Which healthcare and educational operations are VAT-exempt in Spain?
Under Spanish tax law, Article 20 of Law 37/1992 (VAT Law) establishes clear exemptions for medical care and education. Providing an exempt service means you must not charge VAT (IVA) on invoices issued to patients or students. However, this also affects your ability to deduct input VAT on your regular business expenses.
Exempt healthcare and medical services
To qualify for this VAT exemption, healthcare services must meet two strict criteria: they must be rendered by a certified medical professional (physician, clinical psychologist, physiotherapist, dentist, nurse) and serve a diagnostic, therapeutic, or curative purpose.
* Exempt: Medical consultations, clinical psychotherapy, dental treatments, curative physiotherapy, and hospital care.
* Non-exempt (taxed at 21%): Aesthetic surgery without reconstructive purpose, expert medical legal reports, non-therapeutic massages, and dietary coaching without official health licensing.
Regulated education and private tutoring
The educational exemption applies to accredited institutions and self-employed tutors teaching subjects found in official government curricula:
* Exempt: Language private lessons, school and university academic subjects, and accredited vocational training.
* Non-exempt: Recreational courses (cooking workshops, hobby classes), lifestyle coaching, and commercial corporate seminars not tied to official curricula.
Whenever you issue an exempt invoice, you must include the formal reference: *«Operación exenta según el artículo 20.Uno de la Ley 37/1992 del IVA»*.
Does VAT exemption excuse you from invoicing or VeriFactu?
Many sole traders mistakenly believe that not charging VAT means they are exempt from invoicing rules. If your client is a company, an insurance firm, or an individual requesting an invoice, you must issue one. Furthermore, if you wonder whether you qualify as one of the freelancers exempt from VeriFactu, the rule is clear: invoicing software requirements apply regardless of VAT rates.
The official deadlines confirmed by the Spanish Tax Agency (AEAT) are:
* January 1, 2027: Mandatory for corporate entities (incorporated clinics and private schools).
* July 1, 2027: Mandatory for freelancers and micro-enterprises.
Upgrading invoicing systems in clinics and education centers
With manual invoicing being phased out, healthcare and training providers must upgrade their software. If you still use spreadsheets, you can importar Excel a VeriFactu seamlessly. Likewise, older desktop environments can be updated by choosing to importar Factusol a VeriFactu, importar Sage 50, or importar Holded into modern, certified cloud applications.
Clinics with medical scheduling tools can connect directly using an API VeriFactu, enabling swift integración ERP VeriFactu and functioning as a reliable pasarela VeriFactu para software without disrupting clinical workflows.
To keep your healthcare practice or tutoring business fully compliant with Spanish tax authorities, Fakturia.es offers a dedicated invoicing platform ready for VeriFactu and the Spanish Anti-Fraud Law.