Writing invoices as a Heilpraktiker

Non-medical practitioners (Heilpraktiker) are explicitly named in § 4 No. 14 UStG: medical treatment of humans is VAT-exempt. What matters is the therapeutic purpose – the service must serve the diagnosis, treatment or relief of an illness or health disorder.

Without a therapeutic goal, the exemption does not apply. Pure wellness, relaxation or beauty treatments are taxed at 19 % – even when provided by a Heilpraktiker.

Many practices offer both: therapeutic treatments (exempt) and wellness or course offerings (taxable). On the invoice, both areas should appear clearly separated as their own line items so the tax office can follow the split.

Those providing only exempt treatments cannot deduct input VAT on purchases. As soon as taxable turnover is added, proportional input-VAT deduction becomes possible – here it is worth looking at the small-business rule.

Unlike physicians, Heilpraktiker are not bound by a binding fee schedule. The Heilpraktiker fee directory (GebüH) serves as the customary guide and is used as a benchmark by many private health insurers. Fees can be freely agreed but should remain transparent and comprehensible.

A VAT-exempt invoice also needs the mandatory details under § 14 UStG: name and address of practice and patient, tax number, issue date, sequential invoice number, service description and service date. For exempt treatments, add a note such as "VAT-exempt under § 4 No. 14 UStG".

Patients often submit your invoice to private health insurance. A clear diagnosis/service description and the GebüH reference make reimbursement easier. A payment term and a payment link help you get paid faster.