Provision of medical research services for commercial organizations: VAT payment procedure

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Published: December 28, 2017

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Along with food products, vehicles, furniture, clothing, printing and other goods, medical products and services in Russia are subject to VAT on a general basis.

VAT on goods and services in the amount of 10%: basis for calculation
In what cases does 18% VAT apply?
VAT exemption: when possible
What legal documents govern the sale of goods and services?

According to the Tax Code, VAT on the sale of medical drugs and services can be calculated using a rate of 10% VAT, in some cases - 18%, and sometimes no product tax is paid at all.

Master List

By law, medical services for prevention, diagnosis and treatment that are provided to the population are exempt from value added tax:

medical organizations;
businessmen conducting medical activities.

Moreover, the VAT exemption for medical services does not depend on:

on the form of payment by the patient;
source of their payment.

At the same time, having a medical license is mandatory.

There is a basic List of such medical services, which was approved by Decree of the Government of the Russian Federation dated February 20, 2001 No. 132 and is of an extremely general nature. According to it, the following services are tax free:

1. For diagnosis, prevention and treatment directly provided to the population on an outpatient basis in a clinic (including pre-medical care), including a medical examination.

2. For diagnosis, prevention and treatment directly provided to the population in a hospital, including medical examination.

3. For diagnosis, prevention and treatment, directly provided to the population in day hospitals and by the services of general (family) doctors, including medical examinations.

4. For diagnosis, prevention and treatment, directly provided to the population in sanatorium and resort institutions.

5. On health education, directly provided to the population.

Practice shows that using this List of the Government of the Russian Federation for tax purposes is extremely inconvenient and risky.

VAT exemption: when possible

In matters of exemption of medical goods and services from VAT, Article 149 of the Tax Code of the Russian Federation (clause 1, clause 2) gives clear instructions: a zero tax rate applies to Russian and foreign medical products that are included in the List approved by the Government of the Russian Federation.

The latest and current edition of the List of services and products, the import and sale of which are not taxed, is set out in Decree of the Government of the Russian Federation dated September 30, 2015 No. 1042.

According to the document, sellers and distributors will not have to pay taxes for the following categories of goods:

medical instruments and strategic products (surgical instruments, radiation installations, examination equipment, laboratory kits, etc.);
lenses for ophthalmic use and spectacle frames;
devices for the rehabilitation of disabled people (motorized wheelchairs, manually operated vehicles, equipment for bathrooms, books with a special font, etc.);
goods for prosthetic and orthopedic purposes, as well as materials for their production.

As for medical services, the implementation of which, according to the law, is not subject to VAT, its preferential list includes:

service provided for health insurance;
emergency medical services;
medical care for pregnant women and newborns, disabled and seriously ill people;
pathological services.

The absence of the need to pay taxes for medical goods and services implies, however, that the selling company provides special documentation to the tax authorities.

We are talking about submitting registration certificates, licenses, contracts with suppliers of preferential category products, bank statements on financial transactions for the supply of goods, as well as all technical documentation for goods: manufacturer certificates, national and industry standards.

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Additional lists

According to the Ministry of Finance, in order to understand in detail which medical services are not subject to VAT, you can and should refer to the following by-laws:

List of works (services) that constitute medical activities (Appendix to the Decree of the Government of the Russian Federation of April 16, 2012 No. 291 “On licensing of medical activities” (contains about 150 items);
in general, the Regulations on licensing of medical activities;
Requirements for the organization and performance of work (services) in the provision of primary health care, specialized (including high-tech), emergency (including specialized emergency), palliative medical care, provision of medical care during sanatorium-resort treatment, during medical examinations, medical examinations, medical examinations and sanitary and anti-epidemic (preventive) measures as part of the provision of medical care, during transplantation of organs and (or) tissues, circulation of donor blood and (or) its components for medical purposes (approved by order of the Ministry of Health dated March 11, 2013 No. 121n);
The nomenclature of medical services is a systematic list of codes and names of medical services in healthcare (approved by order of the Ministry of Health dated October 13, 2017 No. 804n).

Also see “Instructions: how a medical worker can obtain the title “Veteran of Labor.”

What medical services are exempt from VAT?

According to subparagraph 2 of paragraph 2 of Article 149 of the Tax Code of the Russian Federation, medical services provided by medical organizations or individual entrepreneurs, according to the list defined in the same paragraph, are exempt from VAT. The most important condition is that the medical organization has a license

for carrying out medical activities.

Everything seems simple, there is a list in the Tax Code of the Russian Federation. If a medical service is named in the list, then it is not subject to VAT; if it is not named, then it is subject to VAT.

However, questions arise regarding the classification of a certain type of medical service as a service from the list.

For example, consultation with a psychologist and nutritionist, diagnosis of infectious diseases, pre-trip and post-trip examinations of drivers and other medical services. Will they be subject to VAT?

In order to answer these questions, it is necessary to analyze the following documents:

We turn to the Tax Code of the Russian Federation, subparagraph 2 of subparagraph 2 of Article 149;
In the case of providing services to the population for diagnosis, prevention and treatment, we refer to the list approved by Decree of the Government of the Russian Federation of February 20, 2001 N 132. The list contains the names of services that are not subject to VAT. In this case, it is necessary to keep in mind that the form and source of payment do not matter;
We are guided by Order of the Ministry of Health of Russia dated March 11, 2013 N 121n, which approved the Requirements for the organization and performance of work (services) in the provision of medical care, incl. sanatorium and resort, etc. This was emphasized by the Ministry of Finance in one of the last letters dated June 20, 2018 No. 03-07-07/42113
We take into account the concept of medical services from the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation.” This is mentioned in the Letter of the Federal Tax Service dated March 27, 2013 N ED-18-3/ [email protected]
Due to the fact that medical activities are subject to licensing and this is one of the conditions for applying the VAT exemption, we study the Federal Law of 05/04/2011 N 99-FZ “On licensing of certain types of activities”, as well as the Regulations thereto, approved by the Decree of the Government of the Russian Federation dated 04/16/2012 N 291

Having studied the above documents, you can make an informed decision about whether such a medical service can not be subject to value added tax.

So, for example, analyzing the above documents, the Ministry of Finance, in its addressed response, letter dated August 10, 2021 N 03-07-07/51370, concludes that medical services for pre-trip and post-trip medical examinations are exempt from VAT taxation.

There are also letters from the Ministry of Finance that contain informational and explanatory nature. For example, in its latest letter dated April 11, 2021 N 03-07-07/25551, the Ministry of Finance also refers to Art. 149 of the Tax Code of the Russian Federation with a list of non-taxable medical services.

We remind you that if all the necessary documents have been analyzed, and the organization or individual entrepreneur has doubts about the taxation of medical services, you can always write a addressed request to the Ministry of Finance

and receive a targeted response.

Accounting services for companies providing medical services - leave a request on the website, or get the necessary information by phone

Author: Ilyina Elena

Registration

If veterinary and sanitary-epidemiological services are financed from the budget, then they are also not subject to VAT.

This benefit is established by subparagraph 2 of paragraph 2 of Article 149 of the Tax Code of the Russian Federation.

The benefit can be used by:

medical organizations and institutions;
individual entrepreneurs - doctors engaged in private medical practice;
medical centers owned by non-medical companies.

Here is a list of medical services that are not subject to VAT.

1. Services provided under compulsory health insurance. Such services can be provided to both individuals and companies. The list of these services is given in Decree of the Government of the Russian Federation of October 4, 2010 No. 782 and Methodological recommendations approved by the Ministry of Health of the Russian Federation and the Federal Compulsory Health Insurance Fund on August 28, 2001 No. 2510/9257-01, 3159/40-1.

2. Services provided to the population according to the list approved by the Government of the Russian Federation dated February 20, 2001 No. 132. These include:

diagnostic, prevention and treatment services directly provided to the population within the framework of outpatient (including pre-medical) medical care, including medical examination;
diagnostic, prevention and treatment services directly provided to the population as part of inpatient medical care, including medical examination;
diagnostic, prevention and treatment services directly provided to the population in day hospitals and by the services of general (family) doctors, including medical examinations;
diagnostic, prevention and treatment services directly provided to the population in sanatorium and resort institutions;
health education services provided directly to the public.

According to the Ministry of Finance, if a licensed organization provides the population with medical services mentioned in this list free of charge, then these services are also not subject to VAT (letter of the Ministry of Finance of Russia dated April 13, 2021 No. 03-07-11/21224).

3. Services for collecting blood from the population. A medical organization or private doctor must have an agreement with a medical organization providing medical care in outpatient and inpatient settings.

4. Services provided by medical organizations and private doctors to pregnant women, newborns, disabled people and drug addicts.

5. Emergency medical services.

6. Services for medical personnel on duty at the patient's bedside.

7. Pathological and anatomical services.

8. Services of pharmacies for the manufacture of medicines for medical use (the benefit is provided for in subclause 24, clause 2, article 149 of the Tax Code of the Russian Federation).

9. Services for the manufacture and repair of spectacle optics (except for sun protection), repair of hearing aids and prosthetic and orthopedic products, services for the provision of prosthetic and orthopedic care (the benefit is provided for in paragraph 24, paragraph 2, article 149 of the Tax Code of the Russian Federation).

10. Sanitary, epidemiological and veterinary services financed from budget funds. In this case, the company must have the following documents:

license;
contract for the provision of veterinary or sanitary-epidemiological services indicating the source of financing;
written notification of the customer, to whom funds have been allocated from the federal budget, to the company about the targeted budget funds allocated to him to pay for sanitary-epidemiological and veterinary services;
a certificate from the financial authority about the opening of financing of veterinary and sanitary-epidemiological services at the expense of the regional or local budget.

Veterinary and sanitary-epidemiological services that are not financed from the budget or are financed on a repayable basis are subject to VAT.

A company or doctor engaged in private practice must have a license to practice medicine. If there is no such license, then the benefit cannot be applied.

If your company provides medical services that are not subject to VAT, then you cannot refuse this benefit.

Services of intermediaries in the field of medical services are subject to VAT.

Chapter 7. Taxation in medical organizations (1st level)

7.1. Calculation and payment of VAT and excise taxes in medical organizations (2nd level)
7.2. Special tax regimes in healthcare institutions (2nd level)

Excise taxes.
In accordance with subparagraph 2 of paragraph 1 of Article 181 of the Tax Code of the Russian Federation, excisable goods are alcohol-containing products (solutions, emulsions, suspensions and other types of products in liquid form) with a volume fraction of ethyl alcohol of more than 9 percent. In this case, the following are not considered as excisable goods:

medicinal, treatment-and-prophylactic, diagnostic products that have passed state registration with the authorized federal executive body and are included in the State Register of Medicines and Medical Products,

medicinal, therapeutic and prophylactic products (including homeopathic drugs), manufactured by pharmacy organizations according to individual recipes and the requirements of medical organizations, bottled in containers in accordance with the requirements of state standards of medicines (pharmacopoeial articles), approved by the authorized federal executive body.

In accordance with Article 149 of the Tax Code of the Russian Federation, the following are not subject to taxation:

1. provision by the lessor of premises for rent on the territory of the Russian Federation to foreign citizens or organizations accredited in the Russian Federation.

2. sale (as well as transfer, execution, provision for one’s own needs) on the territory of the Russian Federation:

1) the following medical goods of domestic and foreign production according to the list approved by the Government of the Russian Federation:

essential and vital medical equipment;

prosthetic and orthopedic products, raw materials and materials for their production and semi-finished products for them;

technical means, including motor vehicles, materials that can be used exclusively for the prevention of disability or rehabilitation of disabled people;

glasses (except for sunglasses), lenses and frames for glasses (except for sunglasses);

2) medical services provided by medical organizations and (or) institutions, doctors engaged in private medical practice, with the exception of cosmetic, veterinary and sanitary-epidemiological services. The restriction established by this subparagraph does not apply to veterinary and sanitary-epidemiological services financed from the budget.

Medical services include:

services specified in the list of services provided under compulsory health insurance;

services provided to the population for diagnosis, prevention and treatment, regardless of the form and source of payment, according to the list approved by the Government of the Russian Federation;

services for collecting blood from the population, provided under contracts with inpatient medical institutions and outpatient departments;

emergency medical services provided to the population;

services for medical personnel on duty at the patient’s bedside;

pathological-anatomical services;

services provided to pregnant women, newborns, disabled people and drug addicts.

According to subparagraph 4 of paragraph 2 of Article 164 of the Tax Code of the Russian Federation, when selling medicines, including medicinal substances, including in-pharmacy production, and medical products of domestic and foreign production, value added tax is taxed at a tax rate of 10 percent.

Separately, I would like to dwell on the procedure for recording costs associated with the provision of preferential or free (charitable) services by medical centers. Costs for gratuitous services are not accepted for tax purposes (subclause 16, article 270, part two of the Tax Code of the Russian Federation).

According to subparagraph 1 of paragraph 1 of Article 146 of Part Two of the Tax Code of the Russian Federation, the provision of services free of charge is recognized as their sale and subject to VAT. In this case, the tax base is calculated based on prices determined in accordance with Article 40 of Part One of the Tax Code of the Russian Federation (Clause 1 of Article 154 of Part Two of the Tax Code of the Russian Federation). This means that the tax base is taken as the market price for medical services provided free of charge, that is, either the cost of identical services provided by this organization, or (in their absence) homogeneous services provided by other companies in a similar field of activity.

In accounting, costs for services provided free of charge are reflected in account 91 “Other income and expenses”, subaccount 91-2 “Other expenses”:

debit account 91-2 credit account 20 (26)

– the actual cost of services provided free of charge is written off;

debit of account 91-2 credit of account 68, subaccount “VAT calculations”

– VAT is charged on services provided free of charge.

Most medical services are not subject to VAT. Therefore, medical organizations usually do not transfer this tax to the budget. At the same time, in practice, commercial medical firms often rent premises from a state or municipal authority. In this case, doctors must transfer VAT to the budget for the landlord.

Example 1.

LLC provides VAT-free medical services.

The LLC rents premises in the district clinic from the municipal authority. The monthly rent is 20,000 rubles. Rent for July was transferred in August 2006.

The lease agreement concluded with a state or municipal authority specifies the amount including VAT. Therefore, the landlord’s demands to pay VAT on top of the rental amount are unfounded.

Despite the fact that the LLC does not provide services subject to VAT, the accountant of this organization must transfer the amount of VAT on the rent to the budget. Indeed, in this case, the LLC acts as a tax agent (clause 3 of Article 161 of the Tax Code of the Russian Federation).

VAT must be calculated on the entire rental amount. In this case, the accountant of the LLC, “according to paragraph 4 of Article 164 of the Tax Code of the Russian Federation, needs to use the calculation method, that is, multiply the amount of the rent by the rate. The rate is determined as a percentage of the tax rate (10 or 18%) to the tax base, taken as 100 and increased by the corresponding tax rate. The LLC must transfer VAT on rent in whole rubles:

20,000 rub. ? 18%: (100% + 18%) = 3051 rub.

For the amount of VAT on rent, you need to draw up an invoice in one copy. and make a note “Rental of municipal property”. In this case, it is necessary to be guided by the letter of the State Tax Service of Russia dated March 20, 1997 No. ВЗ-2-03/260. The amount of VAT on rent (3,051 rubles) must be transferred to the LLC budget no later than the 20th day of the month following the expired tax period (clause 1 of Article 174 of the Tax Code of the Russian Federation).

The tax period for VAT for a medical organization can be either a month or a quarter. Everything depends on revenue.

If it is less than RUB 1,000,000. (excluding VAT) for a quarter, then the tax period is equal to a quarter, otherwise – to a month (Article 163 of the Tax Code of the Russian Federation).

In this case, the revenue does not need to include the amount of rent that the organization transfers to the lessor. The LLC's revenue exceeds 1,000,000 rubles, so the VAT tax period is a month.

In a payment order for the transfer of VAT on rent, code 02 must be indicated in field 101. If an organization indicates code 01, then it will transfer the tax for itself, and not for the landlord.

Having transferred the rent and VAT on this amount, you should register the previously drawn up invoice in the sales book. The LLC cannot accept for deduction “input” VAT on rent payments. The fact is that a tax agent can reimburse “input” VAT only if he carries out transactions subject to VAT (clause 3 of Article 171 of the Tax Code of the Russian Federation). Thus, the invoice issued by the organization is not entered into the purchase book, because only those for which a tax deduction is applied are registered there.

No later than the 20th day of the month following the expired tax period, a VAT return is submitted to the tax office.

Operations for renting municipal property.

In July:

debit 20 credit 60 20,000 rub.

– rent for July has been accrued.

In August:

debit 60 credit 68 subaccount “VAT calculations” 3051 rub. (RUB 20,000 ? 18%: 118%)

– VAT payable to the budget has been accrued;

debit 60 credit 51 16,949 rub. (20,000 – 3051)

– the rent is transferred to the lessor;

debit 68 subaccount “Calculations for VAT” credit 51 3051 rub.

– transferred to the VAT budget.
VAT on the provision of medical services.
Not all types of activities of medical organizations are exempt from VAT; organizations can offset “input” VAT on them. However, they can only do this if they keep separate records.

Clause 6.17.1 of the Methodological Recommendations for the Application of Chapter 21 “Value Added Tax” of the Tax Code of the Russian Federation provides an additional condition for the application of benefits for the manufacture of medicines. To take advantage of the benefit, medicines must be manufactured under contracts with legal entities (for example, hospitals) and from the customer’s raw materials.

Also, according to subparagraph 18 of paragraph 3 of Article 149 of the Tax Code of the Russian Federation, services of sanatorium-resort, health-improving and recreational organizations located in Russia, issued with vouchers or course vouchers, which are strict reporting forms, are not subject to VAT.

Based on the conditions discussed above for the exemption of medical services from VAT, we can draw conclusions about which medical services are still subject to VAT.

Thus, pharmacies will have to charge and pay VAT on operations for the manufacture of medicines in all cases, except for the manufacture of medicines from the customer’s raw materials under an agreement with a legal entity.

A sanatorium-resort institution will also charge VAT if its services are not issued with vouchers or course vouchers, which are recognized as strict reporting forms.

Let us also draw attention to the fact that the exemption provided for by subparagraph 2 of paragraph 2 of Article 149 of the Tax Code of the Russian Federation does not apply to cosmetic services.

You will also have to pay VAT to organizations and private practitioners who provide veterinary and sanitary-epidemiological services if their activities are not financed from the budget.

A private clinic that does not receive funding from the budget or the compulsory health insurance fund will also have to pay VAT on operations to provide food to its patients.

A medical organization has the right not to maintain separate accounting for VAT and accept all VAT for deduction. But for this it is necessary that the share of expenses for services on which VAT is not paid should be no more than 5 percent of the organization’s total VAT expenses for the tax period.

If a medical organization carries out activities subject to VAT and activities not subject to this tax, then it is obliged to maintain separate records. This is defined in paragraph 4 of Article 149 of the Tax Code of the Russian Federation.

It follows from paragraph 1 of Article 153 of the Tax Code of the Russian Federation that it is necessary to maintain separate accounting for transactions that are subject to different VAT rates.

If the tax falls on goods and services that are used in activities not subject to VAT, then in this case the “input” VAT must be included in their cost. If it’s the other way around, then the “input” VAT can be deducted.

It happens that the same goods and services are used in both VAT-taxable and non-VAT-taxable activities. In this case, the “input” VAT must be divided between these types of activities. For this purpose, the share from the provision of VAT-taxable services to total income and the share from the provision of VAT-free services to total income are used.

Medical organizations can apply a simplified taxation system and can be transferred to UTII. Moreover, they can be subject to two taxation regimes.

If a medical organization applies the “simplified tax” simultaneously with UTII (for example, it provides veterinary services and sells medicines), then the accountant is obliged to organize separate accounting of income and expenses, property, liabilities and business transactions from these types of activities.

Within the framework of the simplified tax system, when choosing income reduced by the amount of expenses as an object of taxation, the taxpayer must be sure that this or that expense was incurred specifically for activities taxed under the “simplified” and not the “imputed” system. In the first case, it will affect the amount of tax due to be paid to the budget, but in the second - not.

However, even when using the “simplified taxation” with the object of taxation “income”, the organization is interested in ensuring that separate accounting of transactions is carried out correctly and justifiably. After all, the amount of the “imputed” tax does not change depending on whether a lot or little income is received from activities carried out within the framework of this tax regime, which cannot be said about the single “simplified” tax.

So it will be important for the taxpayer to reasonably prove that this or that income relates specifically to activities under the UTII system.

According to paragraph 8 of Article 346.18 of the Tax Code of the Russian Federation, expenses, if it is impossible to divide them, are determined in proportion to the share of income from the corresponding type of activity in the total income of the organization.

Thus, if an expense cannot be unambiguously qualified as relating to a “simplified” or “imputed” taxation system, the amount that can be taken to reduce the tax base for a single tax under a simplified taxation system can be determined using the formula:
expenses related to simplified tax system = income from activities according to the simplified tax : income from all types of activities x the amount of expenses related to the simplified tax system and UTII activities
Not all expenses related to “simplified” activities can be accepted for tax purposes, only those listed in paragraph 1 Article 346.16 of the Tax Code of the Russian Federation.

When combining the general regime and UTII, in order to avoid distortion of the tax base for corporate income tax, expenses should be distributed between types of activities by reporting periods on an accrual basis from the beginning of the year. At the same time, the income in proportion to which such distribution of expenses is carried out is also calculated on an accrual basis from the beginning of the year (Letter of the Ministry of Finance of Russia dated March 14, 2006 No. 03-03-04/1/224).

Example 2.

A medical organization carries out two types of activities. For activities related to the provision of services, the company applies the “simplified tax” system, and for the sale of medicines at retail, it has been transferred to the payment of UTII.

Organizations using the simplified system may not keep accounting records. And organizations transferred to pay UTII must keep accounting records.

In such a situation, according to the Russian Ministry of Finance, the organization must maintain accounting and present financial statements for the organization as a whole (see Letter dated March 26, 2004 No. 04-02-03/69). In this case, the organization reflects expenses for different types of activities in different accounts:

– for medical services – on account 20;

– for the sale of medicines – on account 44.

But to reflect financial results, the company needs to open different sub-accounts for account 99:

– subaccount “USN”;

– subaccount “UTII”.

Let us assume that at the end of the reporting period:

– revenue from medical services – 600,000 rubles;

– direct expenses for medical activities (rent of premises, depreciation of equipment, salaries of medical workers with deductions) – 80,000 rubles;

– revenue from retail trade – 200,000 rubles;

– cost of medicines – 180,000 rubles;

– direct expenses for retail trade (salaries of salespeople, rent of premises, depreciation of retail equipment) – 50,000 rubles;

– indirect costs (maintenance of the management staff, rent of common premises, cleaning of premises, etc.) – 70,000 rubles.

The total revenue is:

600,000 rub. + 200,000 rub. = 800,000 rub.

We determine the share of income from retail trade. It will be equal to:

200,000 rub.: 800,000 rub. ? 100% = 25%.

Indirect costs are distributed in proportion to the share of income received from each type of activity. Then retail trade indirect costs account for:

70,000 rub. ? 25% = 17,500 rub.

And the share of medical services accounts for indirect costs:

70,000 rub. – 17,500 rub. = 52,500 rub.

In the organization’s accounting, the accountant will reflect the distribution of expenses between types of activities as follows:

debit 44 credit 26 17,500 rub.

– expenses related to retail trade (activities under UTII) are written off;

debit 20 credit 26 52,500 rub.

– expenses attributable to medical services are written off (activities under the simplified tax system).

Example 3.

The pharmacy dispenses medicines both in cash to customers and by bank transfer to hospitals. At the same time, cash trading has been transferred to the payment of a single tax on imputed income. For the first quarter of 2006, the pharmacy's revenue from the sale of medicines amounted to: - for cash payments - 210,000 rubles. (without VAT);

– for non-cash payments – 139,700 rubles. (including VAT at a rate of 10% - 12,700 rubles).

The pharmacy stores all medications in a warehouse. The residual value of drugs in this warehouse as of April 1, 2006 is 320,000 rubles. When calculating property tax for the first quarter of 2006, you can include in the calculation only part of the residual value of drugs from the warehouse:

320,000 rub. ? (RUB 139,700 – RUB 12,700): (RUB 210,000 + RUB 139,700 – RUB 12,700) = RUB 120,593.47

Example 4.

The pharmacy dispenses medications using free and discounted prescriptions.

Its activities in the retail trade of medicines have been transferred to the payment of a single tax on imputed income.

In March 2006, the pharmacy purchased 300 packages of Tsifran for 118.8 rubles. per package (including VAT at the rate of 10% - 10.8 rubles). Assume that the maximum retail markup for free and discounted prescription drugs is 20 percent. Therefore, the pharmacy can set the sales price for Tsifran no higher than:

118.8 rub./pack. + 118.8 rub./pack. ? 20% = 142.56 RUR/pack.

Table of contents

VAT on the provision of medical services

This List includes health education, as well as diagnosis, prevention and treatment, if they are provided: 1) on an outpatient basis in clinics or during pre-medical care, including medical examination; 2) in a hospital (including medical examination); 3) in day hospitals by the services of general (family) doctors (including medical examination).

If medical organizations are fully or partially financed from the budget or from the compulsory health insurance fund, then they are not subject to VAT in accordance with subparagraph. 5 p. 2 art. 149 of the Tax Code of the Russian Federation, sales of food products produced by canteens of medical organizations and sold in these medical organizations. Not taxed

Zero VAT does not exempt medical organizations from submitting a tax return

Elena Titova, an expert at the legal consulting service “Garant”, a member of the Chamber of Tax Consultants, answers:

According to subclause 1 of clause 2 of Article 170 of the Tax Code of the Russian Federation, the tax amounts charged to the buyer when purchasing goods (work, services) on the territory of Russia are taken into account in the cost of such goods (work, services) if they are used to provide services , not subject to VAT, in particular, on the basis of subparagraph 2, paragraph 2, article 149 of the Tax Code of the Russian Federation. Thus, due to the direct instructions of the Tax Code of the Russian Federation, VAT is not allocated in the accounting of the taxpayer-buyer, i.e. is not separated from the cost of purchased goods (works, services). VAT on such goods (work, services) may not even be allocated separately on account 19. The indicated amounts of VAT as part of the cost of purchased goods (work, services) are reflected in those accounting accounts that reflect the cost of these goods (work, services).

When taxpayers carry out transactions that are not subject to VAT (exempt from taxation) in accordance with Article 149 of the Tax Code of the Russian Federation, invoices are not drawn up, invoice journals and sales books are not filled out. At the same time, organizations that carry out only non-taxable transactions based on Article 149 of the Tax Code of the Russian Federation do not keep a purchase book (clause 3 of Article 169 of the Tax Code of the Russian Federation), but are not exempt from the obligation to submit VAT returns.

The VAT return is submitted only in electronic form via telecommunication channels no later than the 25th day of the month following the expired tax period (clause 3 of Article 80 and clause 5 of Article 174 of the Tax Code of the Russian Federation, see also the letter of the Federal Tax Service of Russia dated September 30. 2013 No. PA-4-6/17542).

The form of the VAT tax return and the procedure for filling it out were approved by order of the Federal Tax Service of Russia dated October 29, 2014 No. ММВ-7-3/ [email protected] When carrying out transactions exempt from taxation in accordance with Article 149 of the Tax Code of the Russian Federation, the taxpayer fills out section 7 declaration, in column 1 of which it is necessary to reflect the transaction code in accordance with Appendix No. 1 to the Procedure (clause 44.2). In particular, when selling medical services, with the exception of cosmetic, veterinary and sanitary-epidemiological services (except for veterinary and sanitary-epidemiological services financed from the budget), provided for in subclause 2 of clause 2 of Art. 149 of the Tax Code of the Russian Federation, code 1010211 is indicated.

When carrying out transactions exempt from VAT, section 7 of the declaration is filled out for the tax period in which the service was provided (letter of the Federal Tax Service of Russia dated 02/08/2007 No. MM-6-03 / [email protected] ).

How are medical services subject to VAT?

who provides medical services: individual entrepreneur, state or private commercial organization (clause 11 of article 2 of the Law on Health Protection, Letter of the Federal Tax Service of Russia dated May 26, 2019 N SD-4-3/[email protected]);
who is the customer of medical services and who pays for them: the patient himself, his employer (organization or individual entrepreneur), insurance company (Part 2 of Article 84 of the Law on Health Protection, Letter of the Ministry of Finance of Russia dated June 17, 2015 N 03-07-07/35004, Federal Tax Service of Russia dated March 27, 2013 N ED-18-3/);
form of payment for medical services.

Medical services that do not fall under the list of non-taxable ones are subject to VAT.

Medical services are not subject to VAT

No. 03-07-14/49684 “On the exemption from VAT of medical services for preliminary periodic medical examinations of individuals provided by medical institutions, including under contracts with legal entities”).

provision of funeral services, work on the production of tombstones and the design of graves, as well as the sale of funeral supplies according to the list approved by the Government of the Russian Federation;
sale of medical goods according to the list approved by the Government of the Russian Federation;
sale of folk arts and crafts products of recognized artistic merit (with the exception of excisable goods), samples of which are registered in the manner established by the Government of the Russian Federation.
provision of premises for rent to foreign citizens or organizations accredited in Russia;

Also not subject to VAT are transactions on the sale of goods produced and sold by firms whose authorized capital consists entirely of contributions from public organizations of disabled people (provided that among the members of these organizations disabled people and their legal representatives make up at least 80%), if: In accordance with According to the legislation in force in the Russian state, organizations and individual enterprises are not required to pay value added tax to the budget if an individual or legal entity applies the taxation regime for agricultural producers, works under a simplified taxation system, has been transferred to the single tax regime, or has received an exemption from VAT.