Updated 2026-10-03 · 3 min read
This article is about Spanish tax law and does not apply outside Spain: if your clinic is in the United Kingdom, the United States or Portugal, your own country's tax rules apply. Most clinics in Spain know that physiotherapy carries no VAT. What isn't always clear is what else is charged at the clinic and which regime each thing falls under: the cream sold at reception, Tuesday's Pilates class or the pack of ten sessions.
This article is a general framework for organising the till. Each clinic's specific case is decided by its accountant, who knows its activity and its legal form.
The session: exempt
The Spanish VAT Act (article 20.Uno.3.º) declares exempt the care of individuals provided by recognised health professionals, and a physiotherapist is one. A physiotherapy session with a therapeutic purpose is invoiced without VAT, with the mention of the exemption on the receipt.
A pack of sessions follows the same rule as the sessions it contains: it's an advance payment for exempt care.
Reception products: with their VAT
Selling products isn't healthcare. The cream, the ankle support or the foam roller sold at reception carry their VAT, the rate that applies to each product, and must appear on the receipt with their rate.
That's why it's worth the till distinguishing each line: the exempt session and the product with its VAT, on the same receipt and without adding up by hand.
Group classes: it depends on what they're for
Here's the grey area. A group class led by a physiotherapist with a therapeutic purpose may be considered exempt healthcare. A maintenance or training class without that purpose, even if a physiotherapist teaches it, is normally subject to VAT.
The practical thing is to decide it with the accountant and reflect it in the catalogue: each treatment or class carries its VAT in its record, and the till applies it on its own when charging.
| What's charged | Usual regime | Who confirms it |
|---|---|---|
| Physiotherapy session | Exempt (art. 20.Uno.3.º of the Spanish VAT Act) | General rule |
| Pack of sessions | Like the sessions it contains | General rule |
| Reception product | With its VAT | Each product's rate |
| Group class | Depends on its purpose | The clinic's accountant |
How it's handled in ClaudIA's till
In ClaudIA each treatment, class and product has its VAT in its record. When charging, each line is recorded with its own —the session exempt, the product with its rate— and the summary for the accountant separates what's exempt from what carries tax.
In Spain the till issues payment receipts, and what's passed to the accountant already arrives separated by VAT rate. The simplified invoice compliant with the regulation is in preparation, without the clinic having to send anything to the Tax Agency.
Questions clinics ask
Does physiotherapy carry VAT in Spain? Care provided by a physiotherapist with a therapeutic purpose is VAT-exempt under article 20.Uno.3.º of the Spanish VAT Act. What isn't healthcare, such as selling products, carries its VAT.
And a Pilates class at the clinic? It depends on its purpose. With a therapeutic purpose it may be exempt; as a maintenance or training activity, it normally carries VAT. The clinic's accountant has to confirm it.
Can an exempt session and a product with VAT be charged on the same receipt? Yes. In ClaudIA's till each line carries its VAT: the session comes out with the exemption and the product with its rate, on the same receipt.