the communication is sent within the next seven days from the deadline; equal to € 50.00 if the communication is sent between the eighth and ninetieth days following the deadline; over the ninetieth day there’s a penalty of € 100.00

The taxpayer must annually pay five installments of the same amount, consisting of the minimum contributions for the current year and an advance on the balance due for the previous year, and a sixth installment equal to the balance between the above-mentioned sums already paid and the total amount due as subjective and supplementary contribution, based on the declarations of net professional income and turnover. Advances must be paid in five installments due by the 10th of February, April, June, August and September. The sixth installment must be paid by December 10th.

The institution will send each subscriber specific MAV bulletins in time to make payments by the due dates.

Otherwise, the taxpayer can pay the contributions in a single solution by December 10th.

Freelance Nurses who cease or suspend their professional activity may submit an application for exemption from contributions on the appropriate form that can be downloaded from the ENPAPI website, attaching a document of identity. The exemption is effective from the first day of the month following the termination of the activity. During the exemption period, the member does not accrue contributory seniority and is not entitled to take advantage of maternity and assistance benefits.
If the person submitting the application for exemption has not accrued at least five years of contributions useful for the “pensione di vecchiaia” retirement scheme, they can request the refund of the contributions paid with consequent cancellation of the contributory position.
The refund sums are equal to the amount paid for the subjective contributions.

Only the member who has accrued at least five years of effective contribution can request the redemption of the contributions paid in previous management. The taxpayer, duly registered with ENPAPI at the time of submitting the application, must submit an application to the Entity, which will promote the procedure towards the other Entity/ies to which the professional was previously registered. Totalization can only be requested once. In this case we speak of inbound totalization.
The taxpayer can also request outbound totalization, or ask the Entity to which he is registered to, to transfer the contributions previously paid to ENPAPI. In this case, the application must be submitted to the Social Security Management with which the taxpayer is registered and not to ENPAPI.
The amount of the contributions to be transferred is equal to the sum of the social security contributions paid, plus the compound interest at the annual rate of 4.50% starting from the first day of the year following the one to which they refer and until December 31st of the year immediately preceding the one in which the transfer is made.

Subjective and maternity contributions are tax deductible for personal income tax purposes. The supplementary contribution, on the other hand, is not deductible.

Taxpayers, in compliance with all payments, can submit an application for the following study periods to be considered for the general retirement plan:

  • the achievement of the university degree;
  • the achievement of diplomas and equivalent certificates
  • the achievement of a Bachelor’s Degree in Nursing and a Master’s Degree in Nursing Sciences;
  • participation in the First and Second level Masters


The application, which can be downloaded from the ENPAPI website, must be sent by registered letter with return receipt. or delivered directly to the offices of the institution, attaching the certification as evidence of the degree, the date on which it was obtained, the legal duration of the course of study and its time frame, plus a copy of a valid identity document.

Subjects who benefit from the 50% reduction of the minimum subjective contribution:

  1. those who in addition to the freelance activity, work also as part-time employee with a number of working hours less than or equal to half of full time (reduction for contextual employee work);
  2. those who remained inactive for at least six continuous months during the calendar year (reduction due to professional inactivity);
  3. members who were not thirtieth year old at the time of the first registration with the institution (reduction by age);
  4. members holders of a Partita IVA for the first 4 years of registration with the institution.

The reductions are not cumulative and apply only to the minimum subjective contribution.

You want to open a ‘Partita IVA’ and need help?

Nursing Project provides consulting services to nurses who want to become self-employed or who simply want to be informed.