Virginia Administrative Code
Title 23 - TAXATION
Agency 10 - DEPARTMENT OF TAXATION
Chapter 210 - RETAIL SALES AND USE TAX
Section 23VAC10-210-940 - Medicines, drugs, eyeglasses, and related items
Current through Register Vol. 41, No. 3, September 23, 2024
A. Definitions. The following words and terms when used in this section shall have the following meanings unless the context clearly indicates otherwise:
"Controlled drugs" means medicines or drugs for which the manufacture, distribution, and dispensation are strictly regulated by both state and federal laws due to the potential for abuse and physical and psychological dependence. Controlled drugs are separated into six schedules and itemized under et seq. Article 5 (§ 54.1-3443 et seq.) of Title 54.1 of the Code of Virginia. For purposes of this definition, "controlled drugs" does not include devices.
"Cosmetics" means articles applied to the body for cleansing, beautifying, promoting attractiveness, or altering the appearance including makeup, body lotions, cold creams, and hair restoration products.
"Devices" means instruments, apparatuses, and contrivances, including their components, parts, and accessories, intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in human beings or to affect the structure or any function of the human body. A partial list of devices that the federal Food and Drug Administration recognizes is provided at 21 CFR Part 862.
"Drug" means
"Durable medical equipment" means medical equipment that meets all of the following requirements:
"Glycolic acid products" means cosmetic items used to smooth or lighten skin or to remove age spots and wrinkles for the purpose of promoting attractiveness or altering the appearance.
"Hemodialysis" means a renal replacement therapy method of removing waste products as well as free water from the blood when the kidneys are incapable of removing these wastes.
"Homeopathic product" means a product derived from the system of medical practice that treats a disease by the administration of minute doses of a remedy that would, in larger amounts, produce in healthy persons, symptoms similar to those of the disease.
"Licensed physician" means a person licensed as a medical doctor. For purposes of this definition, a "licensed physician" does not include a veterinarian, chiropractor, optician, optometrist, or similar person.
"Nonprescription drug" means a substance or mixture of substances containing medicines or drugs for which no prescription is required and that is generally sold for internal or topical use in the cure, mitigation, treatment, or prevention of disease in human beings.
"Peritoneal dialysis" means a renal replacement therapy method of removing waste from the blood, as well as excess fluid, when the kidneys are incapable of removing these wastes, by instilling a specially formulated dialysis fluid around the peritoneal membrane that surrounds the intestine.
"Prescription" means an order for drugs or medical supplies written or signed or transmitted by word of mouth, telephone, telegraph, Internet, or other means of communication to a pharmacist by a duly licensed physician, dentist, veterinarian, or other practitioner authorized by law to prescribe and administer drugs or medical supplies.
"Proprietary medicine" means any nonprescription drug that is sold to the general public under the brand name or trade name of the manufacturer and that does not contain any controlled substance or marijuana.
"Prosthetic device" means any device that replaces a missing part or function of the body. For purposes of this section, a prosthetic device includes any supplies physically connected to the device.
"Toilet articles" means articles advertised or held out for sale for grooming purposes including toothpastes, hairsprays, shaving products, colognes, and deodorants.
B. Generally. Purchases of the following items are exempt from the retail sales and use tax:
C. Medicines and drugs, specifically.
D. Nonprescription drugs and proprietary drugs.
Acne products |
Headache relief aid products |
Alcohol, rubbing |
Hemorrhoidal treatments |
Alcohol swabs |
Hydrogen peroxide |
Allergy relief products |
Ibuprofen |
Analgesics |
Insect bite and sting preparations |
Anesthetics |
Iodine |
Antacids |
Itch and rash relievers |
Antibiotic ointments |
Laxatives |
Antifungals |
Lice products used to kill lice that infect humans |
Antihistamines |
Liniments |
Antimalarials |
Lip balms, ice and salves, medicated |
Antinauseants |
Lotions, medicated |
Antiseptics |
Menstrual cramp relievers |
Aspirin |
Mercurochrome |
Asthma preparations |
Milk of Magnesia |
Baby powder, medicated |
Mineral oil |
Bandages, gauze, or swabs, provided these items contain antiseptic or bacterial control products in the pad |
Motion sickness remedies |
Bee sting relievers |
Mouthwashes containing antiseptic |
Benzoin |
Muscle ache relievers |
Boric acid ointment |
Nasal drops and sprays |
Burn remedies |
Nicotine supplements that treat nicotine withdrawal symptoms |
Calamine lotion |
Oil of wintergreen |
Camphor |
Pain relievers, oral or topical |
Castor oil |
Parasiticides for humans |
Cathartics |
Peroxide, medicinal |
Cold or canker sore preparations |
Poison ivy and oak preparations |
Cold capsules and remedies |
Powder, medicated |
Contact lens lubricating and wetting solutions for insertion directly into the eye |
Rectal preparations |
Contraceptive creams containing nonprescription drugs and intended to treat a disease |
Shampoos, medicated |
Cough and cold items, cough drops, cough syrups |
Sinus relievers |
Dandruff and seborrhea preparations |
Sitz bath solutions |
Decongestants |
Skin irritation relievers |
Diarrhea remedies |
Sleep aids and sleep inducers |
Digestive aids |
Soap, including germicidal, surgical, therapeutic, or other soaps used for medical treatment |
Disinfectant for use on or about the human body |
Styptic pencils |
Diuretics |
Sunburn lotions |
Earache and earwax removal preparations |
Sunscreen containing SPF protection |
Eczema preparations |
Suppositories, excluding contraceptives |
Epsom salts |
Teething preparations |
Expectorants |
Throat lozenges, medicated |
Eye drops, lotions, ointments, and washes for healing, treatment, or therapeutic use |
Tooth desensitizers |
Fever blister aids |
Toothache relievers |
First aid healing agents, cleaners |
Upset stomach relievers |
Fluoride rinses and antiseptic dental washes |
Vaginal infection remedies |
Foot care products for treatments of infections, medicated callous or corn removers, ingrown toenail preparations, and athlete's foot treatments |
Wart removers |
Fungicides for human use |
Witch hazel |
Glucose tablets |
Worming treatments for human use humans |
Glycerine products intended for medical use |
Zinc oxide ointments |
Hay fever aid products |
Adhesive bandages, dressings, and cotton |
Household disinfectants and insecticides |
Adhesive removers |
Infant formula |
Adhesive tape |
Insect repellant |
Ammonia |
Mouthwashes, excluding antiseptic mouthwashes |
Appetite suppressants |
Nutraceutical products |
Bath crystals, milks, oils and powder |
Oral electrolyte mixtures for rehydration |
Birth control preparations |
Pet medical supplies |
Breath fresheners and sweeteners |
Pet medicines |
Bubble bath |
Petroleum jelly |
Bunions or corn pads, unless medicated |
Powders, nonmedicated |
Cleaning creams and lotions |
Prophylactics |
Cod liver oil |
Pumice powder |
Contact lens cleaning solutions and disinfectants, unless designed to be applied directly in the eye |
Saline solution |
Cosmetics, whether or not containing medicinal properties or acne treatments |
Sanitary napkins, tampons, and similar items |
Cotton applicators, rolls, balls, and swabs |
Shampoos, nonmedicated |
Cuticle softener |
Shaving products |
Denture adhesives, cleaners, and preparations |
Skin bleaches |
Deodorants and antiperspirants |
Soaps for general use |
Depilatories |
Stimulants |
Dental floss and threaders |
Suntan lotion without SPF protection |
Diet aids |
Talcum powder |
Dietary foods, supplements, and substitutes |
Testing kits |
Distilled water |
Thermometers |
Exfoliants |
Toothpastes, polishes, powders, and whiteners, including products containing fluoride or peroxide |
Glycolic acid products |
Vitamins and mineral supplements |
Hair restoration products |
Wax |
Hand sanitizers, sprays, foams, gels, soaps or wipes, including antibacterial items |
Weight control preparations |
Herbal teas, drinks, pills, or powder supplements |
Wrinkle removing and concealing preparations |
E. Eyeglasses and other ophthalmic aids and supplies.
F. Durable medical equipment, devices, and certain products for diabetics.
In addition, parts or supplies that are specifically designed for use with the items outlined in this subdivision are exempt from retail sales and use tax. For example, because hearing aids qualify as durable medical equipment, hearing aid batteries also are exempt durable medical equipment because these items are a part or supply specifically designed for use with hearing aids. General purpose medical supplies such as tape, gauze, dressings, alcohol swabs, and sharps containers for disposal of used needles and waste bags are not designed for use with durable medical equipment; therefore, they do not qualify for the exemption.
Aerosol compressors, stationary and portable |
Oxygen concentrators |
Air oxygen mixers |
Oxygen conserving devices |
Alternating pressure pads |
Oxygen cylinders |
Alternating pressure pumps, if used with alternate pressure pads |
Oxygen equipment |
Apnea monitors and accessories |
Oxygen fittings and accessories |
Aspirators |
Oxygen humidifiers |
Bed rails |
Oxygen tubing |
Bedside commodes |
Oxygen |
Bone fracture therapy devices |
Paraffin baths |
Catheter devices and supplies |
Patient care equipment for physical and occupational therapy |
Colostomy supplies and devices |
Patient lifts |
Communication aids for physically impaired |
Patient lift slings |
Continuous passive motion devices |
Patient transport devices and boards |
Continuous positive airway pressure (CPAP) and CPAP accessories |
Percussors and vibrators |
Crawlers |
Physical therapy items such as wrist and ankle weights, shoulder braces, supports and braces when rehabilitative related |
Crutches, crutch pads, and tips |
Phototherapy lights, provided they are used to serve a medical purpose and not for sun tanning purposes |
Cylinder stands and support devices |
Pneumatic compression units and accessories |
Cylinder transport devices, sheaths and carts |
Posture back supports, including back supports for seating |
Decubitus seating pads and bed pads |
Raised toilet seats |
Dressing aids, button loops, zipper aids, etc. |
Reaching aids |
Eating and drinking aids |
Regulators and flowmeters |
Emergency oxygen delivery units |
Respiratory accessories, such as PFLEX or Peak Flow items |
Enteral and parenteral feeding equipment and supplies, including tubes, pumps, and containers |
Respiratory therapy equipment |
Face masks |
Restraints |
Fitted stroller |
Room humidifiers with script |
Foam seating pads |
Shampoo trays |
Foam wedges |
Shower seating and bath benches |
Gas oxygen refills and tanks |
Shower grip bars |
Geriatric chairs |
Sitting and sleeping cushions |
Glucose monitors and supplies, except batteries |
Specialized seating, desks, and work stations |
Grooming aids and dental aids |
Specially designed hand utensils |
Hand exercise equipment putty |
Splints and holders |
Heating pads |
Stairglides and lifts in home |
Hospital beds |
Standing frames, devices, and accessories |
Hospital bed mattresses and egg crates |
Stethoscope |
Household aids for the impaired |
Tank wrench |
Hydro-collators |
Transcutaneous electrical nerve stimulator (TENS) unit and muscle stimulators |
Hydro-therm heating pads |
TENS accessories (electrodes, wiring specifically for use with TENS units) |
Ice bags |
Toilet safety frames |
Intermittent positive pressure breathing (IPPB) circuits, devices and supplies |
Tracheotomy and suction supplies |
Intravenous (IV) stands |
Traction stands, pulleys, etc. |
IV supplies such as catheters and tubing |
Trapeze bars and bar stands |
Leg weights, related to rehabilitation |
Ultrasonic nebulizers |
Lift recliners |
Vaporizer |
Liquid and gas oxygen systems, stationary and portable |
Volume ventilators, respirators, and related device supplies |
Manual resuscitators |
Walker accessories |
Muscle stimulators |
Walkers |
Nasal cannulas |
Walking canes, quad canes, accessories |
Nebulizers and tubing |
Wheelchairs |
Overbed tables |
Wheel walkers |
Oximeters |
Writing and speech aids for the impaired |
Example 1: A physician purchases a disposable capsule for a specific patient that must be ingested to capture internal images of the body. Because the capsule is disposable, it is not able to withstand repeated use. Therefore, the capsule does not qualify as durable medical equipment.
Example 2: A physician offering gynecological services purchases intrauterine copper contraceptive devices for a specific patient. Because the contraceptive devices are not useful in the absence of illness or injury, they are not durable medical equipment. Although there are instances of pregnancy that may threaten the health of a patient, and in which the patient may not be able to use other forms of contraceptive, the devices are designed for contraceptive use. Therefore, they are not exempt durable medical equipment.
Example 1: A physician maintains an inventory of crutches or ace bandages that are dispensed to individual patients as needed. The physician must pay sales or use tax on these items because the original purchase was not made on behalf of a specific patient.
Example 2: A physician determines that a patient needs a brace and purchases a brace specifically designed for that patient. The purchase is made on behalf of the individual and is exempt from the tax.
The Department of Taxation has not prescribed a certificate of exemption to use when durable medical equipment and other exempt items under subdivision 1 of this subsection are purchased on behalf of a specific person. When the purchaser has no blanket exemption for its purchases and no certificate of exemption or other exemption notice from the Department of Taxation applies, the dealer must get a signed statement from the medical service provider making the purchase, such as the hospital, nursing home, licensed physician, or infusion service business, certifying that the durable medical equipment is purchased on behalf of a specific patient through a doctor's prescription or hospital's work order and is for sole use by that patient. The purchaser is also responsible for retaining a copy of the doctor's prescription or hospital work order as part of the record of the transaction for tax auditing purposes. The fact that a purchaser can trace durable medical equipment back to a specific patient after the fact is not sufficient to establish that the durable medical equipment was purchased for a specific individual; therefore, the purchaser's documentation must have included patient identification information at the time of purchase in order for the purchase to be deemed made on behalf of an individual. For purposes of proving that the sale was for a specific individual in the event of a sales and use tax audit, the purchaser may redact any identifying information in order to comply with federal and state privacy laws.
G. Hemodialysis and peritoneal dialysis equipment, supplies, and drugs. Hemodialysis and peritoneal dialysis equipment, supplies, and drugs used in dialysis are not subject to the tax. This exemption is applicable regardless of the nature of the purchaser. Therefore, hemodialysis and peritoneal dialysis equipment, supplies, and drugs may be purchased exempt by physicians, individuals, for-profit and nonprofit hospitals, and other entities.
H. Samples distributed to authorized recipients. Pharmaceutical manufacturers are not subject to sales and use tax for samples of prescription drugs and medicines or the packaging when distributed free of charge to licensed physicians, hospitals, pharmacies, and other health care facilities upon the written request of these medical providers in accordance with the federal Food, Drug, and Cosmetic Act ( 21 USC § 301 et seq.).
I. Purchases of medicines and drugs by veterinarians. Veterinarians who dispense medicines or drugs on prescription are deemed the users or consumers of all such medicines and drugs and must pay the retail sales and use tax on these purchases; however, veterinarians may purchase exempt of the sales and use tax all medicines and drugs that will be used in caring for, medicating, or treating agricultural production animals. For additional information on the taxability of drugs dispensed by veterinarians, see 23VAC10-210-6050.
J. Purchases of medical products and supplies by certain Medicaid recipients. Medicaid recipients are authorized to purchase medical products and supplies that are otherwise taxable, such as bandages, gauze dressings, incontinence products, and wound care products exempt from the retail sales and use tax, provided the purchase is made through a Department of Medical Assistance Services (DMAS) provider agreement. This exemption applies to any type of medical product or supply, incontinence, or wound care product, provided DMAS pays for the product or supply. Sellers must maintain sufficient documentation to verify that the purchase transaction meets the criteria of the exemption. The documentation must (i) identify the item sold; (ii) identify that the purchaser is a Medicaid recipient; and (iii) verify that the transaction is billed in accordance with a DMAS provider agreement.
Statutory Authority: § 58.1-203 of the Code of Virginia.