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The VAT exemption will no longer apply to therapeutic treatments. But the definition of these treatments still needs to be clarified.
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At present, care provided in particular by a doctor, a dietitian, a dentist and a physiotherapist is generally exempt from VAT. In other words, no VAT applies on their fees, the only exceptions being purely cosmetic procedures and treatments carried out by a doctor. Things should fundamentally change from the 1is January 2022. “Only therapeutic treatments and interventions will be exempt from VAT. This measure does not apply only to doctors, but will be extended to all medical and paramedical staff, ”explains Tim Van Sant, VAT specialist at PwC Tax Consultants.
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“Treatments and interventions without a therapeutic objective go well beyond purely aesthetic care. For example, a general practitioner who provides a certificate for life insurance, a dentist who whitens teeth or a physiotherapist who provides support to an athlete will have to, according to the new law, apply a 21% VAT on its services. ” The bill which severely limits the exemption from VAT on medical care received the green light from the Finance Committee on June 23 and was voted on in the House on June 1.is July.
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A circular will specify the care (not) exempt from VAT
The central services of the tax administration must, in consultation with the sector, draft a circular containing more details on the care that will or not be subject to VAT. “Discussions on whether or not therapeutic care have been going on for years. This question has not yet been decided. Often, there are interactions between the aesthetic, the somatic and the psychological”, explains Marc Moens, of the union doctors, ABSyM. “But where do you put the border? Are you going to let a financial inspector, who is not a doctor, go through a patient’s medical file?”
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“Often there are interactions between the aesthetic, the somatic and the psychological.”
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The association of Flemish dentists, the VVT (Verbond der Vlaamse Tandartsen) is delighted that the new law speaks of a therapeutic objective and not of aesthetics. “It will all depend on the definition of what is or is not therapeutic, objective criteria which will serve as a basis for evaluating the files and the persons who will be empowered to take a decision. A person who has lost a tooth or has badly discolored teeth may continue to talk and laugh, but may not dare to do so again. In this case, the mouth is no longer functional and the treatment therefore has a therapeutic objective, ”explains spokesperson Stefaan Hanson. “If a treatment is not considered therapeutic, it will inevitably cost more to the patient since the VAT will be added to the price of the care.”
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New VAT regime for paramedics
The VAT regime applicable to paramedical professions is also changing. Today it is linked to their recognition. Recognized paramedical professions, such as speech therapy and dietetics, are exempt from VAT, while unregulated professions, such as osteopathy, acupuncture and chiropractic, must charge VAT. “The new legislation will take into account the nature of the processing. In the event of therapeutic treatment, osteopaths or chiropractors will be exempt from VAT. A physiotherapist who will provide non-therapeutic care will have to charge VAT “, adds Van Sant. In addition, hospitals will only be able to exempt their services from VAT if there is a therapeutic objective. For example, the rental of a television set to an inpatient or visitor parking will no longer be exempt from VAT, says Van Sant.
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The FPS Finance expects income of 20 million euros, most of which should come from dentists.
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The bill follows European case law which has stated that the application of VAT on aesthetic treatments introduced in 2016 could not be limited to doctors and should apply independently of the care provider. The FPS Finance expects income of 20 million euros, most of which should come from dentists. When the mandatory VAT for cosmetic treatments was introduced in 2016, additional revenues of 90 million euros were expected.
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In practice, however, not all doctors and paramedics will charge VAT. Those who derive income of less than 25,000 euros from non-therapeutic care will be able to opt for the exception scheme for small businesses. “But in this case too, a certain number of formalities will have to be fulfilled. For example, healthcare providers wishing to benefit from this exemption will have to register with the VAT office, apply for a VAT number and keep their accounts in accordance with VAT rules, ”explains Van Sant. “Almost no dentist today has a VAT number,” adds Hanson.
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