Tax Planning for Physicians in Massachusetts (2026)
Physicians in Massachusetts face a top rate of 9% on top of the 37% federal bracket and payroll taxes. This guide summarizes the 2026 Massachusetts rules that matter most to doctors, dentists and practice owners.
Massachusetts income tax rates for 2026
Massachusetts's top 2026 rate is 9%. Brackets apply to state taxable income.
Single
| Rate | Taxable income |
|---|---|
| 5% | $0 to $1,083,150 |
| 9% | Over $1,083,150 |
Married filing jointly
| Rate | Taxable income |
|---|---|
| 5% | $0 to $1,083,150 |
| 9% | Over $1,083,150 |
Pass-through entity tax (SALT workaround)
Yes. The state has an elective pass-through entity tax (PTET) that partnerships and S corporations can use to deduct state income tax at the entity level.
For physician practice owners, the PTET matters more in 2026 because the federal SALT deduction for individuals phases back down toward $10,000 once modified AGI passes $505,000. Read our guide to the pass-through entity tax for physicians.
Local income taxes
Massachusetts physicians generally do not face a separate city or county income tax on wages.
Planning notes for Massachusetts physicians
- Massachusetts taxes most income at 5% and adds a 4% surtax on income over $1,083,150 (2026), so a single large year, such as a practice sale, can trigger the surtax.
- Spreading a practice sale across tax years or using an installment sale can reduce exposure to the Massachusetts millionaire's surtax.
Federal strategies that apply in every state
State tax is only part of the picture. The federal rules drive most of the savings for physicians in Massachusetts:
- W-2 physician tax strategies: maximize 401(k)/403(b), 457(b), HSA and the backdoor Roth.
- 1099 physician tax planning: solo 401(k), deductions and the S corporation decision.
- Practice owners: entity, compensation, cash balance plans and exit planning.
- Real estate and cost segregation for physicians with time to participate.
City guides for Massachusetts physicians
Local taxes and planning notes for physicians in Boston, Worcester, Springfield, Cambridge. Our planning is delivered virtually, so location does not limit access.
Guides by specialty
Surgeons · Anesthesiologists · Radiologists · Orthopedic Surgeons · Cardiologists · Dentists · Dermatologists · Emergency Physicians · Gastroenterologists · Ophthalmologists · Neurosurgeons · Plastic Surgeons · Psychiatrists · Hospitalists · Pain Management Physicians
Frequently asked questions
What is the Massachusetts state income tax rate for physicians in 2026?
Massachusetts has a top rate of 9% for 2026. Your effective state rate depends on deductions and filing status.
Does Massachusetts have a pass-through entity tax?
Yes. The state has an elective pass-through entity tax (PTET) that partnerships and S corporations can use to deduct state income tax at the entity level.
Can GenWealth 360 help physicians in Massachusetts?
Yes. GenWealth 360 provides tax planning for physicians, dentists and practice owners in all 50 states, including Massachusetts, through virtual meetings.
Get a tax plan built for your situation
GenWealth 360 builds proactive, tax-first plans for physicians, dentists and medical practice owners in all 50 states. Start with a conversation about your income, entity and goals.
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Sources
This article is for general educational purposes and is not tax, legal or investment advice. Tax law changes often and its application depends on your facts. Figures reflect 2026 rules as published by the sources listed above. Consult a qualified professional before acting. See our editorial policy.