Medical practices have tax rules of their own. GMS payments arrive with 20% professional services withholding tax already deducted, and most medical care is exempt from VAT. We prepare accounts and tax returns for GPs, physiotherapists and other practices, claim your PSWT credit, and help you choose the right practice structure.
Information checked 3 October 2026 against Revenue and CRO guidance.
What's included
The HSE is an accountable person for professional services withholding tax (PSWT), so it deducts tax at 20% from GMS payments before paying the GP. The GP includes the gross fee in income and claims a credit for the PSWT deducted, against income tax or, for a practice company, Corporation Tax. Keeping the PSWT records for each payment is what makes that credit easy to claim.
Worked example
A GP's GMS fees for the year are €150,000. The HSE deducts 20% PSWT, €30,000, and pays €120,000. The return shows €150,000 of fee income and claims a €30,000 credit against the GP's tax for that year.
Medical care is exempt from VAT when a professional on a statutory register provides it to protect, maintain or restore a patient's health. Revenue looks at the purpose of each service, not only at who provides it. A service that is not medical care, for example a report prepared for a legal or insurance claim, can be taxable, so each income stream needs checking.
Sole practice, partnership, expense-sharing arrangement and company each change how profit is taxed, how costs are shared, and what happens when someone joins or retires. Our article on private medical practice structures in Ireland sets out the options.
Physiotherapy practices share the same core questions: VAT on treatment, cash flow between insurer payments, pricing and staff costs. Read building a financially resilient physio practice and tax strategies for physiotherapy practices.
From practices we work with
My experience with M.A. Whately has been fantastic, in fact it couldn’t have been better. Their extensive knowledge, experience and dedicated team make them a pleasure to work with. They are truly EXCELLENT, they really go above and beyond the standard duty of an accountant. They are a team you can trust. A BIG THANK YOU to the whole team!
Paul and the team have been absolutely fantastic to work with. I initially sought his services purely for accounting purposes but as time has passed, I have realised his depth of knowledge surrounding business planning, strategy and marketing has been invaluable to my new physiotherapy clinic.
No. PSWT is an advance payment of tax. The practitioner, or the practice company, claims credit for it on the tax return for the year in which it was deducted.
Source: Revenue: Professional Services Withholding Tax (PSWT), checked 3 October 2026.
Physiotherapy that is medical care, given by a physiotherapist on a statutory register, is generally exempt from VAT. Services that are not medical care can be taxable, so check each income stream.
Source: Revenue: Medical services (VAT), checked 3 October 2026.
Six years for tax purposes, including PSWT details, invoices, bank statements and payroll records. Patient records follow separate medical and data protection rules.
Source: Revenue: Keeping records, checked 3 October 2026.
Next step
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