Doctrine by topic · DGT Observatory

Healthcare 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

Refined position High confidence 66 rulings · 2014–2026

Current position

The VAT exemption requires the coexistence of an objective requirement (services for the diagnosis, prevention, or treatment of diseases) and a subjective requirement (provision by medical or healthcare professionals). Following the CJEU jurisprudence, the status of a healthcare professional is not limited to professions regulated by national regulations, provided that the professional possesses the necessary qualifications to guarantee a sufficient level of quality.

The DGT's position has evolved from an approach based on national regulation toward one aligned with CJEU jurisprudence. Initially, the exemption was linked to professionals with specific titles, but more recent rulings allow the exemption for non-regulated professionals (such as osteopaths) if they prove sufficient qualifications to guarantee the quality of the service.

Turning points

  1. V2684-20

    Introduces the CJEU interpretation indicating that the exemption is not limited to professions regulated by national regulations, provided that the necessary qualifications are possessed.

Analysis based on 63 of 66 rulings with a stated position. Updated 21 September 2026.

Rulings on this topic

24
V0276-26 9 Feb 2026

Preventive medical services in healthcare facilities exempt from VAT

SG de Impuestos sobre el Consumo
asistencia sanitariaexención de IVAmedicina preventivaprofesional sanitarioprevención de enfermedades LIVA — Ley 37/1992 del IVA art. 4.unoLIVA — Ley 37/1992 del IVA art. 5.uno
Affects CompanyExpat · Non-residentIndividual
V2676-21 5 Nov 2021

Telehealth services may be VAT exempt if they serve a therapeutic purpose

SG de Impuestos sobre el Consumo
exenciónasistencia sanitariafinalidad terapéuticaentidad de carácter socialservicios prestados por vía electrónica 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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