Tax Planning for Physicians in Missouri (2026)
Physicians in Missouri face a top rate of 4.7% on top of the 37% federal bracket and payroll taxes. This guide summarizes the 2026 Missouri rules that matter most to doctors, dentists and practice owners.
Missouri income tax rates for 2026
Missouri's top 2026 rate is 4.7%. Brackets apply to state taxable income.
Single
| Rate | Taxable income |
|---|---|
| 2% | $1,348 to $2,696 |
| 2.5% | $2,696 to $4,044 |
| 3% | $4,044 to $5,392 |
| 3.5% | $5,392 to $6,740 |
| 4% | $6,740 to $8,088 |
| 4.5% | $8,088 to $9,436 |
| 4.7% | Over $9,436 |
Married filing jointly
| Rate | Taxable income |
|---|---|
| 2% | $1,348 to $2,696 |
| 2.5% | $2,696 to $4,044 |
| 3% | $4,044 to $5,392 |
| 3.5% | $5,392 to $6,740 |
| 4% | $6,740 to $8,088 |
| 4.5% | $8,088 to $9,436 |
| 4.7% | Over $9,436 |
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
Kansas City and St. Louis each levy a 1% earnings tax on residents and on nonresidents who work in the city.
Planning notes for Missouri physicians
- Missouri's top rate is 4.7%, but the 1% earnings tax in Kansas City and St. Louis applies to wages and practice net profits.
- Physicians on the Kansas or Illinois side of the metro areas still pay the city earnings tax on work performed in Kansas City or St. Louis.
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 Missouri:
- 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 Missouri physicians
Local taxes and planning notes for physicians in Kansas City, St. Louis, Springfield, Columbia. 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 Missouri state income tax rate for physicians in 2026?
Missouri has a top rate of 4.7% for 2026. Your effective state rate depends on deductions and filing status.
Does Missouri 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 Missouri?
Yes. GenWealth 360 provides tax planning for physicians, dentists and practice owners in all 50 states, including Missouri, 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
- Tax Foundation: state individual income tax rates, 2026
- Tax Foundation: 2026 state tax changes
- AICPA: state pass-through entity tax map
- IRS Notice 2020-75 (entity-level state taxes)
- IRS: 2026 inflation adjustments (IR-2025-103)
- Charles Schwab: the SALT deduction
- City of Kansas City, Missouri: earnings tax
- City of Kansas City, Missouri: tax form descriptions
- NextSTL: St. Louis earnings tax
- Local income tax rates (Pay44 local tax reference)
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.