Doctrine by topic · DGT Observatory

Chiropractic: DGT doctrinal evolution

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

← DGT Observatory

How the DGT's position has evolved

Settled doctrine High confidence 16 rulings · 2020–2022

Current position

The VAT exemption for healthcare services requires an objective requirement (diagnostic, prevention, or treatment services) and a subjective one (provider with professional qualifications). It is not necessary for the profession to be regulated by Spanish national regulations. The professional must demonstrate qualifications equivalent to European standards to guarantee a sufficient level of quality.

The DGT's position has remained constant since 2020. All rulings confirm that the lack of national regulation of chiropractic does not prevent the exemption if the diagnostic or treatment requirements are met and sufficient professional qualification is demonstrated. The latest ruling adds the need to demonstrate European standards.

Turning points

28 February 2022 V0396-22

Specifies that, even if they are not regulated professions, the exemption applies if the professional demonstrates qualifications equivalent to European standards.

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

Rulings on this topic

16

V0396-22 28 Feb 2022

Osteopathy and chiropractic services may be VAT exempt if qualification and health purposes are met

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariacualificación profesionalosteopatíaquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V1689-21 2 Jun 2021

Chiropractic services may be VAT exempt if the professional proves sufficient qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5.uno

Affects CompanyExpat · Non-residentIndividual

V1135-21 28 Apr 2021

Chiropractic services may be VAT exempt if the professional holds the required professional qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V0598-21 16 Mar 2021

Chiropractic services may be VAT exempt if the professional holds the required professional qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V0596-21 16 Mar 2021

Chiropractic services may be VAT exempt if the professional proves sufficient qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V0366-21 25 Feb 2021

Chiropractic services may be VAT exempt if the professional proves required qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesión sanitariacualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2707-20 3 Sept 2020

Chiropractic services may be VAT exempt if the professional holds the required professional qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariacualificación profesionalsociedad mercantilquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2684-20 2 Sept 2020

Chiropractic services may be VAT exempt if the professional demonstrates sufficient qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5.uno

Affects CompanyExpat · Non-residentIndividual

V2467-20 20 Jul 2020

Chiropractic services may be VAT exempt if the professional demonstrates sufficient qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4.unoLIVA — Ley 37/1992 del IVA art. 5.uno

Affects CompanyExpat · Non-residentIndividual

V2466-20 20 Jul 2020

Chiropractic services may be VAT exempt if the professional proves the required qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2465-20 20 Jul 2020

Chiropractic services may be VAT exempt if the professional proves required qualifications

SG de impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2344-20 9 Jul 2020

Chiropractic services may be VAT exempt if the professional holds the required professional qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesión sanitariacualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2155-20 25 Jun 2020

Chiropractic services may be VAT exempt if the professional holds the required professional qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2153-20 25 Jun 2020

Chiropractic services may be VAT exempt if the professional proves sufficient qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2150-20 25 Jun 2020

Chiropractic services may be VAT exempt if the professional proves sufficient qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5

Affects CompanyExpat · Non-residentIndividual

V2148-20 25 Jun 2020

Chiropractic services may be VAT exempt if the professional proves the required qualifications

SG de Impuestos sobre el Consumo

exenciónasistencia sanitariaprofesional sanitariocualificación profesionalquiropráctica LIVA — Ley 37/1992 del IVA art. 4LIVA — Ley 37/1992 del IVA art. 5.uno

Affects CompanyExpat · Non-residentIndividual

Apply this to your case

VAT advisoryTalk to the team applying this doctrine daily.

Talk to the tax teamWe check whether this criterion affects you and what it means in your situation.

Contact