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Chiropractors and physiotherapists

Accountants for chiropractors and physiotherapists, from first clinic to exit

Physiotherapy and chiropractic fees are exempt from VAT, but a clinic that also sells massage or other therapies has a mixed position. This page follows the practice from first day to exit, with the tax and VAT points that matter at each stage.

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Your clinic, vertebra by vertebra

StartStructureEquipVATTeamCashExit

At a glance

What sets therapy practices apart

€0VAT on exempt therapyPhysiotherapy and chiropractic are exempt, so no VAT is charged and none is reclaimable on costs.

13.5%Massage servicesMassage is taxable at the reduced rate, even when a clinic offers it alongside exempt care.

€42,500ThresholdRegister for VAT when taxable services exceed, or are likely to exceed, this amount.

8 yearsEquipment write-offPlant and machinery is generally written off at 12.5% a year.

The spine of your practice

Seven stages, in the order they arrive

Register and set up

Day one

Make sure your professional registration, indemnity and business set-up are in place before you invoice.

Keep your professional registration and insurance receipts
Open a separate business bank account

Choose a structure

Before you start

Sole trader, partnership or company. Each is taxed differently.

Sole trader: income tax, USC and PRSI on profit
Company: 12.5% on profit, then tax on what you take out

Equip the clinic

Before you buy

Couches, ultrasound units and software add up, and the relief is spread over years.

Plant and machinery is generally written off at 12.5% a year over eight years
Keep invoices and dates of purchase

Know your VAT position

Every invoice

Exempt therapy and taxable services can sit in the same clinic.

Physiotherapy and chiropractic: exempt
Massage services: reduced rate
Taxable sales above €42,500 mean registering

Bring in colleagues

As you grow

Associates and employees are treated differently by Revenue.

Check status on the facts, not the label
Employees mean payroll submissions on every pay date

Manage cash and tax

Every October

Income often arrives unevenly, but tax bills do not.

Form 11 due 31 October, or 18 November 2026 on ROS
Preliminary tax: 90% of this year, 100% of last year, or 105% of the year before by direct debit

Sell or step back

Years later

Goodwill is often the biggest asset in a clinic.

Reliefs may reduce tax on a sale but have conditions
Plan pension and exit together

VAT by service

Which therapies are exempt and which are not

Based on Revenue guidance. Reduced rate is 13.5%.

Service	VAT treatment	Note
Physiotherapy	Exempt	Listed by Revenue as qualifying care
Chiropractic	Exempt	Listed by Revenue as qualifying care
Osteopathy and chiropody	Exempt	Listed by Revenue as qualifying care
Massage services	Reduced rate (13.5%)	Includes sports massage; physiotherapy itself remains exempt
Cosmetic procedures not medically required	Reduced rate (13.5%)	Not treated as care
Medico-legal reports	Standard rate (23%)	A service to a third party

Structure

Sole trader or company?

SIMPLEST

Sole trader

TaxIncome tax, USC and PRSI on all profit
AdminForm 11 each year
Best whenYou work alone and draw most of the profit

Most new clinics start here.

RETAINED PROFIT

Limited company

Tax12.5% on trading profit, then tax on salary and dividends
AdminPayroll, CT1 and company filings
Best whenYou reinvest profit or have several clinicians

The VAT exemption is the same either way.

Straight answers

Three clinic myths

MythEverything a registered therapist sells is exempt.

✓

FactThe exemption covers the care itself. Massage and other taxable services in the same clinic are treated separately.

MythSports massage is exempt because a physio gives it.

✓

FactMassage services are taxable at the reduced rate, while the physiotherapy itself is exempt.

MythAn associate physio is automatically self-employed.

✓

FactStatus depends on how the work is done, not on the contract heading.

Quick answers

Questions about accountants for chiropractors and physiotherapists

Short, plain answers to what people ask us most.

Is physiotherapy exempt from VAT?

Yes. Revenue lists physiotherapists among the professionals whose qualifying care is exempt, so you charge no VAT and cannot reclaim VAT on costs.

What about chiropractic?

Chiropractic care is also exempt under Revenue’s guidance.

Is massage subject to VAT?

Yes. Massage services, including sports massage, are taxable at the reduced rate of 13.5%.

When must I register for VAT?

When taxable services, such as massage, exceed or are likely to exceed €42,500.

How do capital allowances work on clinic equipment?

Plant and machinery is generally written off at 12.5% a year over eight years.

Should I use a company?

It depends on how much profit you draw. The company pays 12.5% on profit, but salary and dividends are taxed again.

How do I treat an associate or locum therapist?

Revenue looks at the facts of the working relationship, so check status before you decide on payroll or invoicing.

When is my Form 11 due?

31 October, or 18 November 2026 if you file and pay through ROS.

Keep reading

Related guides

SECTOR

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Your services and prices
Your structure and year end
Whether you have associates
Your equipment spend

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