Tax Planning for Physicians in Boston, MA (2026)

Physicians in Boston pay federal tax at up to 37% plus Massachusetts income tax (a top rate of 9%). Here is how the 2026 rules apply to doctors, dentists and practice owners in Boston, MA.

2026 at a glance for Boston, MA physicians

State tax figures apply Massachusetts's 2026 brackets to state taxable income and ignore credits, deductions and local taxes.

Local taxes in Boston

Boston does not levy a city income tax, and Massachusetts physicians generally do not face a separate city or county income tax on wages. Your tax picture is the federal rules plus Massachusetts, which has a top rate of 9%.

State rules that apply in Boston

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.

• 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.

Where the savings usually come from

For most Boston physicians, federal planning drives the largest results: W-2 strategies such as 401(k)/403(b), 457(b) and the backdoor Roth; 1099 and locum planning; entity and cash balance plan design for practice owners; and real estate strategies for physicians with time to participate.

More physician tax guides

• Other Massachusetts cities: Worcester, Springfield, Cambridge.
• State rules: Massachusetts physician tax guide and all 50 state guides.
• By specialty: Emergency Physicians, Plastic Surgeons, Surgeons, Cardiologists and every specialty.
• Core strategy: tax planning for physicians, tax planning for medical practice owners, advanced strategies for high-income physicians and S corporation tax planning for physicians, plus the physician tax glossary.

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.