Important Tax Tips July 2020
Decisions of the Court of Justice of the European Union (CJEU) regarding VAT on medical services
The following services qualify for the VAT exemption as medical services:
- Therapeutic care provided as part of an outpatient service by qualified nursing staff. – Case C-141/00 Kugler.
- Psychotherapeutic treatment given by qualified psychologists. – Case C-45/01 Dornier.
- Conducting medical examinations or taking blood and other samples to test for the presence of disease on behalf of employers and insurers or certifying medical fitness to travel where such services are intended principally to protect the health of the person concerned. – Case C-307/01 d`Ambruminel.
- Medical tests prescribed by a medical practitioner but carried out by a third party, such as a laboratory, which allow patients to be observed and examined before it becomes necessary to diagnose care for, or heal, potential illness. – Case C-106/05 Lu P.
- Services consisting in the performance of plastic surgery and cosmetic treatments when intended to diagnose, treat, or cure diseases or to protect restore or maintain health. – Case C-91/12 PFC.
- Medical services provided by telephone, consisting in giving advice relating to health and illnesses, are likely to fall under the exemption, provided that they pursue a therapeutic aim (i.e. to diagnose, treat and, as far as possible, cure illnesses or health anomalies or for protecting, including maintaining or restoring, the health of individuals). – Case C-48/19 X.
The following activities do not qualify for VAT exemption as medical services:
- Genetic tests carried out by a doctor to establish paternity. – Case C-384/98 D.
- General care and domestic help provided as part of an outpatient service. – Case C-141/00 Kugler.
- Provision of a doctor’s report on a person’s state of health for the purposes of a war or disability pension claim or of personal injury litigation given that the principal purposes of the service effected is to provide the third party with the necessary element for taking a decision and the main purposes of such service is not the protection of that persons health. – Case C-212/01 Unterpertinger.
- Services consisting in the performance of plastic surgery and cosmetic treatments when not intended to diagnose, treat, or cure diseases or to protect restore or maintain health. – Case C-91/12 PFC.
- Services consisting in the communication of information (e.g. by telephone) on pathologies or therapies, but which are not capable, by reason of their general nature, of helping to protect, maintain or restore the health of persons are not exempt. – Case C-48/19 X.
- Services which consist in the supply of administrative information (e.g. by telephone), such as the contact details of a doctor, cannot be assimilated to services covered by the medical exemption. – Case C-48/19 X.