Texas Sales Tax Medical Exemption for Hospitals Includes Many Categories of Purchases

Matthew Soifer • Aug 25, 2023

In addition to the Texas sales tax medical exemption for orthopedic devices and appliances provided in the Zimmer ruling , there are several other categories of exemptions available to Texas hospitals and healthcare providers. Texas Tax Code Ann. § 151.313 provides a sales and use tax exemption for the following items:

  • Prescription drugs or medicines
  • Hypodermic syringes or needles
  • Braces used on the human body to correct a physical ailment or defect
  • Prosthetic devices
  • Hospital beds and related parts
  • Wound care dressings
  • Blood glucose monitoring test strips
  • IV systems and related supplies

For most of these items, the definitions in Texas Admin. Code §3.284 have not changed since 2004. Prosthetic devices are defined as, “an item that is artificial and replaces a missing part of the body, performs the function of a vital organ or appendage of the human body, or that is permanently implanted in the body.” Some examples of prosthetic devices are heart-lung pumps, ventilators, gastrointestinal devices, and urethral stents. Wound care dressings are defined as, “an item that absorbs wound drainage, protects healing tissue, maintains a moist or dry wound environment (as appropriate), or prevents bacterial contamination.” Bandages, gauze, hemostats, and nasal packing strips are some types of items that would meet the definition of a wound care dressing.

There was a significant change to the definition of intravenous systems that occurred in 2013. Effective Sept. 1, 2013, House Bill 3169 altered the definition of an IV system to any product “designed or intended to be used to administer fluids, electrolytes, blood and blood products, or drugs to patients or to withdraw blood or fluids from patients, regardless of whether the product is designed or intended to be inserted subcutaneously into any part of the body.” Prior to this change, intravenous systems and supplies only qualified for the Texas sales and use tax exemption if they were administered subcutaneously, which means they had be used for injection below the skin. With this change, some items that now qualify as exempt are angiographic catheters, anesthesia infusion catheters, contrast media injection tubing, fluid drainage catheters, and infusion pumps.

There has also been a recent change to the sales and use tax exemption related to radiation emitting equipment repairs and maintenance. In 2012, Texas Ruling #201209577L stated that the repair, remodeling, maintenance, or restoration of diagnostic imaging or therapeutic equipment subject to oversight under the Radiation Control Program administered by the Texas Department of State Health Services qualified for the sales and use tax exemption found under Texas Tax Code Ann. § 151.338. Types of radiation equipment that were determined to be exempt in this ruling were computed tomography (“CT”), x-ray radiographic and/or fluoroscopic (“XR” and “XF”), cardiac catheterization and similar vascular (“XV”), mammography (“MM”), bone densitometers, gamma camera and other nuclear medicine (“NM”). This exemption also applied to component parts of an integrated unit of qualifying diagnostic imaging or therapeutic equipment, including x-ray tubes, filters, detectors, power supplies, operator’s workstations, viewing equipment, printers, patient tables, networking equipment, and associated computer software.

On June 28, 2018, Ruling #201209577L was superseded by Texas Ruling # 201806001L , which limited the exemption to only separately stated labor charges to repair diagnostic and therapeutic equipment that emit radiation. Therefore, any component or integrated part that is attached or connected to this equipment that does not emit radiation itself will not qualify for a Texas sales and use tax exemption.

From our experience working with hospitals and health care providers in Texas, we’ve found that vendors like Cardinal Health, Medline and Owens & Minor are charging sales tax on IV systems and supplies, wound care dressings, and hypodermic syringes and needles that would qualify for a Texas sales and use tax exemption. In order to claim the exemption on future qualifying purchases from their vendors, Texas hospitals and healthcare providers need to supply their vendors with a properly completed Texas Certificate of Exemption (Form 01-339). If sales tax has already been paid, collected, and remitted on the purchase of any of these qualifying health care supplies in Texas, the purchaser can apply for a refund from the Texas Comptroller of Public Accounts, provided they do so within the 48-month statute of limitations for which the TX Comptroller allows refunds to be filed.

As with all sales and use tax research, the specifics of each case need to be considered when determining taxability. Agile Consulting Group’s sales tax consultants can be found on our page summarizing Texas sales and use tax exemptions. If you have questions, comments or would like to discuss the specific circumstances you are encountering regarding this issue or any other sales and use tax issue, please contact any of Agile Consulting Group’s sales tax consultants at (888) 350-4TAX (4829) or via email at info@salesandusetax.com. 

Sales Tax Exemption for Manufacturers
25 Apr, 2024
Understand South Carolina's generous sales tax exemption for manufacturers: requirements, eligibility, and claiming process explained concisely.
A man wearing a hard hat and safety glasses is working in manufacturing in West Virginia
15 Apr, 2024
Learn about West Virginia's sales tax exemption for manufacturers and how it can benefit your business.
A couple are standing at a grocery store check out taking advantage of the sales tax exemptions
By Matt Soifer 08 Apr, 2024
Unlock savings for healthcare facilities in Louisiana! Agile Consulting Group secures sales tax exemption for food purchases.
a man with a prosthetic arm is using a laptop, he has received a sales tax exemption
26 Feb, 2024
Maximize your savings with Agile's insights on Alabama's sales tax exemption for prosthetic devices.
a man is driving a forklift in a warehouse, Arizona transaction privilege tax exemption for forklift
12 Feb, 2024
Explore Arizona's transaction privilege tax exemption for forklifts in our informative blog. Unlock potential savings and navigate the details efficiently.
two women walking down the street with shopping bags, economic nexus guided the amount of sales tax
06 Feb, 2024
Explore the economic nexus landscape across states, navigating tax obligations and thresholds. A comprehensive guide for businesses to stay compliant.
2024 Sales Tax Holidays
By Aaron Giles 29 Jan, 2024
Sales tax holidays give shoppers a break from paying tax on purchases. Many states offer sales tax holidays to boost consumerism and help their local economies. In some cases, sales tax holidays are held on multiple dates throughout the year. They may be inclusive, meaning all items are included in the tax-free shopping, or they may be selective, in which case only certain things are part of the sales tax holiday.
Michigan Sales Tax Exemption for Prosthetic Devices
By Mike Martin 03 Jan, 2024
The Michigan sales tax exemption for prosthetic devices has been expanded by the Michigan Department of Treasury’s response to Agile Consulting Group’s recent ruling request. The Tax Professionals at Agile Consulting Group, a proud member of the Michigan Ambulatory Surgery Association (MASA) , received updated written guidance from the Michigan Department of Treasury’s Tax Policy group regarding the Michigan sales tax exemption for prosthetic devices. From Agile’s recent experience at the MASA 2023 Education Day and subsequent interactions with its members, most Michigan Freestanding Surgical Outpatient Facilities, licensed under Part 208 of Michigan’s Public Health Code , and Hospitals, are aware of the law
Implants that Qualify for Michigan Sales Tax Exemption
By Aaron Giles 22 Sep, 2023
Explore Michigan's Sales Tax Exemption for Implants: Learn about the changes in the law, which prosthetic devices qualify for exemption, how to recover overpaid sales tax, and get expert insights from Agile Consulting Group.
Show More
Share by: