Medical.Accountants
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Regulated & AML supervision
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Aesthetics

Accountants for Botox and injectables practitioners

Whether you inject alongside NHS work or run your own aesthetics business, injectables income needs its own records, a clear view on VAT and the right structure. We look after the tax side so you can focus on treatments.

Do Botox practitioners have to charge VAT?

Only once you are VAT registered — required when VATable turnover passes £90,000 in a rolling 12 months. Purely cosmetic injectables are standard-rated even when given by a nurse, dentist or doctor; treatment given mainly for a medical reason may be exempt.

Fixed fees, specialist healthcare accountants, and every HMRC and NHS Pensions deadline handled.

  • Fixed monthly fee — no surprises
  • Specialist in NHS pension and healthcare tax
  • Onboarding within 48 hours
Get my fixed-fee quoteBook a free 15-min tax review
  • ICAEW & ACCA regulated
  • 5,000+ clients served by ACCOTAX
  • Specialist healthcare accountants

Reviewed by Waqas Sagar ACA FCCA FMAAT, Founder of ACCOTAX, 18+ years' experience · Last reviewed: 8 October 2026 · Updated for the 2026/27 tax year

Medical.Accountants by ACCOTAX, ICAEW/ACCA-regulated chartered accountants, London, serving clients across the UK. Over 5,000 clients served.

Key takeaways

  • Purely cosmetic injectables are standard-rated once you are VAT registered.
  • Side-income from aesthetics normally needs a Self Assessment return.
  • Indemnity, training and product costs used for the business are usually allowable.

Which accountancy support fits your income?

Start with how you are paid. Different income sources can need different accounts, returns and expense checks.

How you workWhat we checkSupport to explore
Employed or umbrella (PAYE)Tax codes, eligible employment expenses and whether a tax return is needed.Healthcare tax refund support
Genuinely self-employedBusiness income and expenses, Self Assessment and MTD eligibility.Healthcare Self Assessment service
Your own limited companyCompany accounts, Corporation Tax, director income and off-payroll status where relevant.Healthcare limited company accounts
PartnershipPractice accounts, allocated profit and each partner’s personal tax position.Healthcare partnership accounts

Sound familiar?

Problems we fix for aesthetics practitioners and clinics

  • "I may be charging VAT wrongly on cosmetic treatments."
  • "I think I've gone over the VAT threshold without registering."
  • "The new licensing scheme in England worries me."
  • "I sell products and training as well as treatments."
  • "I'm setting up a clinic and hiring staff."

What it's costing you

Leaving it unfixed is rarely free

Overpaid tax
Unclaimed expenses and wrong tax codes mean paying more than you owe, year after year.
HMRC penalties and interest
Late returns attract automatic penalties, plus interest on tax paid late.
Lost evenings
Hours spent on forms, invoices and spreadsheets after a long shift.

General examples — your position depends on your own figures.

How we solve it

What we actually do for you

VAT review and registration

We separate medical and cosmetic income and register you if needed.

Clinic structure

The right set-up for treatments, products and training.

Bookkeeping

Clean records that make VAT returns simple.

Licensing readiness

A finance checklist to prepare for licensing.

How we help

01

Self Assessment for side income

Aesthetics income reported alongside your PAYE salary, with allowable costs claimed and payments on account planned.

02

VAT threshold monitoring

Rolling 12-month turnover checked so you register at the right time, not after a penalty.

03

Limited company set-up

Where your profits justify it, we form the company and run payroll and dividends properly.

04

Bookkeeping and Making Tax Digital

Records kept in MTD-compatible software, with quarterly updates handled. MTD for Income Tax applies from April 2026 where qualifying self-employment and property income is over £50,000, and over £30,000 from April 2027.

What to know before you decide

When cosmetic work is VATable

Medical care by a registered health professional is exempt from VAT only where its main purpose is to protect, maintain or restore health. Following Illuminate Skin Clinics v HMRC (Upper Tribunal, 2025), treatments that are purely cosmetic are standard-rated. Each treatment is judged on its facts, so we review your menu treatment by treatment before you register or price.

VAT Registration & Returns for Doctors & Healthcare Professionals

The VAT registration threshold

You must register for VAT when your VATable turnover goes over £90,000 in any rolling 12 months — not just at your year end. We check that figure every month so registration never takes you by surprise.

VAT Registration & Returns for Doctors & Healthcare Professionals

Mixing NHS and private work

Your NHS salary stays under PAYE; your aesthetics income is taxed separately. We combine both in one return and work out what to put aside each month.

VAT Registration & Returns for Doctors & Healthcare Professionals

Your questions answered

Are my services exempt or standard-rated?

Medical care provided by registered health professionals is generally VAT exempt if the primary purpose is protecting health. Purely cosmetic procedures and medicolegal reports are typically standard-rated at the prevailing rate. You must monitor your taxable turnover against the £90,000 registration threshold. Determining the correct liability requires a detailed review of your specific services.

Check the official guidance · www.gov.ukWant us to check this for you? Get a free review →

What is partial exemption?

Partial exemption applies when a healthcare business makes both VAT-exempt and taxable supplies. You cannot usually reclaim all input VAT if you have exempt income. A specific calculation determines how much VAT on overheads is recoverable. This is a common requirement for GPs and consultants with mixed income streams.

Check the official guidance · www.gov.uk

Help with this question: VAT Registration & Returns for Doctors & Healthcare Professionals

Help with this question: Payroll & Pensions for Doctors & Healthcare Professionals

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What happens if I registered late?

Failure to register for VAT when your taxable turnover exceeds £90,000 may result in financial penalties. HMRC may also charge interest on the VAT that should have been paid from the effective date of registration. You will be liable for the VAT on past sales regardless of whether you charged it. Early disclosure often helps in mitigating these penalties.

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Quick quote

See what you could save — get a fixed fee in one working day

Three fields. No obligation. A specialist replies, not a sales team.

Packages for your working life

Accountancy packages for aesthetics practitioners

Self-employed income, a limited company, PAYE or a mixture: start with the support that matches how you actually work. We check your status and agree the scope and fee before starting.

Self-employed accountants for aesthetics practitioners packages

For genuine sole-trader income. We prepare your business accounts and Self Assessment, review allowable expenses and explain payments on account.

  • Sole-trader accounts and personal tax return
  • Allowable business expenses reviewed
  • Tax reserve and payment deadline guidance
  • MTD support scoped separately where required

Fixed fee quoted after a review

Discuss this package

Limited company accountants for aesthetics practitioners packages

For clinicians working through their own company. Choose Essential/Compliance, Core/Complete or Growth according to your accounts, bookkeeping and payroll needs.

  • Statutory accounts and Corporation Tax return
  • One director return for salary and dividends from the same company
  • Confirmation statement support; filing fee extra
  • Bookkeeping, VAT and payroll according to your chosen plan

Company packages from £45.83 + VAT / month

Compare company packages

Personal tax return packages for aesthetics practitioners

For employed clinicians, partners and people with mixed income who need a return. We check whether Self Assessment is required and reconcile the relevant income, expenses and pension tax information.

  • Self Assessment requirement checked
  • PAYE and other income reconciled
  • Eligible employment expenses reviewed
  • Pension tax work agreed separately where needed

Fixed fee quoted after a review

Discuss this package

Employment status is determined by the facts, not the package you choose. PAYE, umbrella and partnership arrangements may also apply. A limited company does not override IR35 or off-payroll rules, and not every employed clinician needs a tax return.

Overpaid tax?

Tax refund support for aesthetics practitioners

We review tax codes, eligible professional expenses and overpaid tax, then prepare a claim where you qualify. A refund is not guaranteed; HMRC decides the claim.

£249 + VAT

For refunds up to £5,000, our fee is £249 plus VAT. For refunds above £5,000, add 5% of only the amount above £5,000 to the £249 fee. VAT applies to the total professional fee.

Example: a £6,000 refund means £249 + £50 = £299 plus VAT.

Professional fee, excluding VAT

£249

Ask about a tax refund

This illustrates the fee only, not whether you qualify or how much HMRC will refund. We agree the claim scope and payment terms before work starts.

What's included

Limited company packages — compare what's included

Essential/Compliance

For locums, salaried GPs and dentists with a limited company

from £45.83 + VAT /month

  • FRS 105 or FRS 102 1A statutory accounts
  • Corporation tax return (CT600) and tax computation
  • Confirmation statement preparation and filing support
  • One director Self Assessment return
  • Deadline reminders ahead of every filing date

Core/Complete

For private practice, consultants and associate dentists

from £62.50 + VAT /month

  • Everything in Essential/Compliance
  • Monthly bookkeeping and bank reconciliation
  • Quarterly Making Tax Digital VAT returns
  • Director payroll with RTI filing and pension submissions
  • Quarterly review call on numbers and tax position

Growth

For clinics, dental practices and growing medical teams

from £75.00 + VAT /month

  • Everything in Core/Complete
  • Payroll for up to five employees

Prices exclude VAT. Making Tax Digital quarterly updates available as an add-on. Compare fees

Why clinicians trust us

Chartered accountants who know the NHS

  • ACCOTAX has served over 5,000 clients.
  • Regulated chartered accountants (ICAEW and ACCA).
  • Founded by Waqas Sagar ACA FCCA FMAAT, with 18+ years' experience.

Reviewed by Waqas Sagar ACA FCCA FMAAT

Chartered accountant and founder of ACCOTAX. Last reviewed October 2026.

Get my fixed-fee quote

How it works

  1. 01

    Free call

    A 15-minute chat about your income, structure and deadlines.

  2. 02

    Onboarding in 48 hours

    We set up your records, software and HMRC agent access.

  3. 03

    We handle the rest

    HMRC, NHS Pensions and every deadline, with reminders before each one.

Free resource

Get the aesthetics VAT checklist free

Tell us where to send it and we'll email it to you.

Your questions, answered

Can I claim my training courses?
Training that updates skills you already use in the business is usually allowable. A course that gives you a new qualification to start a new trade usually isn't.
I'm a nurse injecting part-time — do I need a return?
Yes, normally, if you have self-employed income above the £1,000 trading allowance.

Speak to a specialist today

Leave your details and we'll call you back, or book a free review straight away.

Book a free 15-min tax review

Related healthcare expertise

VAT Registration & Returns for Doctors & Healthcare ProfessionalsPayroll & Pensions for Doctors & Healthcare ProfessionalsAesthetic Nurse AccountantsAesthetic Practitioner AccountantsVAT on Aesthetic Treatments: UK GuideAccountants for aesthetic, cosmetic and skin clinics
Accountants for healthcare professionalsHealthcare tax questions answered

General information for the 2026/27 tax year, prepared from the official guidance linked below. It is not personalised tax or regulated financial advice. Rules and circumstances can change; confirm your position before acting.

Official sources referred to on this page: GOV.UK: VAT registration; HMRC VAT Notice 701/57 (health professionals); GOV.UK: MTD sign-up.

Official guidance

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