Accounting & tax supportfor doctors.

VAT on Medical Services & Telemedicine

The VAT treatment of a healthcare service depends on its actual content and purpose. Medical care provided in the exercise of medical professions may qualify for exemption when its substance is diagnosis, prevention, monitoring or treatment.

Not every fee received by a doctor automatically receives the same treatment. Services to businesses, research partnerships, consultancy and other income streams must be assessed separately.

The same applies to telemedicine: remote delivery alone does not change the tax character of the service. The decisive issue is whether it is genuinely medical care. The current framework is included in Law 5144/2024, with specific guidance on telemedicine in AADE Circular E.2008/2026.

Medical Practice Expenses & Input VAT

Proper monitoring of practice expenses directly affects taxable profit, but an invoice issued in the doctor’s name does not by itself make an expense tax-deductible.

Expenses must be genuinely connected with the professional activity, relate to a real transaction, be recorded correctly and be supported by the required documents. Examples may include:

• premises and utilities
• electricity, telephone and internet
• consumables and medical supplies
• medical and IT equipment
• software and practice-management applications
• professional services and external partners
• payroll and employer contributions
• professional insurance and eligible subscriptions

Income-tax deductibility and the right to deduct VAT are separate questions. Where a practice carries out VAT-exempt transactions without input-VAT deduction, the VAT on related purchases is generally not recoverable. Mixed exempt and taxable activities require closer monitoring.

A Doctor’s Car: Purchase or Leasing?

Whether a car can be treated as a professional expense has no single answer. Its real connection with the activity and the general tax-deductibility conditions must first be examined.

Relevant costs may include depreciation, lease payments, fuel, maintenance, insurance and other running costs. VAT is a separate issue: passenger cars and related expenditure are subject to specific restrictions, subject to statutory exceptions.

Purchase and leasing should therefore be compared using the upfront capital, monthly burden, financing cost, tax treatment, liquidity impact, holding period, running costs and residual value—not simply which option creates the larger expense.

Medical Equipment, Depreciation & Financing

New medical equipment may be one of the practice’s most important investment decisions. High-value diagnostic, ultrasound, laser, dental or other equipment is not necessarily deducted in full in the year of purchase; depreciable assets are normally recognised through the applicable depreciation rules.

The assessment should include:

• initial cost and financing method
• tax depreciation and VAT treatment
• maintenance costs
• impact on liquidity
• expected additional revenue
• payback period
• available finance or subsidies

The real question is not only the size of the instalment, but how much additional return the equipment must generate for the investment to be financially sustainable.

myDATA & Electronic Invoicing

Correct document issuance and transmission to myDATA are now central to the daily operation of a medical practice. The setup should reflect the doctor’s customer and partnership mix, including private patients, businesses, clinics and diagnostic centres.

The second phase of mandatory electronic invoicing begins on 1 October 2026 for businesses within its scope, with a transition period to 31 December 2026 where the relevant conditions and timely declarations are met.

Electronic invoicing is not the same as simply sending data to myDATA. The practice must use an approved issuance method suitable for its circumstances. Planning the invoicing process before the obligation applies materially reduces everyday errors.

POS, IRIS & Reconciliation of Receipts

Electronic payments are integral to a modern medical practice. Since 1 December 2025, account-to-account instant payment services such as IRIS must be accepted in business-to-consumer transactions under the applicable framework.

The issue is not limited to having POS or IRIS. A reliable financial picture requires reconciliation between:

• issued documents
• POS receipts
• IRIS receipts
• bank movements
• other collections
• accounting records

Regular reconciliation helps identify discrepancies and provides a clearer picture of actual collections and practice liquidity.

Minimum Deemed Income for a Self-employed Doctor

A doctor operating through a sole proprietorship may, where the relevant conditions apply, be affected by the minimum net income assessment system for individual business activity.

Accounting profit is therefore not always the only figure determining taxable income. The review should cover actual accounting results, the amount arising under the minimum-income system, lawful reductions or exemptions, years of operation, employees and the specific circumstances of the activity.

The calculation is best prepared before the tax year closes, allowing the doctor to anticipate the likely tax burden and organise liquidity in good time.

Individual Practice or Company?

As a practice grows, it may become appropriate to compare continuing as an individual activity with operating through a suitable company form. There is no turnover threshold above which a company automatically becomes the better option.

The analysis should consider annual revenue, net profitability, the doctor’s personal cash needs, total tax and social-security burden, profit distribution, administration costs, minimum deemed income, partners, future investment, staffing needs and the long-term growth plan.

The decision should result from a comparative tax and financial analysis, not from comparing only two tax rates.

Partnerships with Clinics & Diagnostic Centres

Many doctors combine private practice with work for clinics, group practices, diagnostic centres or other healthcare businesses. Different partnership arrangements should not all be treated in the same way.

The actual service, agreement terms, fee calculation, correct document, VAT treatment, any withholding tax, myDATA transmission, invoicing date and collection date should all be reviewed.

Distinguishing genuine medical care from other services supplied to a business is particularly important. Correct organisation from the start prevents invoicing problems and helps reveal the agreement’s true financial result.

Employees & the True Cost of Payroll

Hiring administrative, nursing or other staff can improve the practice, but the true cost goes beyond the net salary. Gross pay, employer contributions, statutory bonuses, leave, overtime, equipment, training and other role-related costs must be considered.

Before hiring, the practice should estimate the annual cost, the capacity or revenue the position can add and the impact on cash flow. Payroll should be viewed both as an employment obligation and as an investment that must be financially sustainable.

Financial Organisation & Practice Profitability

A doctor needs to know more than the balance in the bank account. A useful monthly picture can include revenue by source, operating costs, staff costs, receivables, liabilities, tax and social-security obligations, investment payments, cash flow and available liquidity.

Profitability can also be examined by service, partnership or activity. This helps distinguish high-turnover work from work that genuinely creates value after time, costs and collection delays are taken into account.

Accounting information becomes more valuable when it supports pricing, investment, staffing and growth decisions—not only compliance.