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Cairos for nutritionists and dietitians

The invoicing software for nutritionists and dietitians

Clinical nutrition is exempt from VAT and sports advice is not. Almost no practice does only one of the two, and as soon as they live side by side the prorrata appears: you stop deducting in full the VAT on the rent, the electricity and the software.

Exempt and taxable kept apartProrrata worked out and adjustedPasses and follow-ups
erp.cairos.es
General
Dashboard
Invoices
Quotes
Contacts
Expenses
Products
Accounting
6.840 €
Invoiced this month
4.960 €
Exempt from VAT
1.880 €
Subject to VAT
27 %
Provisional pro rata
F-2026/0412First visit · digestive condition70,00 €Exempt
F-2026/0411Sports nutrition plan181,50 €VAT 21%
F-2026/0410Workshop at a company · 2 h484,00 €VAT 21%
F-2026/04095-review pass180,00 €Exempt
What changes

What is particular about invoicing for nutritionists and dietitians

What decides whether your invoice carries VAT is not your qualification alone or the price of the session: it is what the thing you did in that consultation is for.

The clinical consultation is exempt

Article 20.Uno.3º of the VAT Act exempts care given to natural persons by medical or healthcare professionals, and article 7 of Ley 44/2003, on the regulation of the healthcare professions, expressly includes dietitian-nutritionists. If what you do is prevent, diagnose or treat, your invoice goes without VAT. It is not an option: it is an exemption.

Sports advice is not

A plan to improve performance in a marathon, or a weight-loss plan for cosmetic purposes, neither prevents nor treats any illness. It goes at 21%. The same happens with talks to companies, collaborations with brands and reports for evidential purposes: change the purpose, change the VAT.

And that means prorrata

With exempt and taxable income at the same time you do not deduct all the VAT on your expenses, but the percentage that transactions carrying a right to deduct represent. During the year the previous year's final percentage is applied, and in the last return of the year the final one is worked out and adjusted. The result is always rounded up.

The income arrives in passes and follow-ups

A dearer first visit, a five-review pass, a monthly follow-up fee and the odd patient who disappears at the third. Without keeping track of how many sessions are left on each pass and which fees are up to date, the practice invoices from memory.

Day to day

How it is done today, and how it looks with Cairos

The problem in a nutrition practice is not getting paid. It is that everything is invoiced the same way when half of it should not be.

A real photo of a nutrition practice in Spain: a bioimpedance scale, a tape measure, a plate of real food on the table and the patient's record on screen. Natural light, no identifiable patients.

sector-nutricionistas.webp · 1200×675 px

Without Cairos

  • Every invoice comes out exempt, including the sports plan and the company talk.
  • Or they all come out with VAT, and the patient is charged too much.
  • Nobody has worked out the prorrata, and the practice's VAT is deducted in full.
  • The pass is paid for in full and recorded in pieces, as the sessions are used up.
  • Supplements are sold at the same rate as the consultation.

With Cairos

  • Each service is born marked as exempt or taxable on its own record.
  • The invoice comes out with the treatment that belongs to it, without deciding one by one.
  • The prorrata comes out of your own income and is adjusted in the last return.
  • The pass is invoiced the day it is paid for, exempt or at 21% according to what it is.
  • The product has its own rate in the catalogue, different from the service's.
Taxes

What is exempt and what is not in a nutrition practice

The exemption covers care with the purpose of prevention, diagnosis or treatment. Anything that does not fit there carries VAT, even if the same person does it in the same room.

ServiceVATWhy
A clinical nutrition consultation: digestive or metabolic conditions, allergiesExemptHealthcare under art. 20.Uno.3º given by a qualified healthcare professional.
Follow-up of a patient with diabetes, coeliac disease or high blood pressureExemptThere is a therapeutic purpose, which is what marks out the exemption.
A sports nutrition plan to improve performance21 %It does not prevent, diagnose or treat an illness.
A weight-loss plan for cosmetic purposes21 %Same reason: the purpose is not therapeutic.
A workshop or talk on food at a company21 %The customer is a company, not a natural person being cared for.
A collaboration with a food brand21 %It is advertising, and the advertiser needs the invoice in order to deduct it.
Sale of supplements or of over-the-counter productDepending on the productIt is a supply of goods, outside the exemption. Products for human nutrition go at 10% (art. 91.Uno.1.1º) and there is a closed list that drops to 4% (art. 91.Dos.1.1º): you look product by product, you do not assume.
A report for evidential purposes or an expert report21 %What takes it out of the exemption is the purpose, not who pays for it.
Teaching on a master's course or at a training centreExempt or taxableIt goes under the education exemption in art. 20.Uno.9º, which is a different one and has its own requirements.

The sector's summary fits on one line: clinical nutrition is exempt and sports advice is not. And a consequence almost nobody applies: if you are registered as a professional — section two of the IAE — invoices to companies carry a 15% withholding, or 7% in the year you register and the two following, if you notify it in writing. Private patients are never withheld from.

The modelos you end up filing

FormWhenWhy in your case
303QuarterlyOnly for the taxable part — sports advice, talks, product — and with the prorrata applied to the input VAT.
390JanuaryThe summary of the year, with the final prorrata percentage already in.
130QuarterlyIf you are an autónomo and less than 70% of your income had withholding applied. Invoicing patients, that is almost always the case.
111QuarterlyIf you have staff at the practice or pay other professionals with a withholding.
115QuarterlyThe 19% withholding on the rent for the practice.

Try it with your practice's invoices

Free plan with up to 30 documents a year, no card needed. And if it does not work for you, your data leaves with you.

Questions from nutritionists and dietitians

If you are a qualified dietitian-nutritionist and what you do is prevent, diagnose or treat, they are exempt, whether the patient or their insurer pays: the law says «cualquiera que sea la persona destinataria», whoever the recipient is. What falls outside the exemption is advice for sporting or cosmetic purposes, talks to companies and anything you sell as a product.
That you are on prorrata from the first taxable invoice. You do not deduct all the VAT on shared expenses — rent, electricity, software — but the percentage that your transactions carrying a right to deduct represent. During the year you apply the previous year's final figure, and in the last return of the year you work out the final one and adjust.
No. Selling a product is a supply of goods and it falls outside the healthcare exemption whatever happens. The rate depends on what each line is: products used for human nutrition go at 10% and there is a closed list that drops to 4%. It is worth entering them in the catalogue with their rate, one by one, instead of applying 21% by default.
A video consultation is not a «servicio prestado por vía electrónica», an electronically supplied service: there is human intervention, so it does not fall under the e-commerce One-Stop Shop or its thresholds. Its place of supply is where you are established and it is invoiced like the rest of your sessions. If the patient is outside the European Union, look at the rules in article 69.Dos first.
Look at a single figure: what share of your previous year's income came with withholding. If it did not reach 70%, you have to file it, and since private patients do not withhold, in a practice that lives off private patients that is the norm. The detail is on the form 130 page.
No. Cairos is invoicing, receipts, accounting and taxes; the clinical records and the diary you carry on keeping in your own program. We say so plainly because it is the first question a practice asks.

Your practice invoices differently. So does the program.

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