Accountants for GPs and medical practitioners, built around how a practice really runs
A medical practice earns from several places at once: public payments, private fees, and services that sit outside the VAT exemption. We follow the money through each room of the practice, so the accounts, the VAT and the tax credits all line up.
Click a room to see what it means for your accounts
Reception: fees in, claims out
Every payment that reaches the practice starts here, so this is where good records begin.
- Record private fees daily, by patient and service
- Submit GMS and other claims through PCRS and keep each statement
- PSWT withheld from public payments shows on ROS as “PSWT Withheld from you”
- Reconcile card, cash and bank lodgements weekly
Waiting room: what patients see
Fees, receipts and notices are part of your compliance too.
- Issue receipts for every private fee
- Display fees that match what you record
- Keep the register of who paid what and when
Consulting rooms: income and credits
Most of your income is earned here, and each stream is taxed or credited differently.
- Public payments may carry 20% PSWT, which you claim as a credit
- Private consultations are exempt from VAT as qualifying medical care
- Record each income stream separately so the return is easy to build
- Form 11 due 31 October, or 18 November 2026 on ROS
Treatment room: exempt or taxable?
Not everything done in a surgery qualifies for the VAT exemption. The table below lists the services Revenue treats differently.
- Consultations and treatment: exempt
- Vaccination programmes to protect employees at risk: exempt
- Medical reports for statutory purposes: standard rate
- Cosmetic-only procedures and massage: reduced rate
Staff room: payroll and people
Practice nurses, receptionists and managers each add obligations.
- Register as an employer and submit every payroll to Revenue on or before the pay date
- Check status for anyone you treat as self-employed
- Keep payslips and contracts for six years
- Pension contributions for staff and principals follow separate rules
Back office: structure and succession
Behind the scenes, three big decisions shape your tax: structure, drawings and exit.
- Sole practitioner, partnership or company: model all three
- The VAT exemption does not depend on legal form
- Partnership agreements decide how profit and goodwill are shared
- Plan retirement and sale early, because reliefs have conditions
What to know before your next return
Which services are exempt and which are not
Based on Revenue guidance for medical services. Reduced rate is 13.5%.
| Service | VAT treatment | Why |
|---|---|---|
| GP and consultant consultations and treatment | Exempt | Qualifying medical care by a registered practitioner |
| Pre-employment medicals | Exempt | Listed by Revenue as qualifying care |
| Vaccination programmes to protect at-risk employees | Exempt | Listed by Revenue as qualifying care |
| Medical reports for statutory purposes | Standard rate (23%) | Not treated as care of the patient |
| Medico-legal reports | Standard rate (23%) | A service to a third party |
| Work absence advice programmes for employers | Standard rate (23%) | Advice to the employer |
| Cosmetic procedures not medically required | Reduced rate (13.5%) | Not medical care |
| Massage services | Reduced rate (13.5%) | Not exempt, even when offered by a clinic |
Sole practitioner, partnership or company
Sole practitioner
- TaxIncome tax, USC and PRSI on all profit
- AdminForm 11 each year
- Best whenYou work alone and draw most of the profit
Partnership
- TaxEach partner is taxed on their share
- AdminPartnership return plus each partner’s Form 11
- Best whenSeveral principals share premises and staff
Three practices, three different priorities
A new single-handed GP
Mostly GMS and private fees, no staff yet.
A consultant with private rooms
Hospital contract plus private clinic and medico-legal reports.
A four-GP group practice
Shared premises, staff and a partnership agreement.
Three things practices get wrong
Questions about accountants for GPs and medical practitioners
Short, plain answers to what people ask us most.
Which medical services are exempt from VAT?
Qualifying care by registered practitioners, such as consultations and treatment, pre-employment medicals and vaccination programmes to protect at-risk employees. Reports for statutory purposes, medico-legal reports and work absence advice are taxable at the standard rate.
What is PSWT and how do I claim it?
A 20% withholding that public bodies and authorised health insurers deduct from certain payments. It appears on ROS as PSWT withheld from you and is claimed as a credit when you file your return.
Do I still get F45 forms?
No. Paper F45 forms ended on 1 July 2021 and PSWT is notified electronically.
When do I need to register for VAT?
When taxable services, such as medico-legal work, exceed or are likely to exceed €42,500.
Should my practice be a company?
It depends on how much profit you draw. The company pays 12.5% on trading profit, but salary and dividends are taxed again. The VAT exemption is the same either way.
How do we handle practice staff payroll?
Register as an employer, submit each payroll to Revenue on or before the pay date and keep records for six years.
What records should a practice keep?
Fee records, PCRS statements, bank and card records, payroll, equipment invoices and VAT records, for six years.
Can you help with buying or selling a practice?
Yes. Talk to us early, because the tax reliefs on a sale have conditions that need planning.
Related guides
Accountants for medical professionals
Tax, VAT and structure for doctors, dentists, therapists and pharmacists.
SECTORAccountants for locum doctors
Status, VAT and tax for doctors working shifts across employers.
TAXIncome tax returns (Form 11)
Filing and paying through ROS, with the right deadline.
PAYROLLPayroll services
PAYE, PRSI and Revenue submissions handled on time.
Running a medical practice?
Tell us how the practice is structured and how it is paid. We will show you where the tax credits and VAT traps are.
- Your structure and year end
- Your main income streams
- Whether you employ staff
- Any taxable services outside patient care
Contact Us
Office Address
Unit 80, Cherry Orchard Business Park, D10NX96, Dublin 10, Ireland
Working Hours
Mon–Fri 9:00 AM – 6:00 PM
Email or Call Us
Email: moh@tasconsulting.ie
Mobile: +353 85 1477625