CNAE for an orofacial harmonization clinic: how to choose

Anyone opening or regularizing an orofacial harmonization (HOF) clinic in Brazil soon runs into the CNAE: the seven-digit code that appears on the CNPJ card (Brazil's company registration) and that the city, the health surveillance agency and the Receita Federal use to decide what the company can be and how much it pays. Choosing the wrong code does not prevent the clinical act, but it can lead to improper taxation, unnecessary requirements and headaches in an inspection.

This guide explains what the CNAE is, how to think about choosing the main and secondary codes and what to check with the right people. It does not replace the accountant, who is the one who builds your company's classification.

What is the CNAE and who defines the codes?

The National Classification of Economic Activities (CNAE) organizes Brazil's economic activities into sections, divisions, groups, classes and subclasses. It is maintained by the IBGE through the National Classification Commission (CONCLA) and used by the Receita Federal, states and cities.

A company has one main economic activity and may have secondary activities. The main one is usually the one that generates most of the revenue and guides tax classification and licensing. Secondary ones record other activities carried out.

How does the CNAE relate to orofacial harmonization?

Orofacial harmonization is not a separate economic activity in the table. It is a set of procedures performed by qualified healthcare professionals, and it is the type of activity that defines the code. In general terms:

• Human health care activities fall under division 86 of the CNAE (section Q, human health and social services).
• Within it there are subclasses for dental activity, outpatient medical activity and other health care activities.
• Beauty care activities, such as aesthetics and beautification, fall under another division and describe services that are not healthcare procedures.

To give an idea of the kind of code, the following often appear in health and aesthetics clinics, among others: dental activity (8630-5/04), other unspecified human health care activities (8690-9/99) and aesthetics and other beauty care activities (9602-5/02). This is not a recommendation on classification: the right code for your case depends on the profession and on the activity the company actually carries out, and the official CONCLA table should be consulted at the time of choosing.

What is the difference between a main and a secondary code?

Adding codes "just in case" seems harmless, but each registered activity can attract a requirement for a business permit, a health license or inspection. If the clinic also sells skin care products or offers a non-clinical aesthetics service, that is a case for the secondary code, as long as it really happens.

How do you choose your clinic's CNAE in 6 steps?

1. Define who performs the procedure. Dentist, physician, biomedical professional, nurse and pharmacist have different activities and councils. Confirm your council's rules on what may be performed and advertised.
2. List what the clinic will actually do. Consultation, injectable procedures, product sales, non-clinical aesthetics, courses.
3. Check the official CONCLA/IBGE table. Look up division 86 and the other activities that apply, and read the description and explanatory notes of each subclass.
4. Take the list to your accountant. They cross the code with the possible tax regime and the city's ISS.
5. Confirm with the city. The city says which codes it accepts for a business permit and what requirements each brings. What holds for one city may not hold for another.
6. Confirm the health requirements. The municipal or state health surveillance agency tells you what the activity requires in facilities, license and responsible professional.

Does the CNAE change taxes?

It can. Tax classification depends on the chosen regime (Simples Nacional, presumed profit, actual profit), the activity, revenue and the city's ISS rules (the municipal services tax). In some regimes, the code defines the applicable table or rate. That is why the choice should be made together with the accountant, not afterward.

Other points that usually depend on the activity:

• whether the company can opt for a given regime;
• the amount and method of ISS payment in the city;
• business permit and license requirements;
• the company's registration with a professional council, where required.

To know how much each patient yields before doing this math, see the average ticket in HOF. Tax reform will also change the rules in the coming years, and the accountant should follow it along with your company's classification.

What does the CNAE not do?

• It does not qualify anyone to perform procedures. That depends on training and council registration, according to each profession's rules.
• It does not replace the business permit or health license. Regular operation depends on them, plus other city requirements.
• It does not define permitted advertising. What the clinic may advertise follows the council's rules and CONAR's (Brazil's advertising self-regulation body). See what you may advertise.
• It does not settle clinical documentation. Patient records, consent and lot records remain mandatory. See patient records and informed consent.

How much does it cost to open a CNPJ and change the CNAE?

There is no single number. The cost of opening a company depends on the type (partnership, sole proprietor, simple partnership), the state, the city and the accountant's fees. Some items appear in most cases:

Changing the CNAE later is also possible, and the accountant handles the registration change. But remember that changing the code may require a new permit or a new review by the city. That is why it is better to get it right before opening.

Hypothetical example: a dentist who works in her own office wants to open a company to offer dental consultations and HOF procedures. She lists the activities and takes them to the accountant, who suggests the main code compatible with dental activity and discusses whether a secondary code makes sense. She then confirms with the city which codes it accepts for a business permit and which health requirements apply. Only then does she open the CNPJ. This path avoids discovering, after opening, that the chosen code is not accepted by the city.

CNAE checklist

• Do I know the profession of whoever performs the procedures and what my council says?
• Did I list everything the clinic will do, not just the main procedure?
• Did I check the subclass descriptions in the official CONCLA/IBGE table?
• Does the main code reflect most of the expected revenue?
• Do the secondary codes match real activities?
• Did the accountant assess the effect on the tax regime and the ISS?
• Did the city confirm it accepts the code and state the requirements?
• Did health surveillance state the license and responsible professional?
• Did I record in writing what each professional confirmed?

The CNAE is a registration, not a strategy. Choose with information, record the answers in writing and review it when the clinic changes its activity. For the design of the clinic as a whole, the page how to position the HOF clinic helps you think through the offer before formalizing the business.