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A plastic surgeons' association has queried whether healthcare exemptions extend to psychological issues. The DGT has ruled that aesthetic interventions are exempt if their purpose is to treat an illness, injury, or congenital physical defect, noting that health issues may be psychological provided there is medical verification.
Cuestión planteada Aplicación de la exención a las prestaciones de cirugía plástica que tengan por objeto actuaciones conducentes al restablecimiento o mejora de la salud de los pacientes. En concreto, si el concepto de "enfermedad" previsto en el artículo 20.Uno.3º de la Ley 37/1992 se limita a dolencias físicas o también comprende las de tipo psicológico.
Están exentos los servicios de asistencia médica, quirúrgica o sanitaria para diagnóstico, prevención o tratamiento de enfermedades, prestados por profesionales cualificados. Las intervenciones de naturaleza estética pueden estar exentas si tienen como finalidad tratar a personas que, debido a una enfermedad, lesión o defecto físico congénito, necesiten dicha intervención. Los problemas de salud pueden ser de tipo psicológico, pero la apreciación no puede ser una percepción subjetiva del paciente, sino una constatación médica realizada por personal cualificado. Si la intervención responde a fines meramente cosméticos, estará sujeta al tipo general del 21%.
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