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Cairos for psychologists and psychotherapists

The invoicing software for psychologists and psychotherapists

Therapy is exempt from VAT, but the exemption does not come from the degree: it comes from having healthcare authorisation and from the service serving to prevent, diagnose or treat. Coaching, expert reports and staff selection meet neither condition, and they go at 21%.

Exempt and taxable kept apartThe pass is invoiced when it is paid forThe item says just enough
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Accounting
5.480 €
Invoiced this month
4.320 €
Exempt from VAT
1.160 €
Subject to VAT
21 %
Provisional pro rata
F-2026/0233Psychotherapy session60,00 €Exempt
F-2026/0232Expert report · court605,00 €21% VAT · −15%
F-2026/0231Coaching programme · 4 sessions484,00 €VAT 21%
F-2026/02308-session pass440,00 €Exempt
What changes

What is particular about invoicing for psychologists and psychotherapists

A psychologist can have half their practice exempt and half at 21% without changing office. Almost every tax question they have comes from there.

The exemption comes from the authorisation, not from the qualification

Article 20.Uno.3º exempts care given to natural persons by medical or healthcare professionals. Anyone holding the Clinical Psychology specialism or the Psicólogo General Sanitario qualification — created by the seventh additional provision of Ley 33/2011, General de Salud Pública — is inside it. Holding a degree in Psychology, on its own, puts nobody there.

Coaching and expert reports carry VAT

A coaching programme, career guidance, an expert report for a court, psychometric selection tests or a workplace-climate workshop are not healthcare: they do not prevent, they do not diagnose and they do not treat. They go at 21%, and they carry withholding if you are registered as a professional and the client is a company.

With both, prorrata

As soon as exempt and taxable income live side by side you stop deducting all your input VAT. During the year you apply the final percentage from the previous year and you adjust it in the last return. If the taxable part is small it is worth looking at the special prorrata, which deducts in full the VAT on whatever you use only in the taxable part.

The item on the invoice says just enough

A patient's name tied to psychological treatment is health data, with the reinforced protection of the European Regulation, and on top of that there is professional confidentiality. On the invoice, «psychotherapy session» and the date are enough: the clinical detail lives in the patient's notes, not in a document that is going to end up in somebody's accounts.

Day to day

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

In a psychology practice there is little paperwork, but it is badly spread: lots of small sessions, the odd large assignment and no clarity about which one carries VAT.

A real photo of a Spanish psychology consulting room: two armchairs facing each other, a low table with a paper tissue and a lamp, warm natural light. No people, so that nobody is identified.

sector-psicologos.webp · 1200×675 px

Without Cairos

  • Every session is invoiced the same way, coaching and expert reports included.
  • Receipts are done by hand and the numbering breaks every summer.
  • The item on the invoice describes the reason for the consultation.
  • The pass is paid for in full in March and declared in pieces until June.
  • Nobody has worked out the prorrata, and the VAT on the rent is deducted in full.

With Cairos

  • Every service is created marked as exempt or taxable, and the invoice comes out on its own.
  • Numbering is sequential within each series and it never breaks.
  • The item says «psychotherapy session» and the detail stays out.
  • The pass is invoiced on the day it is paid for, which is when the VAT becomes chargeable.
  • The prorrata comes out of what you invoiced and is adjusted in the December return.
Taxes

What carries VAT in a psychology practice

Two questions settle almost everything: is it given by someone with healthcare authorisation? and does it serve to prevent, diagnose or treat? If either one is missing, there is VAT.

ServiceVATWhy
A psychotherapy session given by a psychologist with healthcare authorisationExemptHealthcare given to a natural person under art. 20.Uno.3º.
The same session paid for by the patient's employer or by their health insurerExemptThe law says «cualquiera que sea la persona destinataria» — whoever the recipient is: what decides is the purpose, not who signs the payment.
Coaching, guidance or personal development21 %There is no prevention, diagnosis or treatment of an illness.
An expert report for a court21 %The purpose is evidential, not care.
Psychometric tests and staff selection21 %The customer is the company and the purpose is not a healthcare one.
A workplace-climate workshop or training in a company21 %A supply to a legal person.
Case supervision for another professional21 %It is not care given to a patient.
Renting out your consulting room by the hour to another therapist21 %A lease of business premises, outside the exemption in art. 20.Uno.23º.
Teaching at a training centreExempt or taxableIt goes under the education exemption, which has its own requirements.

A psychologist who only does coaching charges VAT on 100% of what they invoice and deducts 100% of their input VAT, with no prorrata at all. One who only does therapy charges none and deducts none. The awkward case is the one in the middle, which is the most common: there is prorrata there, and it is worth deciding from the start whether the general or the special one suits you.

The modelos you end up filing

FormWhenWhy in your case
303QuarterlyFor the coaching, the expert reports and the training, with the prorrata applied to the input VAT.
390JanuaryThe summary of the year, with the prorrata percentage already settled.
130QuarterlyIf you are an autónomo and less than 70% of your income had withholding applied. With private patients, almost always.
111QuarterlyIf the practice has staff or pays other therapists with withholding.
115QuarterlyThe 19% withholding on the office rent.

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 psychologists and psychotherapists

If you have healthcare authorisation — the Clinical Psychology specialism or the Psicólogo General Sanitario qualification — and the service has the purpose of preventing, diagnosing or treating, they are exempt. And they stay exempt even if the patient's employer or an insurer pays for them, because the law says expressly «cualquiera que sea la persona destinataria», whoever the recipient is.
Coaching goes at 21% and with withholding if you are registered as a professional and the client is a company or a professional. Having exempt and taxable income at the same time puts you into prorrata: you do not deduct in full the VAT on the rent, on the electricity or on the software. Cairos keeps each service marked from its record so that the invoice comes out right without you thinking about it every time.
A video consultation with a therapist is not a «servicio prestado por vía electrónica» — an electronically supplied service, since 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 lives outside the European Union, look at the rules in article 69.Dos first.
The minimum that identifies the service: «psychotherapy session» and the date. Health data has reinforced protection under the European Regulation and on top of that you are bound by professional confidentiality; an invoice ends up in other people's accounts, so the reason for the consultation should not be there. More detail in security and data.
If 70% or more of your previous year's income came with withholding, you are off the hook; in any other case, it has to be filed. Private patients do not withhold, so a private practice almost always ends up on the 130. Cairos checks it against your real invoices; the detail is on the form 130 page.
Yes. Each professional can have their own invoice series, and the practice sees the whole. If you also rent out consulting rooms by the hour, that rent is a transaction taxable at 21% and it goes into the prorrata calculation. The user limits are on pricing.

Your practice invoices differently. So does the program.

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