VAT on Massage Services: What Counts as Medical and What Doesn’t?
If you run a massage business, or you’re a physiotherapist or osteopath who also offers massage services, you might be wondering when VAT applies and when it doesn’t.
The rules around massage and VAT can be confusing, especially when some treatments are considered medical and others are seen as lifestyle or cosmetic. In this guide, we’ll break it down so you know where you stand and how to stay compliant.
Why This Matters
Massage therapy is a growing industry, with clients booking for everything from back pain to stress relief. But the purpose of the treatment, and who delivers it, can make a big difference when it comes to VAT.
Getting this wrong could mean undercharging VAT (and facing penalties), or overcharging clients unnecessarily. Understanding how VAT works here can help you:
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Price your services correctly
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Stay on the right side of HMRC
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Avoid admin headaches as your business grows
Is Massage Therapy VAT Exempt?
The answer depends on who provides the service and why the treatment is given.
1. Massage by a Regulated Health Professional (e.g. Physio, Osteopath)
VAT exempt, but only when the massage is part of a medical treatment plan.
If you’re a registered physiotherapist or osteopath, and you include massage as part of a therapeutic treatment, it’s likely to be VAT exempt – because the primary aim is medical.
However:
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The treatment must be focused on health (e.g. rehabilitation, pain relief, injury recovery).
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You must be professionally registered (e.g. with the HCPC or GOsC).
Example: A physio treating a client’s shoulder pain with a mix of joint mobilisation and massage – this would typically be exempt from VAT.
2. Massage by a Non-Regulated Practitioner or Beauty Therapist
VATable if your business is not classed as a healthcare provider.
Massage parlours, spas, or mobile therapists offering general wellness, relaxation, or beauty treatments do not qualify for VAT exemption. Even if clients say the massage helps their back pain, unless it’s medically directed by a qualified health professional, HMRC sees it as a standard-rated service.
Example: A massage therapist offering Swedish or deep tissue massage for stress relief or relaxation – this would usually be subject to VAT once the business passes the threshold.
Watch Out for Mixed Services
If you provide a mix of exempt and taxable services (like a physiotherapist who offers both rehab sessions and general relaxation massages), you may need to:
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Apportion your turnover
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Apply partial exemption rules if VAT-registered
This is where things get more technical, so it’s a good idea to speak to an accountant if you’re unsure.
VAT Threshold: When Do You Need to Register?
As of April 2025, the VAT registration threshold is:
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£90,000 in taxable turnover over any rolling 12-month period
Massage businesses that offer only VATable services must register when they pass this threshold. If your services are all VAT exempt (e.g. medical treatments by a physio), you don’t need to register unless you also sell taxable items or services.
If your turnover drops below £88,000, you may be able to deregister.
Source: gov.uk – VAT thresholds and registration
Expert Tips & Common Pitfalls
Tip: Use separate codes in your accounting software (like Xero) for exempt and taxable services: this helps avoid confusion at VAT return time.
Pitfall: Some businesses wrongly assume all massages are exempt if they’re “good for health.” HMRC looks at intent, not outcome. If it’s not medical and not delivered by a regulated professional, it’s likely VATable.
Tip: If you sell massage oils, gift vouchers, or beauty products, those are standard-rated too – and count toward your VAT threshold.
Need Clarity on Your VAT Position?
Whether you’re running a standalone massage therapy business or offering massage as part of your healthcare services, we can help you stay VAT compliant without the stress.
Not sure if you should register for VAT? Book a chat with Love Accountancy and we’ll walk you through it, clearly and simply.
About Love Accountancy
At Love Accountancy, we help health and wellness professionals get confident with their numbers – without the jargon. Whether you’re a massage therapist, physiotherapist, or beauty business owner, we’ll help you manage VAT, plan for growth, and stay one step ahead of HMRC.
Looking for an accountant in Exeter or online accounting support UK-wide? Our tech-driven approach (powered by Xero) makes it easy to stay organised and in control – whatever stage you’re at.