We have recently had re-confirmation from HMRC of the current COS VAT recovery rules applicable patient appliances.

The term ‘patient appliances’ refers to items worn by patients such as footwear, callipers, wigs, etc and also applies to aids such as wheelchairs and walking frames.

Custom Made Items

The supply of bespoke surgical footwear or of a wheelchair or other appliance specifically designed for a particular patient is not eligible for VAT recovery as the supply is primarily of goods.

If however, the manufacturer differentiates on the invoice between the goods element and the services element of modifications and adaptations, VAT can be recovered on the services element under COS heading 37, ‘Maintenance, repair and cleaning of equipment, etc.’

Examples of modifications are:

  • Raising a sole or heel
  • Fitting bespoke straps/supports/callipers

In these circumstances, VAT can be recovered on the parts and spares elements which form a part of the service.  VAT cannot however be recovered on the main supply of the goods, (e.g. the ‘base’ shoes).

Ready Made Items

The supply of ready-made patient appliances such as standard wheelchairs or boots of various sizes is not eligible for VAT recovery as these are treated as goods only.

Maintenance & Repair

Repair services such as re-heeling or re-soling is eligible for VAT recovery under item 37, ‘Maintenance, repair and cleaning of equipment, etc.’, together with the integral goods such as the replacement soles/heels.

Orthotist/Prosthetist Session Fees

These services are exempt from VAT under item 1c, group 7, schedule 9, VAT Act 1994, therefore the suppliers should not be charging VAT on their invoices.