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As I understand it, therapeutic reasons can also include psychological benefits. If there are genuine therapeutic reasons, then the surgery is exempt from VAT. If you are having surgery for purely aesthetic reasons it would be classed as a “standard rated supply”. In this case, the surgeon, or medical organisation providing the service, would need to charge VAT at 20% (assuming that they are registered for VAT).
You could say it’s fortunate that it is up to the medical professional concerned to decide whether the surgery is for therapeutic or aesthetic purposes, rather than HMRC!
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