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A pharmaceutical and medical equipment company has enquired whether the provision of home dialysis services constitutes a single operation exempt as healthcare or a mixed contract. The DGT has determined that it does not constitute healthcare and that these are independent services subject to different tax rates.
Cuestión planteada Tratamiento a efectos del Impuesto sobre el Valor Añadido de las operaciones efectuadas por la entidad consultante y, en concreto, si suponen un contrato mixto que incluye varias prestaciones independientes o bien una operación única que deba calificarse como servicio sanitario exento.
El suministro de bienes y servicios de diálisis domiciliaria no constituye asistencia sanitaria al no asumir la vigilancia clínica ni la atención médica. Se trata de prestaciones independientes: los productos tributan al 4% o 10% según su categoría, mientras que la cesión de uso de equipos técnicos tributa al tipo general del 21%. En operaciones por precio único, la base imponible se determinará proporcionalmente al valor de mercado de cada elemento. Los servicios de formación sobre el uso de los equipos se consideran accesorios a la operación principal.
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