Accounting for healthcare businesses

VAT in healthcare: what is exempt?

Medical care and dental care are exempt from VAT. Medical care means measures to medically prevent, investigate or treat illnesses, physical defects and injuries, when carried out at a healthcare institution or by someone licensed in a healthcare profession. The exemption also covers goods and services that the care provider sells as part of the care. Glasses and other visual aids, however, are always subject to VAT. The rules are set out in Chapter 10 of the Swedish VAT Act (mervärdesskattelagen).

Locum doctors and VAT

If you are hired in as a doctor, dentist or other healthcare professional at someone else's practice, it is the practice that provides the care and that is the patients' counterparty. According to the Swedish Tax Agency (Skatteverket), hiring out healthcare staff is not medical care in itself, so you must charge 25 per cent VAT on your invoices to the practice.

If instead you see patients under your own management and on your own responsibility, the care is exempt from VAT. This requires an organisation of your own that does not belong to any other practice, and it must be clear to patients that it is your practice providing the care. If you sell services subject to VAT, such as consultancy assignments, for more than SEK 120 000 a year, you must register for VAT. Read more at the Tax Agency.

When you sell both exempt and taxable services

Many healthcare businesses have both: VAT-exempt care and taxable services such as consultancy assignments or treatments for purely cosmetic purposes. In that case you may only deduct VAT on purchases that belong to the taxable part. VAT on shared purchases, such as equipment and patient record systems, is split, and if the shares cannot be determined, the split is made on a reasonable basis. We set up the chart of accounts so that the two parts are kept apart from the start in the bookkeeping.

Aesthetic treatments

An aesthetic treatment carried out for purely cosmetic purposes, with no medical grounds, is not medical care and must be sold with VAT. If the treatment is medically justified, it counts as VAT-exempt medical care, and that assessment is made by licensed healthcare staff. This follows from the Supreme Administrative Court (Högsta förvaltningsdomstolen) ruling HFD 2013 ref. 67 and the Court of Justice of the EU ruling C-91/12. If you run a salon offering fillers or other injections, there is more on our page for beauty salons.

Notifying the Health and Social Care Inspectorate (IVO) before you start

Anyone who will provide health and medical care must notify the business to IVO's register of care providers no later than one month before it starts. If the business changes significantly or moves, this must be notified within one month. Since 1 January 2026, private dental care instead requires a licence from IVO.

Patient insurance and patient records

All care providers must have patient insurance. If you provide care under an agreement with a region, it is the region that must hold the insurance. Patient records must be kept for at least ten years after the last entry. Insurance and a patient record system are therefore fixed costs to include in the budget as early as when you start the company.

How we help healthcare businesses

• Ongoing bookkeeping where VAT-exempt and taxable sales are kept apart
• The right VAT on your consultancy invoices
• Payroll and employer declarations
• Salary, dividends and company structure through our advisory service
• Year-end closing, annual report and tax return

Fixed monthly price based on the number of vouchers and employees, no lock-in period, three months' notice. See prices.