Belgium: Guidance regarding amended VAT exemption for medical professions and hospitals

Clarifications on the scope of the so-called "medical VAT exemptions” as effective 1 January 2022

Clarifications on the scope of the so-called "medical VAT exemptions”

Circular 2021/C/114 was published at the end of 2021 and concerns the value added tax (VAT) exemption for medical professions and hospitals. This circular contains clarifications on the scope of the so-called “medical VAT exemptions” as effective 1 January 2022.

The amended legislation follows a ruling by the Constitutional Court in 2019, which overturned several aspects of the medical VAT exemptions under Article 44 §1 and §2, 1° a) of the VAT rules. With the amendment, the scope of these VAT exemptions is now more in line with the view of the Court of Justice of the European Union. 

The amended measures:

  • Modify the scope of persons eligible for the “medical professions exemption”
  • Reduce the scope for the exemption so that it is only available if the services provided have a "therapeutic purpose"
  • Amend the scope of the “hospital exemption”
  • Allows a special exemption rule for small enterprises when the non-therapeutic acts remain below the annual threshold of €25,000
  • Reflect a right of deduction and (positive or negative) adjustments that must be made in the context of the amended rules

The new VAT exemption rules have an effective date of 1 January 2022, but the circular provides for transitional measures in certain special situations.

The circular also contains guidance regarding the submission of VAT returns.

Lastly, the Minister of Finance requested that the VAT administration, for the year 2022, adopt a “flexible attitude” in the event of an apparently unintentional error by a professional.

Read an April 2022 report prepared by the KPMG member firm in Belgium


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