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Medical Professional: 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 11 rulings · 2015–2026

Current position

The VAT exemption requires an objective requirement (assistance services for the diagnosis, prevention, or treatment of diseases) and a subjective one (provided by medical or healthcare professionals). Services with purely aesthetic purposes, such as hair implants or alopecia treatments for cosmetic purposes, are taxed at the general rate of 21%. The determination of whether the purpose is therapeutic or aesthetic is a matter of fact that must be assessed on a case-by-case basis.

The DGT's position remains stable regarding the application of the dual exemption condition (objective and subjective). Since 2018, the doctrine has focused on delimiting the boundary between healthcare assistance and aesthetic services, confirming the 21% tax rate for alopecia treatments or implants without a medical purpose.

Turning points

  1. V2687-18

    Establishes that aesthetic surgery services or aesthetic treatments, such as implants or alopecia treatments, are subject to the general rate of 21%.

Analysis based on 11 of 11 rulings with a stated position. Updated 27 September 2026.

Rulings on this topic

11
V2687-18 2 Oct 2018

Alopecia treatments for aesthetic purposes subject to 21% VAT

SG de Impuestos sobre el Consumo
exenciónasistencia sanitariafines estéticostipo generalprofesional médico 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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