Medical examinations of the type morphology, ECG, ultrasound, and rtg photos shall be exempt from VAT both when performed on the basis of a medical referral and when they constitute a service at the request of the patient. This is due to the interpretation of the National Tax Information Director at 10 August 2017 The signature. 0111-KDIB3-2.4012.301.2017.2.MD.
The applicant of the interpretation is a specialist hospital offering, among others, various types of research performed by qualified specialists with qualifications in the field of medical professions. The services mentioned above are most often due to doctor’s advice. However, some studies are carried out on the patient’s initiative, without referral, at his request and financed by him. The applicant’s question concerned the possibility of applying VAT exemptions to the service on request of the patient.
The tax exemption of medical services is regulated in Article 43(1)(18) VAT Act. According to this provision, medical care services for the prevention, preservation, rescue, restoration and improvement of health are exempt from tax by a person with appropriate professional powers (e.g. a doctor).
The Director of National Tax Information has referred to the case law of the EU Court concerning medical services:
„It follows from the case law of the Court of Justice of the EU that the term ‘medical care’ refers to medical services which are intended to diagnose, care and, where possible, treat diseases or health disorders.’
The research aims at diagnosing the condition of health regardless of whether it is carried out on the basis of a referral. Director of National Revenue Information, that the purpose of medical service should be taken into account:
„Only prevention and health studies will benefit from the exemption. On the other hand, research aimed solely at expert or evidence will not benefit from VAT exemption." For this reason, the applicant has obtained a favourable interpretation that medical examinations are exempt from VAT, regardless of whether they were the result of a doctor’s referral:
„The performance of these diagnostic tests for prevention, behaviour, rescue, restoration and improvement of health is included in the concept of medical care (...) it is not important whether the service is performed on the basis of a doctor’s advice or without a referral, the purpose of the service is relevant’
It should be stressed that the scope of this exemption of medical services has not been clearly specified in the VAT Act, for which reason the interpretation was based primarily on the case law of the Court of Justice of the EU.