Medical practice financing: the banks that fund setup and takeover
In practice, practice financing for doctors consists of several components that must fit together in the right order. Whether setting up, taking over or expanding a practice: the capital requirement is rarely the purchase price alone, and the bank that takes on the case is not always your usual bank. A practice loan and practice financing mean the same structure: investment, working capital and public funding such as KfW. The interest rate for practice financing depends on your creditworthiness, the profitability of the practice and the bank.
What does a practice takeover cost, and in which order is it financed?
A takeover is financed in a fixed order: the KfW application comes first, through your bank and before the project begins. If you have already signed the takeover agreement, the lease or the equipment order, you may lose eligibility, so your bank confirms what counts as the start before you sign. Costs depend on the discipline: according to apoBank, a single-handed GP practice takeover averaged €199,500 in total investment in 2023/2024, a dental one €450,000 in 2024.
Medical practice financing: which lenders provide it, and how does KfW funding come in?
Medical practice financing comes from specialist or general banks, with KfW funding via your house bank.
How is a medical practice financed in Germany? Rarely with a single loan: the right mix of a bank loan, KfW funding and equity — plus leasing for expensive medical technology. In the KfW StartGeld programme (067) the KfW takes on 80 % of the credit risk through its liability exemption, which eases the house bank’s decision, but customary bank collateral is still discussed. KfW does not require equity, yet it counts in the credit assessment. Financing for doctors.
Medical practice financing: what is the most common costly mistake? Applying for funding too late. KfW development loans must be applied for before the project begins — if you have already signed the purchase contract or the order, the entitlement may be lost. As a guide, a GP single-practice takeover averaged €188,200 in total investment in 2022/2023 and €199,500 in 2023/2024, a dental one €450,000 in 2024 (apoBank analyses); six-figure sums are the rule.
Setup, takeover or expansion: Which route has which financing logic?
A new setup builds from the ground up with a high capital requirement; a takeover buys an existing practice including the goodwill; an expansion is often a mix of investment loan, leasing and funding.
- New setup: You build from the ground up: premises, medical technology, IT, initial equipment, start-up liquidity. High capital requirement, but full creative freedom.
- Takeover: You buy an existing practice including the patient base. The intangible value (goodwill) is a separate item that must be cleanly valued.
- Expansion / modernisation: New equipment, additional rooms, digitalisation. Often a mix of investment loan, leasing and funding.
Despite a falling number of doctors in private practice, setting up remains for many the route to professional freedom.
Why do practice and private property need to be planned together?
Because both draw on the same ability to service debt. Setting up in your mid-30s and buying a house two years later is typical, and a practice financing planned without the mortgage puts your own home at risk.
That is precisely where we start: we arrange construction financing and practice loans (Praxisdarlehen) in accordance with Sections 34i and 34c of the German Trade Regulation Act (GewO). We plan the sequence, the repayment structure and the allocation of funds between the banks for both projects together.
You can find out how the bank interprets these two plans together and which items are taken into account under Practice and home ownership.
This page explains financing structures in a way that is easy to understand. It is not tax or legal advice (Section 1 of the Tax Advisers Act (StBerG) and the Legal Services Act (RDG)). The tax assessment of your project is a matter for your tax adviser. We structure the financing accordingly.
What drives the investment sum of a practice takeover?
The investment sums are considerable and depend heavily on the specialism — a GP with ultrasound and ECG has a very different requirement from a radiology practice with X-ray technology and radiation protection.
As a rough guide, apoBank reports for a GP single-practice takeover €110,100 purchase price and €188,200 total investment (2022/2023), and a year later about €121,500 and €199,500, of which €78,000 for modernisation and equipment (2023/2024). A dental single-practice takeover averaged €226,000 and €450,000 in 2024. Medical technology, IT and modernisation are the largest items beyond the purchase price itself. Six-figure sums are the rule, not the exception.
Region matters: in the 2023/2024 apoBank sample a GP takeover in a rural area averaged €151,700 in total investment, in a major city €205,000. A new GP practice from scratch averaged €205,800 in 2022/2023, but only about one in ten GPs chose that route.
Understanding goodwill: in a takeover you pay not only for equipment and fittings, but also for the intangible value — the established patient base and the practice’s reputation. The clean valuation of tangible and intangible assets is the foundation of every sound practice financing. We make sure the goodwill is realistic.
Interest rate on practice financing: What does it depend on?
The interest rate depends on your credit rating, the practice’s profitability and the bank. In the case of subsidised loans, the KfW’s guidelines also apply.
The capital required is rarely the purchase price alone. In any case, the sequence of steps is more important than the interest rate. We have deliberately chosen not to quote specific interest rates here, as they change daily and depend on your individual circumstances.
For the StartGeld (067) scheme, the interest rate is based on the capital market and is set on the date of approval. It remains fixed for the entire term, which is a maximum of 5 years (with one repayment-free year) or a maximum of 10 years (with two repayment-free years). KfW publishes the applicable maximum rates at kfw.de/konditionen.
Under Programme 077, the financing partner classifies the loan into creditworthiness and collateral categories. Each price category has a maximum interest rate; the agreed interest rate may be lower than this. The effective interest rates include guarantee fees charged by the guarantee bank (0.98 % from the Federal Government and 1.01 % from the guarantee bank per annum, as per the information sheet dated 10 December 2025).
In addition, there are ancillary costs which you should factor into your comparison. With StartGeld, the commitment fee for undrawn amounts is 0.15 % per month; it begins two banking days and six months after approval. The loan must be drawn down within 12 months of approval; an extension is not possible. Unscheduled repayments are only possible subject to an early repayment penalty.
If you want to work out the instalments, you’ll find a tool for personal use in the financing calculator. For your practice, we’ll work out the debt servicing with you based on the bank’s offers.
What are the building blocks of your financing?
Practice financing is built from four blocks: a bank loan as the backbone, KfW funding with a liability exemption of up to 80 % of the credit risk, equity and leasing for expensive medical technology.
- Bank loan: The backbone. Classic loans with a fixed instalment suit doctors who want a plannable burden from the start. Specialist medical-profession banks know the typical income and investment patterns and often assess practice projects more favourably than a general commercial bank.
- KfW funding: The KfW supports start-ups in the healthcare sector with low-interest loans for premises, equipment and IT — usable for setup, takeover and expansion. Particularly valuable is the liability exemption: under StartGeld 067 the KfW takes on 80 % of the credit risk, so the house bank carries less risk and lending is easier. A development loan combined with a classic bank loan is a common structure.
- Equity: The more you put in, the better the terms — and the more independent you are of outside capital. KfW StartGeld does not require equity, although it should be contributed where possible and it counts in the credit assessment. Whether a practice can be financed without equity depends on the bank’s check of the case; doctors with a secure income often meet the requirements.
- Leasing: For expensive medical technology (e.g. imaging equipment), leasing can preserve credit lines and maintain liquidity.
KfW in numbers: StartGeld 067 covers up to €200,000 per project, of which up to €80,000 may be working capital, with the 80 % liability exemption and application through your house bank before the project begins (KfW fact sheet of 18 June 2026). It cannot be combined with other KfW or ERP programmes. For larger projects the ERP promotional loan 077 reaches up to €500,000, but finances at most 35 % of the eligible costs and needs a guarantee-bank surety, which adds an approval step. KfW programmes for owner-occupiers is a different set of programmes.
Guarantee banks: a guarantee bank (Bürgschaftsbank) of your federal state guarantees up to 80 % of the default risk to your house bank, up to €2 million per company since 1 January 2023. It replaces missing collateral for the bank, it does not change your duty to repay, and it carries a fee that differs by guarantee bank.
Regional KV grants: each regional Association of Statutory Health Insurance Physicians (KV) pays its investment grants from a structural fund under § 105 (1a) SGB V, and each decides amount, area and conditions in its own guideline. Published ceilings range from €39,000 in Rhineland-Palatinate to €70,000 in Nordrhein and €120,000 in Bavaria where under-supply is established, while Westfalen-Lippe pays no flat grant but offers an interest-free practice loan. Most schemes reimburse after you have started practising, so the bank pre-finances the investment. Treat a grant as a planned extra repayment, not as equity. The German-language KV funding cluster lists all 17 regions.
Illustration, not a commitment: a GP takeover with €199,500 total investment (apoBank 2023/2024) and a grant of €70,000 at the Nordrhein ceiling would leave a residual debt of about €129,500 after reimbursement, before tax and interest. The capital you need on day one stays at €199,500. Plan the liquidity for that gap.
Status and sources. Checked on 4 October 2026: KfW fact sheets for StartGeld 067 and programme 077 (18 June 2026), guarantee-bank guidelines, § 105 SGB V, published KV guidelines as summarised in our KV pages, apoBank analyses 2022/2023, 2023/2024 and 2024. The guideline valid at the time of your application is decisive.
Practice financing for doctors: Why does funding come before the bank?
The financing begins with the funding check, not with the bank. KfW promotional loans are applied for via a financing partner of your choice, usually your usual bank, and before the project begins. No funding is granted retrospectively.
- What is practice financing (Praxisfinanzierung)? Rarely a single loan, but a structure of promotional loans, bank loans, a working capital line and, for expensive medical technology, leasing or hire purchase. The capital requirement is rarely the purchase price alone. Financing for doctors.
- Funding application: before the first signature, via a bank of your choice: The application is not made directly to KfW, but via a financing partner. It must be submitted before the project begins. Refinancing and follow-on financing of projects already started are excluded (KfW information sheet 067, as at 18 June 2026). Federal and state funding.
- How does Perini work? Olga Nikushkina first checks eligibility for funding (KfW, Bürgschaftsbank), then obtains offers from specialist banks for the healthcare professions, universal banks with offers for the healthcare professions and regional banks, and brokers practice loans (Praxisdarlehen) and mortgages under §34i and §34c GewO from one concept. Free initial consultation. Federal and state funding.
What does taking over a medical practice cost, and in what order does the financing run? What taking over a medical practice costs depends heavily on the specialism. See also Calculate debt service capacity, Practice valuation: calculate practice value and Practice exchange: practice handover and succession, as well as the Practice financing calculator.
In 2024, taking over a single dental practice cost on average 226,000 euros purchase price and 450,000 euros total investment (apoBank and IDZ, InvestMonitor Zahnarztpraxis 2024). In 2023/2024, taking over a single GP practice averaged just under 200,000 euros total investment, of which 78,000 euros for modernisation and equipment (apoBank and Zi, press release of 20 November 2025). You will find the figures for all specialisms under Costs by specialism.
The average is the most dangerous figure here, because it smooths out peaks and outliers. For single GP practices, 61 % paid a takeover price of no more than 100,000 euros, for 8 % it was over 200,000 euros.
The order is therefore more important than the interest rate: KfW promotional loans must be applied for via a financing partner before the project begins. Anyone who has already signed the takeover agreement, tenancy agreement or equipment order puts the funding at risk.
What counts as the start of the project in the individual case should be clarified with the bank before any signature. As a guide: in programme 299, KfW names the conclusion of a supply or service contract attributable to the execution as the start. A contract subject to a condition precedent of the funding commitment is not regarded there as harmful to funding (information sheet 299, as at 07/2026). For StartGeld and programme 077, the information sheet only states that the application must be made before the project begins.
That is why the funding check comes at the beginning, not at the end. Anyone who puts the components together in the wrong order pays for it over the entire term.
What is the most common costly mistake?
Applying for funding too late.
Many development loans — above all those of the KfW — must be applied for before the contract is concluded, that is, before the project begins. Anyone who has already signed the purchase contract or the order loses the entitlement. This is the most common and most expensive source of error in practice setups. We therefore put the funding application at the start, not the end.
An important distinction: if it is about your private property (your own home, possibly with practice rooms in the same building), you are in the right place on our page Mortgages for doctors. If it is about wealth building with investment property, that is handled by our partner company AUP Finanzservice UG.
Qualified outside Germany? Licence, specialist recognition, entry in the medical register and admission all come before a bank can finance anything — and the KfW application must be filed before you sign. The full sequence: setting up a practice in Germany.
Frequently asked questions
Advice on practice financing: How much does the initial consultation cost?
The initial consultation is free of charge. First, we check your eligibility for funding; then we obtain quotes from specialist banks for healthcare professionals, high-street banks offering services to healthcare professionals, and regional banks. The fee is usually paid by the bank with which the financing is arranged.
Can I finance the practice and my private home together?
Yes, combined concepts are possible and in part lead to interest advantages. The clean separation of purposes from a tax point of view is important — you discuss that with your tax adviser, and we structure the financing to fit.
Is it possible to finance a practice without equity capital?
In individual cases, yes. apoBank states that financing with or without equity is possible, and under the StartGeld scheme, KfW exempts the intermediary bank from 80 % of the liability. However, approval without equity is still contingent upon a viable business plan, a sound credit rating and a complete set of documents. With the StartGeld scheme, any existing equity is taken into account in KfW’s credit assessment. Find out more under Practice financing without equity.
Is the interest on practice financing tax-deductible?
Interest connected with running the practice is in principle deductible as a business expense — both for setup and takeover. The specific tax assessment is handled by your tax adviser.
When do I need to submit the grant application?
Before the project begins – that is, before you sign a purchase agreement, tenancy agreement or equipment order. The application is processed through a financing partner of your choice, not directly with KfW. Anything financed after the project has begun is excluded. In the case of conditional contracts, check with the bank in advance whether they count as the start date.
Which bank is the right one for my practice?
That depends on the specialism, the project and your situation. Besides general banks there are institutions aimed specifically at the medical professions. We compare and select the right one — independently and free.
Buying a practice or looking to sell one: where can I find listings?
In planning areas subject to licensing restrictions, the KV advertises the vacancy in its official gazettes following an approved vacancy-filling procedure and maintains a list of applicants (Section 103(4) of Book V of the Social Code). In addition, according to its own information, apoBank operates a practice exchange that brings together sellers and buyers. Before you purchase a practice, the financing arrangements should be consistent with the licensing requirements.
Does a KV grant count as equity for the bank?
No. Without an approval notice the grant is only an expectation, there is usually no legal entitlement, and most KVs pay after you have started practising. Obligations such as five years of practice in the funded area, with partial repayment if you leave early, are common. Plan the financing so that it works without the grant.
What does a GP practice takeover cost, and how does it split?
apoBank reports about €199,500 total investment for a GP single-practice takeover in 2023/2024: around €121,500 purchase price and €78,000 for modernisation and equipment. A rural takeover averaged €151,700, one in a major city €205,000. Costs differ strongly by specialty.
Which KfW programme fits a practice?
StartGeld 067 covers up to €200,000 per project and typically fits a GP takeover or a smaller setup. Larger projects, common for dental takeovers, may need programme 077 with a guarantee-bank surety. 067 and 077 cannot be combined. The application goes through your house bank before the project begins.
Can I get a practice loan without a land charge?
For established practices there is a business loan of EUR 20,000 to 750,000 without a land charge through our partner bank, for doctors who have been self-employed for at least two full calendar years. Whether and on what terms it is granted is decided by the bank. Details: practice loan without collateral.
How much does a loan for doctors cost compared to a standard business loan (Firmenkredit)?
There’s no one-size-fits-all answer. The interest rate depends on your credit rating, profitability, the term of the loan and the bank. Subsidised loans such as StartGeld have a reduced interest rate because they are subsidised by ERP funds. Only by comparing several offers will you be able to determine whether a practice loan is more cost-effective for you than a standard business loan.
How long does the financing commitment take?
With complete documents and a clear financing plan, it goes quickly. We prepare your application so that the bank can decide fast.
A similar situation? Let's talk.
Every mortgage is an individual case. In a free initial consultation we tell you honestly what is feasible and which bank fits.
Perini Finance & Property — licensed under §34i and §34c GewO, 650+ banks compared. We know the banks whose lending rules cover practice setup, takeover and expansion — including the specialist medical-profession banks and the KfW application at the start, not the end. Financing information, not legal or tax advice (§ 1 StBerG, RDG), without guarantee.
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Editorially responsible: Olga Nikushkina — owner, §34i GewO (German mortgage brokerage), adviser register D-W-132-ZUCB-95. Specialised in German property financing with an international dimension: non-residents, foreign-currency income, cross-border workers, expats. Siegfried Perini is entered in the German intermediary register under this licence as a person directly involved in brokerage and advice (§ 11a GewO), active in real estate since 1992. Not legal or tax advice.
