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Healthcare Professionals: 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 34 rulings · 2014–2026

Current position

The VAT exemption for healthcare services requires compliance with an objective requirement (diagnosis, prevention, or treatment of diseases) and a subjective one (provision by medical or healthcare professionals with the required training). This exemption applies to services provided via telematics as long as there is human intervention and they are not automated services. The exemption does not apply to services for aesthetic, relaxation, or slimming purposes, nor to alternative methods provided independently of a medical treatment.

The DGT's position has remained constant in requiring both objective and subjective requirements for the exemption. The evolution is limited to the incorporation of video consultation or telematics modalities, confirming that human intervention preserves the healthcare nature of the service.

Turning points

  1. V0601-22

    Clarifies that the exemption applies to video consultations as long as they are not services provided electronically with minimal human intervention.

Analysis based on 34 of 34 rulings with a stated position. Updated 24 September 2026.

Rulings on this topic

24
V0781-23 3 Apr 2023

Physiotherapy deemed a professional activity; VAT exemption depends on service purpose

SG de Impuestos sobre la Renta de las Personas Físicas
rendimientos de actividades profesionalesobligación de retenerexención de asistencia sanitariafinalidad terapéuticaprofesionales sanitarios RIRPF — RD 439/2007, Reglamento del IRPF art. 74RIRPF — RD 439/2007, Reglamento del IRPF art. 75
Affects CompanyExpat · Non-residentIndividual
V2257-20 2 Jul 2020

Health services exempt from VAT; personal training and pilates taxed at 21%

SG de Impuestos sobre la Renta de las Personas Físicas
exención de asistencia sanitariatipo impositivo generalrendimientos de actividad económicaprofesionales sanitariossociedades profesionales LIVA — Ley 37/1992 del IVA art. 4.1LIVA — Ley 37/1992 del IVA art. 20.1.3º
Affects CompanyExpat · Non-residentIndividual

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