Nursing Services: When Is VAT Exempt?
Under the Austrian Value Added Tax Act (Umsatzsteuergesetz), certain healthcare services in the field of human medicine are exempt from VAT. This exemption also covers corresponding services provided by members of the higher-level nursing profession. According to the Austrian Ministry of Finance, two key requirements must be met for the VAT exemption to apply.
First, the professional requirement must be fulfilled. The activity must fall within a professional category expressly listed in the Value Added Tax Act. For self-employed registered nurses (DGKP), this depends in particular on whether the requirements of the Austrian Health and Nursing Care Act (Gesundheits- und Krankenpflegegesetz, GuKG) are met.
Second, the specific service provided must constitute a healthcare treatment in the field of human medicine. Not every nursing activity automatically satisfies this criterion.
What Is the Purpose of the Service?
According to VAT principles, healthcare treatments include activities aimed at the prevention, diagnosis, or treatment of diseases and health disorders. They also encompass measures intended to protect, maintain, or restore human health.
Consequently, it is not sufficient to consider only who performs the service or whether the activity generally falls within the professional scope of nursing practice. The decisive factor is also the specific purpose served by the individual service.
Services that do not have an individual therapeutic purpose do not qualify for the exemption. Therefore, a nursing activity does not automatically become a VAT-exempt healthcare service merely because it is performed by a registered nurse (DGKP).
An inquiry submitted by the Austrian Health and Nursing Association (Österreichischer Gesundheits- und Krankenpflegeverband, ÖGKV) also addressed the question of whether a nursing care allowance assessment (Pflegegeldeinstufung), which may be comparable to certain medical services, can be regarded as a VAT-exempt healthcare treatment. However, the Ministry's response does not support the conclusion that all nursing services, or nursing care allowance assessments in general, are automatically exempt from VAT. Rather, the determining factors remain the nature of the specific activity and, in particular, its individual therapeutic purpose.
Accordingly, a case-by-case assessment is required for self-employed registered nurses (DGKP). Where the professional requirements are met and the specific service serves a therapeutic purpose in the field of human medicine, the VAT exemption may apply..