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Medical Assistance: DGT doctrinal evolution

How the DGT's position on this topic has evolved, and the rulings it rests on.

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How the DGT's position has evolved

Settled doctrine High confidence 16 rulings · 2014–2025

Current position

The VAT exemption requires the coexistence of an objective requirement (services for the diagnosis, prevention, or treatment of diseases) and a subjective one (provision by medical or healthcare professionals). This exemption is maintained for teleconsultation services if human intervention exists and applies even when the professional invoices through a company or association. Automated actions or the mere leasing of machinery with a control technician are not considered exempt services.

The DGT's position remains constant regarding the requirement of objective and subjective criteria for the exemption. Over the years, the doctrine has clarified the scope of the exemption by including teleconsultation with human intervention and invoicing through companies, always maintaining the necessity that the service be healthcare-related and not merely technical or automated.

Turning points

  1. V3077-19

    Clarifies that the leasing of a machine with a control technician does not constitute a diagnostic, prevention, or treatment action.

  2. V0601-22

    Establishes that teleconsultation maintains the exemption as long as human intervention exists and it is not a service provided via automated electronic means.

  3. V1044-23

    Confirms that the exemption is applicable even if the healthcare professional invoices the service through a company or association.

Analysis based on 16 of 16 rulings with a stated position. Updated 26 September 2026.

Rulings on this topic

16
V1816-25 13 Oct 2025

Private medical insurance included in child support amounts

SG de Impuestos sobre la Renta de las Personas Físicas
anualidades por alimentosbase liquidable generalcuota íntegrarégimen de especialidadesasistencia médica LIRPF — Ley 35/2006 del IRPF art. 55LIRPF — Ley 35/2006 del IRPF art. 58
Affects CompanyExpat · Non-residentIndividual
V3656-15 23 Nov 2015

Medical examinations for driving licences are exempt from VAT

SG de Impuestos sobre el Consumo
exenciónasistencia médicadiagnósticoprevenciónprofesional sanitario LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 20.Uno.3
Affects CompanyExpat · Non-residentIndividual
V0556-14 3 Mar 2014

Naturopathy services subject to standard 21% VAT rate

SG de Impuestos sobre el Consumo
exencióntipo impositivoprofesionales sanitariosasistencia médicanaturopatía LIVA — Ley 37/1992 del IVA art. 20.uno.3ºLIVA — Ley 37/1992 del IVA art. 90.uno
Affects CompanyExpat · Non-residentIndividual

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