The transportation of sick or injured persons in specially equipped vehicles is exempt from value-added tax only if there is a genuine medical necessity and the special vehicle equipment is medically indicated (Section 4(17)(b) of the Value-Added Tax Act). The tax exemption does not apply if a special-purpose vehicle is used for patients who could have been transported in a regular vehicle. A medical certificate attesting that transportation by a conventional taxi or rental car is not possible is required.
Is the transportation service the same for both the outbound and return trips?
For taxi services, the reduced sales tax rate applies to trips of up to 50 km (Section 12(2)(10)(b) of the German Sales Tax Act (UStG)). Whether the 50-km limit applies to the total distance or to each individual trip depends on whether the round trip is to be considered a single transportation service or two separate services.
For taxi rides taken by a Passenger to destination and, according to BFH case law, this generally constitutes a separate transportation service in advance, regardless of whether the taxi is waiting as agreed or is being rebooked for the return trip. In the case of Trips to the hospital However, the following applies: If the driver waits for the patient as agreed, this constitutes a single service. The Mecklenburg-Western Pomerania Fiscal Court reached a similar decision regarding dialysis trips (judgment of September 25, 2001, 2 K 137/99).
Rental Cars are, in principle, not is eligible. An exception applies to medical transportation if it is for Special Agreements with Health Insurance Providers are based on agreements that are substantively similar to those applicable to taxi operators, and both operators are active within the same geographical area. The tax authorities implies similarity For the sake of simplicity, when it is practically impossible to provide proof.
If there is only a special agreement specifically for rental car companies, the business owner must provide proof, that an agreement with the same terms exists in the same area for taxi operators. If no such comparable agreement exists, the trip is subject to the Standard Tax Rate.