Do private GPs need to charge VAT?

The rule on VAT on private healthcare is that medical care by a registered health professional is exempt when its primary purpose is to protect, maintain or restore the patient’s health (HMRC VAT Notice 701/57). So most private GP consultations, tests, screening and vaccinations carry no VAT. Reports, certificates and examinations done mainly so a third party can make a decision, and purely cosmetic work, are standard-rated at 20%.

VAT on private healthcare: the medical care exemption

HMRC VAT Notice 701/57 sets out when a health professional’s services are exempt. Both conditions must be met (section 2.3):

1. The service is within the profession you are registered in. For a GP, that means you are on the GMC register and the work is medical care.
2. Its primary purpose is to protect, maintain or restore the health of the person concerned.

Diagnosing and treating illness, analysing samples as part of a diagnosis, health screening and most vaccinations meet this test. The exemption belongs to the service, not to the setting, so a video consultation is treated the same way as a face-to-face one.

Work done by staff who are not registered health professionals is exempt only if strict conditions on direct supervision are met (section 5). If a healthcare assistant runs clinics, check this with your accountant.

What is not VAT exempt: standard-rated work

The test is purpose. Where a report or examination is done mainly so that a third party can make a decision, it is taxable at the standard rate, currently 20% (section 2.4). Services not aimed at preventing, diagnosing or treating a disease, such as paternity testing, and administrative work such as countersigning passport applications, are also standard-rated (section 2.5). Examples from the notice:

Service	Usual VAT treatment	Notice section
Consultation, diagnosis and treatment	Exempt	2.3
Health screening, including in-service and insurance-funded screening	Exempt	2.3, 4.8
Vaccinations such as flu and pneumococcal, and immunisation against work-related infection risk	Exempt	4.11, 7.1
Medicals to assess fitness for proposed work, or ill-health retirement, once someone is employed	Exempt	4.11
Sick notes and certificates whose main purpose is the patient’s health	Exempt	4.2
Pre-employment medicals	Standard-rated	4.11
Medico-legal reports and expert witness work	Standard-rated	4.9
Insurance reports done so the insurer can make a decision	Standard-rated	2.4, 4.8
Fitness certificates for sport or other activities	Standard-rated	4.2
DVLA medicals for initial or continued fitness to drive	Standard-rated	4.8
Medicals to decide whether someone can join a pension scheme	Standard-rated	4.11
Purely cosmetic procedures (cosmetic work within a healthcare treatment programme is generally exempt)	Standard-rated	4.4
Forms for blue badge applications	Standard-rated	7.1
Paternity testing	Standard-rated	2.5
Countersigning passport applications, character references	Standard-rated	2.5

Some insurance work is exempt, such as screening under a private medical insurance policy. Occupational health is mixed: a post-employment fitness assessment can be exempt while a pre-employment medical is taxable. Look up the specific service in the notice rather than assuming.

Medicines and dressings

• Given as part of the treatment. Drugs, dressings and similar items you administer or apply during an exempt consultation are exempt too (section 3.1). A vaccine you inject is an example.
• Supplied for the patient to take away. Items separable from the treatment, such as privately dispensed medicines for self-administration, are not covered by the exemption and are usually standard-rated (section 3.1).
• Dispensed by a pharmacist on your prescription. That is the pharmacy’s supply, and it may be zero-rated if the conditions in section 3.2 are met.

If you plan to sell medicines directly, for example in a travel or weight-management service, get advice first.

Do you need to register?

The VAT registration threshold is £90,000 (checked on GOV.UK on 2 October 2026). You must register if your taxable turnover over the last 12 months goes over £90,000, or you expect it to go over £90,000 in the next 30 days alone. If you go over on the rolling 12-month test, you must register within 30 days of the end of that month, and you are registered from the first day of the second month after you went over. Exempt income does not count. A private GP whose work is almost all exempt consultations will usually never reach the threshold, whatever their total income.

Watch the taxable lines if you grow into medicals, medico-legal work or aesthetics. Check the rolling 12-month total each month. If you register late, HMRC can charge you the VAT you should have charged from the date you should have registered, which you may not be able to recover from patients.

Registering voluntarily is possible, but for a mainly exempt practice it rarely helps. It brings quarterly returns and the partial exemption rules, and you still cannot recover the VAT on costs that relate to exempt work.

What exemption costs you

Exempt is not the same as zero-rated. You do not charge VAT on exempt services, but you also cannot reclaim the VAT you pay on rent, equipment, software and supplies that relate to them (section 8.1). For most private GPs, VAT is a cost of doing business. Budget for costs gross, including VAT, in your start-up costs and fees.

If you do both exempt and taxable work

• Price and invoice the two separately, and keep a record of which is which.
• Count only taxable income towards the threshold.
• Once registered, you charge VAT on taxable work, and you can reclaim only the VAT on costs linked to taxable work, plus a share of overheads under the partial exemption rules (section 8.2, and VAT Notice 706).
• Under the partial exemption de minimis rule, you can recover the VAT on exempt costs as well if that exempt input tax is no more than £625 a month on average and no more than half of your total input tax (Notice 706, section 11.2). Both conditions must be met. Your accountant will check this on each return and at the annual adjustment.
• State whether a price includes VAT. Prices advertised to patients should be the full price they will pay. See how much to charge.

Across the UK

VAT is a UK-wide tax, so the same rules apply in England, Scotland, Wales and Northern Ireland. What differs is how your income is taxed. See tax implications of a private GP service, and should I set up a company? Your business structure does not change whether a service is exempt.

If a service is borderline, ask an accountant who works with medical practices, or ask HMRC for a view before you launch it. HMRC updates the notice from time to time (most recently in August 2026), so check the current version.