1099 Physician Tax Calculator 2026

🩺 Calculate Your 1099 Physician Taxes

Runs entirely in your browser — nothing you type is sent or stored. Official 2026 figures: IRS Rev. Proc. 2025-32 brackets, $16,100 / $32,200 standard deduction, SE tax 15.3% on 92.35% of net profit with Social Security capped at $184,500, 0.9% Additional Medicare above $200,000 / $250,000, and full 2026 progressive brackets for all 41 taxing states + DC. Retirement contributions reduce income tax but not SE tax, exactly as on a real return. QBI is reported as eligible / phased out / not eligible rather than applied.

Why a physician's 1099 tax bill behaves differently

Most 1099 calculators are built for a $60,000 freelancer and quietly break at physician incomes. Four things change once net profit crosses roughly $185,000:

• Social Security stops. The 12.4% Social Security half of self-employment tax applies only to the first $184,500 of net earnings (92.35% of profit) in 2026. Above that, only Medicare continues. A calculator that applies 15.3% to all of a $300,000 profit overstates SE tax by about $9,000.
• Additional Medicare Tax starts. An extra 0.9% applies to net earnings above $200,000 (single) or $250,000 (joint). Employers withhold it automatically for W-2 doctors; 1099 doctors must include it in estimated payments.
• The QBI deduction disappears. Health care is a "specified service trade or business." The 20% qualified business income deduction phases out between $201,750 and $276,750 of taxable income for single filers ($403,500–$553,500 joint) and is unavailable above that. Retirement deferrals that pull taxable income under the threshold can be worth double.
• Federal brackets climb to 32–35%. Combined with a high-tax state, marginal rates on the last dollar reach 45–50%, which is why a Solo 401(k) is the first conversation every 1099 physician should have.

Worked example: locum tenens hospitalist, $300,000 gross

Single filer, $300,000 of 1099 locum income, $15,000 of expenses (malpractice tail, licences, CME, travel not reimbursed), no retirement contribution yet.

Married filing jointly on the same $285,000 in a no-tax state: total tax falls to $72,822 (25.6%), because the 24% bracket extends to $403,550 and the Additional Medicare threshold rises to $250,000.

Now add a $72,000 Solo 401(k) contribution

The employer and employee pieces together can reach $72,000 in 2026 ($80,000 at age 50+). That contribution comes off adjusted gross income, not off self-employment earnings, so SE tax is unchanged — but federal taxable income drops from $253,360 to $181,360, out of the 32% bracket and below the $201,750 QBI threshold. Federal income tax falls by about $21,400 (California tax by a further $6,700), the QBI deduction comes back, and the true cost of putting $72,000 into retirement is $44,000–$51,000 of take-home depending on state. The calculator shows this line by line when you enter a contribution.

Deductions specific to 1099 physicians

The multi-state problem for locums

Income is taxed where the work is physically performed. A Colorado-resident hospitalist who works a 12-week block in Oregon and a 6-week block in Texas owes Oregon tax on the Oregon earnings (non-resident return), owes Texas nothing, and reports everything on the Colorado return with a credit for the tax paid to Oregon. Practical consequences:

• Keep a log of days and gross pay by state — agencies' pay statements usually show the facility location.
• Non-resident returns are needed in most states with income tax once you exceed a small threshold (often the state's filing threshold or a set number of days).
• State estimated payments follow the same logic: the work state may expect quarterly payments too.
• Assignments in Texas, Florida, Tennessee, Washington, Nevada, South Dakota, Wyoming and Alaska generate no state tax and no extra return — a real reason locums cluster there.
• Changing your own residence to a no-tax state only helps if you genuinely move; states like California and New York audit domicile aggressively.

The calculator applies your home state's brackets to all of the income; treat the state line as an upper bound if part of the year was worked in a no-tax state.

Quarterly estimated taxes at physician income

Locum agencies withhold nothing, so the $88,000–$110,000 in the example above must be paid in four instalments — April 15, June 15, September 15, 2026 and January 15, 2027. Two rules matter more for physicians than for other contractors:

The 110% safe harbor. If last year's adjusted gross income was above $150,000 — true for almost every physician — the penalty-proof amount is 110% of last year's total tax, paid in equal quarters, not 100%. First-year locums coming off a residency W-2 often have a low prior-year tax and can pay the safe-harbor amount, which is far less than the current-year projection, then settle the balance in April with no penalty. This is a legitimate, IRS-sanctioned cash-flow strategy — but only if the April balance is actually saved.

Additional Medicare Tax is part of the estimate. Form 1040-ES includes it; forgetting the 0.9% on income above $200,000 is a common cause of a surprise underpayment. Our quarterly tax calculator lays out all four payments and the safe-harbor figure; payments go through IRS Direct Pay or EFTPS.

S-corp for a 1099 physician: the honest math

The common pitch is "save 15.3% on distributions." For a physician that is wrong in an important way: Social Security tax is already capped at $184,500, so once your reasonable salary is at or above the wage base, the S-corp only avoids Medicare (2.9%, or 3.8% with Additional Medicare) on the distribution. On $285,000 of profit with a $185,000 salary, the SE-tax saving is roughly $100,000 × 3.8% ≈ $3,800 — before payroll fees, a Form 1120-S, state S-corp taxes (California charges 1.5% of net income, about $4,300 here, which erases the saving), and a smaller Solo 401(k) employer contribution (25% of salary rather than 20% of total profit). The election usually pays off only when profit is well above $300,000 or when the reasonable salary can defensibly be set well below the wage base. Run it with a CPA who works with physicians rather than assuming.

1099 physician tax FAQ

How much tax does a 1099 physician pay?

A single locum physician netting $285,000 in 2026 owes about $88,600 in a no-income-tax state (31%), $104,000 in New York (36%) and $109,400 in California (38%), before retirement contributions. Self-employment tax is $31,080 of that because Social Security stops at $184,500 of net earnings.

How much should a locum tenens physician set aside for taxes?

Set aside 32–35% of gross locum income in a no-tax state and 38–42% in California, New York, New Jersey or Oregon, then reduce that once you have funded a Solo 401(k). Because locum agencies withhold nothing, the money must go into quarterly estimated payments.

Can a 1099 physician take the QBI deduction?

Only at lower incomes. Medicine is a specified service trade or business, so the 20% QBI deduction phases out between $201,750 and $276,750 of taxable income for single filers ($403,500–$553,500 married filing jointly) in 2026 and is gone above the top figure. Retirement deferrals that lower taxable income can bring some physicians back into the range.

Do locum tenens physicians pay tax in every state they work in?

Generally yes. Income earned while physically working in a state with income tax is taxable there, so you file a non-resident return in each such state and claim a credit on your home-state return. Working assignments in Texas, Florida, Tennessee, Washington or Nevada avoids the extra return.

Is an S-corp worth it for a 1099 physician?

Above roughly $200,000–$250,000 of net profit an S-corp often saves $5,000–$15,000 a year by limiting Medicare tax to a reasonable salary, but Social Security tax is already capped at $184,500 either way, so the saving is Medicare-only (2.9%–3.8%) on the distribution. Payroll, a corporate return, state fees and a smaller QBI base eat into it.

What can a 1099 physician deduct that a W-2 physician cannot?

Malpractice insurance you pay yourself, DEA and state licensing fees, board certification and CME including travel, professional memberships, scrubs and equipment, travel and lodging for assignments away from your tax home, a home office, health insurance premiums, and up to $72,000 of Solo 401(k) contributions.

Related tools

The independent contractor calculator adds a W-2 salary equivalent and safe-harbor figure; Solo 401(k) vs SEP-IRA compares the two retirement plans at high incomes; the main 1099 calculator covers any self-employment income in all 50 states.