Therapeutic chiropractic services may be exempt from VAT

The application of Value Added Tax (IVA) in the health and wellness sector frequently raises doubts, especially when activities overlap with aesthetic or sports services. A recent binding ruling from the Dirección General de Tributos (DGT) has delimited the tax treatment applicable to chiropractic services.

What the DGT has ruled

The advisory body has established that chiropractic services may benefit from the VAT exemption as long as they are performed for therapeutic purposes. This implies that the service must be oriented toward the diagnosis, prevention, or treatment of diseases.

For this exemption to be applicable, two concurrent conditions must be met:

• Therapeutic purpose: The service must have a specific health objective.
• Professional qualification: The provider must possess the necessary professional qualifications to perform said activity, regardless of whether chiropractic is a regulated profession within the legal system.

Conversely, the DGT clarifies that other services that may be provided in the same centers, such as aesthetics, physical maintenance, sports activities, or teaching, do not enjoy this exemption and must be taxed at the general VAT rate, as they do not meet the requirement of therapeutic purpose.

What this means for you

If you manage a commercial entity that offers health and wellness services, it is fundamental to clearly separate the activities performed in your invoicing. The nature of the service determines the applicable tax.

The exemption is not automatic based on the name of the activity, but rather on the objective of the treatment and the technical capacity of the provider. If you perform physical maintenance or aesthetic activities, these must be subject to VAT, while chiropractic treatments for health purposes may be exempt upon fulfillment of the aforementioned requirements.

What should be done

It is necessary to conduct an analysis of the actual activity provided at the center to avoid errors in the tax settlement. The correct classification of services is key to determining whether the exemption under Law 37/1992 applies or if the corresponding VAT must be charged. It is recommended to evaluate the documentation that proves the therapeutic purpose of the treatments and the professional's training to support the chosen tax treatment.