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Medical treatment and care: when the exemption applies
The module’s worked examples, then cases to attempt before revealing their solution · 2 sections · 285 words · 3 min
Worked example
A dentist's in-house laboratory
A dentist treats a patient and fits a crown made in the practice's own laboratory. The treatment itself is exempt as medical treatment. The supply of the crown produced in her own undertaking, however, falls under sentence 2 and is taxable. The invoice separates the two parts; the rate at which the crown is charged is governed by § 12, not by § 4.
Practical case
One practice, two kinds of turnover
A self-employed physiotherapist in Kassel is not a small business because her taxable turnover exceeded the threshold in the previous year. In calendar year 2026 she bills €62,000 for remedial exercise and manual therapy on a doctor's prescription. She also sells wellness massages, booked by guests for relaxation without any health reason, for €30,000 net. How much VAT does she owe for 2026 on her output transactions?
Hint: Check each type of service on its own: is there medical treatment in the field of human medicine? Only for the services where the answer is no does the question of the tax rate arise.
Show the solution
Remedial exercise and manual therapy serve to treat a health disorder and are carried out by a physiotherapist. Both conditions of § 4 No. 14(a) UStG are met, so the €62,000 is exempt. The wellness massages are provided by the same person but pursue no therapeutic aim. They are not medical treatment and are therefore taxable. No reduction applies, so the standard rate is due: €30,000 times 19 percent gives €5,700. The invoices for the massages show rate and tax amount, those for the therapy the reference to the exemption. In her records she keeps the two kinds of revenue apart.
Answer: €5,700 of VAT, on the wellness massages alone
Educational content, current with the sources cited. It does not replace advice tailored to your situation. These courses are neither certifying nor CPF-eligible: they prepare for no certification registered with the French RNCP or specific register.