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Diagnosis: 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 77 rulings · 2014–2026

Current position

The VAT exemption requires that medical, surgical, or healthcare assistance services be intended for the diagnosis, prevention, or treatment of diseases and be provided by professionals with the required training. This exemption is maintained even if the professional acts through a commercial company or via telematics. Services for aesthetic, relaxing, or slimming purposes independent of a medical treatment do not enjoy the exemption, nor do those whose main purpose is to facilitate an opinion for legal decisions.

The DGT's position remains constant regarding the requirement of objective and subjective criteria for the exemption. Over the years, the administration has specified the limits of the exemption, explicitly excluding aesthetic or legal services and validating provision via telematics.

Turning points

  1. V3497-19

    The exemption is delimited by excluding aesthetic massages or slimming methods performed independently of a medical treatment.

  2. V2538-22

    It is established that services whose main purpose is to facilitate an opinion so that a third party may adopt a decision with legal effects do not enjoy the exemption.

  3. V5431-26

    It is confirmed that the provision of services via telematics does not prevent the application of the exemption as long as human intervention exists.

Analysis based on 76 of 77 rulings with a stated position. Updated 23 September 2026.

Rulings on this topic

24
V0820-24 22 Apr 2024

Telemedicine technology platform services are not exempt from VAT

SG de Impuestos sobre el Consumo
telemedicinaexenciónasistencia sanitariaservicios prestados por vía electrónicaplataforma tecnológica LIVA — Ley 37/1992 del IVA art. 4.UnoLIVA — Ley 37/1992 del IVA art. 5.Uno
Affects CompanyExpat · Non-residentIndividual

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