Healthcare
Tax Advisor for Non-Medical Practitioners (Heilpraktiker)
Treatment tax-exempt, shelf taxable: we draw the line before the tax office (Finanzamt) does. As a non-medical practitioner (Heilpraktiker), you work in two tax worlds at the same time: your medical treatment is exempt from VAT (Umsatzsteuer), your product shelf and open courses are not. We make sure that this line does not burden you but is drawn automatically by your bookkeeping: with separate revenue areas, matching invoicing and an eye on the trade tax (Gewerbesteuer) limits, which in joint practices (Gemeinschaftspraxis) decide far more than just the sales revenue itself.
Focus areas for non-medical practitioners
- Freelance professional status (freiberuflich) under § 18 EStG: no trade tax (Gewerbesteuer) on the healing activity, profit determined by a cash-basis profit and loss statement (EÜR)
- VAT (Umsatzsteuer) exemption for medical treatments and the delineation of taxable offerings such as wellness, courses or seminars
- Sale of natural remedies and food supplements: separating commercial income correctly
- Small-business scheme (Kleinunternehmerregelung): when it pays off
- Typical business expenses: practice premises, further training, specialist literature, professional liability insurance
Your treatment is tax-exempt. Your shelf is not.
Do you know the moment when a patient takes a preparation home after the treatment? That is exactly where your most important tax line runs. The medical treatment itself is exempt from VAT (Umsatzsteuer) as a healing activity; the non-medical practitioner (Heilpraktiker) is expressly recognised for this. The sale of food supplements, teas or cosmetics, by contrast, is trade: subject to VAT and commercial for income tax purposes, no matter how well it complements your therapy. Both worlds may exist in one practice, but not in one pot.
Why the separation decides more than just VAT
If you run your practice on your own, mixing the two costs "only" clarity and, in case of doubt, VAT. In a joint practice (Gemeinschaftspraxis) more is at stake: commercial sales revenue can cross-contaminate the entire income of the partnership (Abfärbung). Then the whole freelance practice suddenly pays trade tax (Gewerbesteuer). Only those who stay below narrow de-minimis thresholds (Bagatellgrenze) are spared. We keep an eye on these thresholds every month and raise the alarm in good time, before a well-running shelf turns into an expensive side issue.
In the tax-exempt core, too: document the purpose
Your service is tax-exempt if it pursues a therapeutic purpose: prevention, diagnosis, treatment. Wellness applications, general life counselling or courses without any connection to illness fall outside this. The good news: with clean anamnesis and progress documentation, which you keep anyway, the proof is usually already in place. We tell you where each of your practice's offerings belongs, and we set up your till, invoices and bookkeeping so that the allocation happens along the way, not as an extra task at the end of the year. Formally, your practice stays pleasantly lean in the process: as a freelance professional, the cash-basis profit and loss statement (EÜR) is sufficient, and for the taxable area we check whether the small-business scheme (Kleinunternehmerregelung) applies, using up-to-date threshold values, because these change. We bring your invoices into the right form in each case: without VAT shown for the medical treatment, correctly shown for sales and courses. And because tax audits (Betriebsprüfung) like to start at the border between the two worlds, you get a documentation routine from us that you will no longer notice after two weeks and that prepares you well for queries from the tax office (Finanzamt). In short: you treat, we sort the figures.
Separation checklist
- Separate revenue accounts: treatment / product sales / courses
- Till system with its own product groups for each area
- Separate invoice ranges, no mixed documents
- Quarterly check on the Bagatellgrenze (3 % / 24.500 €) in the joint practice
Example from our advisory practice
Hypothetical example: a non-medical practitioner in a joint practice (Gemeinschaftspraxis) additionally sells preparations and runs an open relaxation course. The challenge: both secondary areas are taxable and can cross-contaminate the practice. Suitable service: a separate revenue structure plus ongoing monitoring of the de-minimis threshold. Intended benefit: the freelance practice remains exempt from trade tax, the sales continue to be taxed correctly. Next step: an initial consultation with your current revenue figures.
Frequently asked questions
Yes, in the core area: non-medical practitioners (Heilpraktiker) are expressly recognised as a healing profession, and your healing treatments with a therapeutic purpose are exempt from VAT. The line runs at offerings with no connection to illness (wellness, general life counselling, open courses) and at the sale of goods: both are taxable. What is decisive is therefore less the professional title than the specific service and its documentation in the patient file.
No. The sale of food supplements, teas or care products is trade: a commercial activity for income tax purposes and taxable for VAT purposes, even if the products usefully complement your therapy. This is not a prohibition but a question of allocation: separate revenue accounts, correct tax disclosure, and where applicable trade tax (Gewerbesteuer) on this area. Kept cleanly apart, both can be run under one practice roof without any problem.
In a joint practice a double de-minimis threshold (Bagatellgrenze) applies: if the commercial net revenue stays both below 3 % of the total net revenue and below 24.500 € per year, nothing happens. If even one of the two limits is exceeded, all income of the partnership is in principle deemed commercial, including the treatments. If your sales are growing, moving them out into a separate entity should therefore be considered in good time.
There is no obligation to use an electronic till at all; you may keep an open cash register (offene Ladenkasse). If you do decide on an electronic system, however, the full requirements apply: individual recording of every sale, a certified technical security device and registration of the system. For a practice with product sales, an electronic till is nevertheless often worthwhile, because it handles the separation of treatment and sales at the same time. We help with the selection and the correct set-up.
Yes: expenses for your professional further training, relevant specialist literature and work materials are business expenses, insofar as they are professionally occasioned. The same applies to practice supplies, room costs and journeys to training courses or house calls. What matters is prompt and complete recording of receipts; we organise this digitally so that nothing is missing at the end of the year. For mixed-purpose expenses, such as literature with a private element, we clarify the allocation in advance instead of leaving it to the tax audit (Betriebsprüfung).
In non-medical practices we are additionally interested in the split between treatment, sales and courses. A few things are enough for the initial assessment: the last business management report (BWA) or the last tax assessment notice, an overview of your service areas and, if available, the current list of accounts. To take over your ongoing support, you will receive a short checklist from us; we set up the powers of attorney and data access together. You do not have to carry paper folders around: you can submit all documents digitally.
Yes. You submit receipts digitally, you receive evaluations electronically, and we hold meetings by video, by telephone or on site, as you prefer. This means that the support is not tied to the office location; what counts is sector knowledge, not the postcode. Whether the till data of your practice system can be connected and which tools are used specifically is something we clarify together with you during the set-up.
For non-medical practitioners, the scope of product sales and courses feeds into the estimate of effort. The remuneration follows the German tax advisor remuneration regulation (Steuerberatervergütungsverordnung) and depends on object values, scope of services and effort; flat-rate agreements are possible for ongoing services. You will receive a solid quote after the initial consultation; for that, the last evaluation, the number of receipts and the desired modules are sufficient. We do not consider made-up fixed prices without a look at your practice to be serious.
Your next step
Do you sell preparations in your practice? Let us set up the separation in an initial consultation. After your enquiry you will receive a confirmation of receipt; your dedicated contact person will then get in touch. Still getting your bearings? We answer the most frequent questions directly above on this page.