Doctors, dentists and all operators in the health arts are obliged to issue the invoice or fee or notula for carrying out the following operations:
Sale of goods purchased in the exercise of the activity. Eg sale of an ultrasound machine, dental unit, furniture, computers, etc. These transfers are exempt pursuant to art. 10 no. 27- quinquies if VAT was not deducted for them at the time of purchase. Otherwise they are subject to ordinary VAT at 22%. If the VAT on purchases has been deducted only in part, the invoice must be issued, partly exempt and partly with the ordinary rate;
RCM Healthcare services that are not exactly typical of the normal activity carried out. Such as legal appraisals, insurance consultancy, insurance certificates, making available to study colleagues and equipment and courses.
What Are The Hospitalization And Treatment Benefits?
In particular, it is important to clearly define, within the meaning of the exemption, what is meant by hospitalization and treatment services . These are accommodation, assistance, diagnosis and treatment, including the administration of medicines, health aids and meals. This aspect assumes importance as the performance of greater hotel comfort(such as a single room, television, etc.) are services that fall within the scope of VAT. The provision of these services is subject to the application of a 10% rate. This is if this service is rendered to hospitalized subjects, unless they are essential to achieve the therapeutic aims of the hospitalized subject. The same services meet the ordinary VAT rate if rendered to non-hospitalized subjects. As, for example, can be the companions.
Hospitalization And Care Services For I Va Purposes
RCM Healthcare services for hospitalization and treatment are exempt from VAT , pursuant to article 10 n. 19 of Presidential Decree no. 633/72. These are those services rendered both on an outpatient and inpatient basis, by the following subjects:
Mutual aid society with legal personality and spa establishments; hospitals , nursing homes and clinics which, on the basis of the agreements entered into with the regions, apply tariffs corresponding to those charged by public bodies;
Services for training courses;
• The legal certificates made to the insurance companies;
• Services not addressed to the person, such as those rendered by veterinary surgeons;
• Medico-legal consultancy regarding the state of health of people aimed at the recognition of a disability or war pension;
• Services of coroners as technical consultants when they have to quantify the damage in legal disputes, or to quantify insurance premiums;
• Finally, the services rendered by chiropractors.
Illegal Health Care Services
Medical, paramedical and dental services, if they are carried out in an abusive manner and, therefore, without the possession of the prescribed professional qualification requisites, are taxable for VAT purposes . This is since in such an event, the provisions of article 10, n. 18, Presidential Decree n. 633/72.
VAT-Exempt RCM Healthcare Services
These are the following:
• Services performed by doctors, surgeons and dentists;
• Services aimed at the diagnosis, treatment and rehabilitation of biologists and psychologists;
• Various certifications, Medical Billing services of cosmetic surgery (only if the service responds to therapeutic purposes). Sports medicine, occupational medicine;
• Services rendered by radiological laboratories and medical analysis and clinical research laboratories;
• Fiscal medical visits on behalf of INPS or Inail.
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