Classify each service offered by the practice
Treatment, training, product sales and rental are not automatically all VAT-exempt because a healthcare provider supplies them. Identify the actual service, provider qualifications and therapeutic purpose where relevant.
Allocate direct costs before shared costs
Separate purchases used solely for taxable activities from those used for exempt care. Shared premises, software and support then require an allocation supported by the applicable rules and actual use, rather than administrative convenience alone.
Review investments when activities change
A new service or different use of premises can affect earlier VAT deductions as well as new revenue. Record the allocation basis and when it must be reviewed. Pricing, invoices, revenue codes and year-end reconciliations should all follow the same assessment.
Source and background: Belastingdienst: BTW aftrekken bij belaste en vrijgestelde omzet.
