- Private clinics can only offer VAT-exempt services if they provide medical treatments or hospital care and meet additional legal requirements.
- The rules changed on 1 Jan 2020: before then, exemption was based on EU law; since then, it is governed by German VAT law (§ 4 Nr. 14 b UStG).
- For services up to 31 Dec 2019, exemption depended on whether the private clinic’s care was socially comparable to public hospitals; authorities used a 40% threshold, while courts assessed the full range of factors, especially pricing.
- For services from 1 Jan 2020 onward, clinics must make a forecast comparing their charges with those of hospitals treating statutory health insurance patients; if charges are not higher in at least 40% of cases, the hospital treatments are exempt.
- Practical application remains difficult because there is still no official BMF guidance and the VAT administrative rules have not yet been updated.
Source: datenbank.nwb.de
Note that this post was (partially) written with the help of AI. It is always useful to review the original source material, and where needed to obtain (local) advice from a specialist.
