Psychologists: no tax obligations?

Updated on 27 September 2026. We have reviewed this article against the rules in force: the tax authority's current approach to the VAT exemption (including online therapy), Social Security contributions for the self-employed in 2026, the abolition of Form 037 and the Verifactu timetable: if you are self-employed, your invoicing software must be compliant before 1 July 2027.

Running a psychology practice involves much more than seeing patients: tax and your obligations as a self-employed professional (autónomo) tend to take a back seat and can cause you serious problems. Many formal requests (requerimientos) that psychologists receive from the tax authorities (Hacienda) or from Social Security (Seguridad Social) do not stem from fraud but from technical errors or poor decisions made when starting out.

There is a widespread misconception in the sector: since psychotherapy is exempt from VAT (IVA), "I have no tax obligations". The exemption only means that you do not charge VAT on certain services; you still have to issue invoices, declare your income and pay contributions. And simply running a workshop, working with a company or signing an expert report can be enough to change your obligations.

VAT: what is exempt and what is not

When your session is exempt

Article 20.Uno.3.º of Law 37/1992 on VAT exempts healthcare provided to individuals and expressly mentions psychologists, but only where it relates to the diagnosis, prevention and treatment of illness. In its binding rulings, the Dirección General de Tributos (DGT, the Directorate-General for Taxation) requires two conditions to be met at the same time:

1. Therapeutic purpose: the service aims to diagnose, prevent or treat a health problem.
2. Healthcare professional: it is actually provided by a healthcare professional. For these purposes, the VAT Law expressly includes psychologists qualified at official institutions or institutions recognised by the authorities (Article 20.Uno.3.º, second paragraph).

The key, therefore, is the purpose. In ruling V0305-25 of 17 March 2025, the DGT held that VAT had to be charged on the couples therapy, work-stress and personal growth services of a psychology graduate with a postgraduate course, because they were not aimed at diagnosing, preventing or treating an illness, and it made clear that her services as a psychologist would be exempt if they did have that purpose. For the DGT, the exemption covers the clinical branch of psychology, not guidance or counselling.

Who may practise is a separate matter: outside VAT, health regulations require you to be a Psicólogo General Sanitario (General Health Psychologist: degree plus the official master's, under the seventh additional provision of Law 33/2011 on Public Health) or a specialist in Clinical Psychology to work as a psychologist in the healthcare sector, whether self-employed or employed.

Two useful clarifications:

• Online therapy: according to ruling V5431-26 of 31 July 2026, a video session in which the psychologist personally takes part is not an "electronically supplied service" and can be exempt under the same conditions as a face-to-face session.
• It does not matter whom you invoice: the exemption applies "whoever the recipient of the services may be", including when you invoice a clinic or a health insurer (mutua), or when you work through a company, provided the service is delivered by a healthcare professional.

Which services carry 21% VAT

Anything that is not aimed at diagnosing, preventing or treating an illness is taxed at 21%, even if a health psychologist provides it. For example:

• Coaching, personal growth, guidance and counselling.
• Workshops and training, unless they fall within one of the education exemptions (Article 20.Uno.9.º or 10.º), which have strict requirements.
• Recruitment or wellbeing programmes for companies.
• Expert reports for a court or an insurer, which generally have no healthcare purpose.
• Performance-focused sports psychology: in ruling V0171-26 of 30 January 2026, only the therapeutic part was exempt.

Which VAT returns you have to file

• If you only provide exempt services, you do not file Form 303 or Form 390 (Article 71 of the VAT Regulations). Watch out for a common exception: if you buy services from businesses not established in Spain (social media or search engine advertising, foreign software or platforms), you will usually have to declare and pay that VAT yourself under the reverse charge rule (inversión del sujeto pasivo, Article 84.Uno.2.º of the VAT Law) using Form 309 (Article 71.8 of the VAT Regulations), even though you cannot deduct it, and register in the Register of Intra-Community Operators (Registro de Operadores Intracomunitarios). Check with your adviser which returns apply to you.
• If you also provide services subject to VAT, you file Form 303 every quarter and Form 390 in January, and you can only deduct part of the VAT on your expenses (the pro rata rule, Articles 102 to 106 of the VAT Law).

The tax authorities have four years to review your returns (Article 66 of the General Tax Law). If you did not charge VAT when you should have, they will claim it from you with interest and, where applicable, a penalty. And if your clients were private individuals, you will normally no longer be able to charge them that VAT (Articles 88.Cuatro and 89.Tres.1.º of the VAT Law), so it will come out of your own pocket.

Invoicing even when there is no VAT

The Invoicing Regulations (Royal Decree 1619/2012, Article 3.1.a) expressly require an invoice for exempt healthcare services. In practice:

• For private patients you can issue a simplified invoice if the amount does not exceed €400 (Article 4). It does not need the patient's details, but it does need consecutive numbering (you may use a separate series for simplified invoices, but you do not have to).
• For clinics, health insurers or companies, issue a full invoice with the client's name, tax identification number (NIF) and address.
• If the service is exempt, state why; for example: "VAT-exempt transaction, art. 20.Uno.3.º Law 37/1992".
• Sessions for the same patient or client within the same month can go on a single summary invoice (factura recapitulativa), which you must issue by the last day of that month or, if the client is a business or professional, before the 16th of the following month (Article 13).

The DGT confirmed this in ruling V5168-26 of 15 July 2026: a psychologist who sees patients online must issue invoices even though the service is exempt and, as each session costs less than €400, may use simplified invoices, which do not need to show her address.

Verifactu and e-invoicing

If you invoice using software, that software will have to comply with the regulations known as Verifactu (Royal Decree 1007/2023) before 1 July 2027 if you are self-employed, or before 1 January 2027 if you invoice through a company subject to Corporate Income Tax. If you invoice by hand, without any software, you are not affected. And the tax authorities do not "approve" software: the manufacturer signs a statement of compliance (declaración responsable). We explain it in our article on Verifactu.

Mandatory e-invoicing between businesses and professionals (Royal Decree 238/2026) is a separate obligation. It will only affect your invoices to clinics, health insurers or companies, not simplified invoices to patients, and its deadlines run from a ministerial order that, as of 27 September 2026, has not yet been published in the BOE (Official State Gazette): for those invoicing €8 million or less, 24 months from that order.

Income tax: withholding, instalment payments and records

Your income counts as income from professional activities for personal income tax (IRPF), usually under the simplified direct assessment method (turnover of up to €600,000), which lets you deduct, on top of your expenses, 5% for hard-to-document expenses, capped at €2,000 a year. There is more detail in our guide to deductible expenses.

• Withholding: when you invoice a clinic, a health insurer or a company, they withhold 15%, or 7% in your first year of activity and the two following years if you did not carry out any professional activity the year before (you must notify the payer in writing). No withholding applies to private patients.
• Form 130: every quarter you pay in advance 20% of your year-to-date net income, less withholding and earlier payments. You are only exempt if at least 70% of your income was subject to withholding the previous year (in your first year, the percentage for the period covered by each payment is used), which is rare if you mainly see private patients.
• Record books: income, expenses, capital assets, and advance funds and outlays (Article 68 of the IRPF Regulations).
• Annual income tax return: if you were registered with RETA at any point in the year, you must file it whatever your income (Article 96 of the IRPF Law).

Registration and Social Security: RETA in 2026

Before you start: registering with the tax authorities and RETA

Register with the tax authorities using Form 036 (Form 037 was abolished on 3 February 2025), under group 776 of section two of the Business Activities Tax (IAE; as an individual you are exempt from paying it), and with RETA (Régimen Especial de Trabajadores Autónomos, the Social Security scheme for the self-employed). RETA registration must be requested before you start work and no more than 60 days in advance.

How much you pay in 2026

You pay contributions according to your net income (your business income plus your own contributions, less 7% for general expenses). You choose a provisional contribution base and, the following year, the Tesorería General de la Seguridad Social (TGSS, Social Security General Treasury) adjusts it using tax data: it claims the difference or refunds any overpayment.

In 2026 the 2025 tables still apply, with a maximum base of €5,101.20 (Order PJC/297/2026). The total rate is 31.5% (28.30% common contingencies, 1.30% occupational contingencies, 0.90% intergenerational equity mechanism, 0.90% cessation of activity and 0.10% vocational training). Some examples using the minimum base of each band:

• You can change your base up to six times a year, and it is worth doing so if your income changes. Remember that your base determines what you will receive for sick leave, cessation of activity or retirement.
• Reduced contribution ("flat rate", tarifa plana): if this is your first registration, or you have not been registered in the previous two years (three if you already had this reduction during your previous registration), you pay a reduced contribution for 12 months, extendable for another 12 if your net income is below the minimum wage (€17,094 a year in 2026). You apply for it when you register. In 2026 Social Security is still applying €80 a month, plus the intergenerational equity mechanism contribution (0.9%): €88.64 a month in total, according to its official guide. The law leaves the amount to the State Budget Act (Ley de Presupuestos Generales del Estado), and none has been passed for 2026, so the amount could change if one is.
• Dual activity (pluriactividad): if you are also employed and in 2026 the total common-contingency contributions paid to RETA and through your job (including your employer's share) exceed €17,323.68, the TGSS refunds 50% of the excess after the annual adjustment, capped at 50% of your self-employed common-contingency contributions (Article 18.8 of Order PJC/297/2026).

Other obligations that are not tax-related

Your practice needs a health authorisation from the regional government (Article 3 of Royal Decree 1277/2003), you must have professional liability insurance (Article 46 of Law 44/2003) and, if you work on your own account, keep the clinical records for at least five years after each episode of care ends (Article 17 of Law 41/2002), with the stronger protection that health data require.

Common mistakes

1. Applying the VAT exemption to everything you do.
2. Not invoicing because "there is no VAT", or leaving out the exemption wording.
3. Not filing Form 130 without meeting the 70% rule.
4. Paying contributions on the minimum base with a high income and then facing an adjustment.
5. Relying on outdated information (Form 037, software "approved by the tax authorities").

Frequently asked questions

Should I set up a company?

It depends on your income. The VAT exemption still applies if the service is delivered by a healthcare professional, but the tax (Corporate Income Tax), the accounting, the Verifactu date and your contributions as a company-director autónomo all change. Run the numbers first.

What should I do if I have already invoiced incorrectly?

Correct it as soon as possible, without waiting for the tax authorities to contact you. If you invoiced a service without VAT when it should have carried VAT:

• Business or professional client: you can issue a corrective invoice (factura rectificativa) to charge them the VAT, within the time limits set by the VAT Law (Articles 88.Cuatro and 89).
• Private patient or client: the law does not allow you to add VAT afterwards (Article 89.Tres.1.º), so you will normally bear it yourself.

In both cases, declare the VAT in a corrective (rectifying) self-assessment return (autoliquidación rectificativa) of Form 303 (for periods before the third quarter of 2024, a supplementary return) or, if you never filed Form 303 for that period, file it late. Doing it on your own initiative avoids a penalty, although late-filing surcharges and, where applicable, interest apply (Article 27 of the General Tax Law).

Need a review of your situation?

If you are just starting out, combine therapy with training, reports or work for companies, or have received a formal request, we can go through with you how to invoice, which returns to file and which contribution base to choose. You can book a tax consultation or write to us via our contact page.

Legislation and sources

• Law 37/1992 on Value Added Tax (consolidated text, BOE)
• Royal Decree 1624/1992, VAT Regulations (BOE)
• Royal Decree 1619/2012, Invoicing Regulations (BOE)
• Law 35/2006 on Personal Income Tax (BOE)
• Royal Decree 439/2007, Personal Income Tax Regulations (BOE)
• Law 58/2003, General Tax Law (BOE)
• Law 20/2007, Self-Employed Workers' Statute (BOE)
• Order PJC/297/2026 on Social Security contributions for 2026 (BOE)
• Social Security guide for the self-employed (Import@ss)
• Royal Decree 1007/2023 on invoicing software (Verifactu) (BOE)
• Royal Decree 238/2026 on e-invoicing between businesses and professionals (BOE)
• Law 33/2011 on Public Health, seventh additional provision (BOE)
• Directorate-General for Taxation binding rulings search engine