Summary
Nurses (perawat) and midwives (bidan) in Indonesia work primarily as hospital or clinic employees. Many also run private practice. Understanding which income is withheld and which must be self-reported is essential for compliance.
Tax Status of Nurses and Midwives
| Work Arrangement | Tax Treatment |
|---|---|
| Employee (hospital/clinic/puskesmas) | PPh 21 withheld monthly by employer |
| Government employee (PNS) | PPh 21 borne by government |
| Private midwifery/nursing practice | Self-employment income, SPT 1770 |
| Visiting nurse/midwife (from entity) | PPh 21 DPP 50% by payer entity |
Most nurses and midwives at the beginning of their careers have income below PTKP and therefore owe no PPh. As income grows, understanding the rules becomes increasingly important.
Key Regulations
| Regulation | Article | Provision |
|---|---|---|
| UU PPh No. 36/2008 | Article 21(1) | Withholding on professional income |
| PMK 168/PMK.03/2023 | Article 13(7) | DPP for expert workers = 50% of gross income |
| PP 80/2010 | Article 1 | Final PPh on civil servant honoraria from APBN/APBD |
| PER-17/PJ/2015 | Appendix | NPPN for healthcare KLU |
| PP 55/2022 | Article 7 | Final PPh 0.5% MSME |
How to Calculate PPh
1. Hospital/Clinic Employee
PPh 21 withheld monthly based on salary and benefits.
Example: Nurse salary IDR 6,000,000/month, single/no dependants.
- Annual gross: IDR 72,000,000
- Less occupational deduction: IDR 3,600,000 (5% x IDR 72M)
- Less PTKP (TK/0): IDR 54,000,000
- Taxable income: IDR 14,400,000
- PPh: 5% x IDR 14,400,000 = IDR 720,000/year (IDR 60,000/month withheld)
Junior nurse (salary IDR 4,000,000/month): Annual gross IDR 48,000,000 — below PTKP — no PPh.
2. Private Practice (Bidan Mandiri/Klinik)
Private practice income is self-employment income. Midwives with a government permit (SIPB) operating a private practice must register a NPWP and file SPT 1770 once income exceeds PTKP.
Example: Private midwifery clinic, annual gross IDR 300,000,000.
With NPPN (KLU 86900, norm 45%, major city):
- Deemed net income: IDR 135,000,000
- Less PTKP (TK/0): IDR 54,000,000
- Taxable income: IDR 81,000,000
- PPh: 5% x IDR 60M + 15% x IDR 21M = IDR 3M + IDR 3.15M = IDR 6,150,000
With final PPh 0.5% (below IDR 500M threshold): IDR 0 (exempt)
3. Honoraria from Government Programs (DIPA/BOK)
Incentives paid by Puskesmas or Dinas Kesehatan from the government budget are subject to PPh final under PP 80/2010, withheld at source by the paying government entity.
VAT for Healthcare
Healthcare services provided by licensed practitioners are exempt from VAT under UU PPN Article 4A. Private midwifery and nursing clinics do not charge VAT on services.
Filing Your Annual Tax Return
Hospital/clinic employee only:
- Use SPT 1770 SS (income below IDR 60M, one employer) or 1770 S
Multiple income sources (employee + private practice):
- Use SPT 1770
- Collect bukti potong from employer and any entity payers
- Report private practice income using NPPN or final PPh 0.5%
- Deadline: 31 March
Real-World Example
Bidan Lena, midwife with private clinic, 2024:
| Source | Gross | PPh Withheld |
|---|---|---|
| Government Puskesmas salary | IDR 84,000,000 | IDR 1,500,000 |
| BOK/government incentive (APBN) | IDR 18,000,000 | PPh final (withheld by Puskesmas) |
| Private midwifery clinic | IDR 180,000,000 | — |
| Total | IDR 282,000,000 | — |
Private clinic income IDR 180M is below IDR 500M threshold: final PPh = IDR 0.
At SPT: report all sources, credit Puskesmas withholding, no underpayment.