Are specialty therapy mattresses (low-air-loss, pressure-relieving, turning, bariatric), HI/LOW and bariatric bed frames, and wheelchairs subject to Colorado sales tax?

Plain-English summary

An out-of-state company asked whether a list of specialty medical products is subject to Colorado sales tax: low-air-loss therapy mattresses, pressure-relieving mattresses, turning mattresses, bariatric bed frames/mattresses, HI/LOW bed frames, and wheelchairs.

Colorado taxes the sale or lease of tangible personal property (§ 39-26-104(1)(a)), but there are several medical exemptions. Two parts of the rule matter here (§ 39-26-717(1)(a)):

• Wheelchairs and hospital beds are expressly exempt.
• Therapeutic devices, appliances, and related accessories are exempt — but when such an item sells for more than $100, it must be sold in accordance with a licensed doctor's written recommendation to qualify.

The Department did not decide whether the specific therapy mattresses and bed frames on the company's list are "hospital beds," "therapeutic devices," or neither — a General Information Letter does not apply the law to particular products. To get a binding answer for these exact items, the company would have to request a private letter ruling. The Department pointed to FYI Sales 68 (medical equipment and supplies) for the framework, and to FYI Sales 5 because the company is located outside Colorado.

What this means for you

Medical-equipment sellers and DME suppliers

Wheelchairs and hospital beds you sell in Colorado are exempt — no doctor's note needed for those two categories. For other items that work as therapeutic devices (the specialty mattresses and frames likely fall here), the exemption is conditional: if the item sells for over $100, keep the written recommendation of a licensed doctor on file, or the sale is taxable.

The "$100 + doctor's recommendation" condition

This is the practical trap. A therapeutic device under $100 can be exempt on its own, but once the price crosses $100 the exemption depends on documentation. Build the doctor's written recommendation into your sales process for higher-priced therapeutic items.

Out-of-state sellers

If you're located outside Colorado, review FYI Sales 5 on when you have to collect Colorado tax, and remember the Department does not administer self-collected home-rule city taxes — check those jurisdictions separately.

Common questions

Q: Are wheelchairs and hospital beds taxable in Colorado? A: No. The medical exemption in § 39-26-717(1)(a) expressly covers wheelchairs and hospital beds.

Q: Are specialty therapy mattresses exempt?
A: The Department didn't decide. If a mattress qualifies as a "hospital bed" or a "therapeutic device," it can be exempt — but a therapeutic device selling for more than $100 needs a licensed doctor's written recommendation. The exact classification of these products would require a private letter ruling.

Q: What's the $100 rule?
A: For therapeutic devices, appliances, and related accessories, the exemption applies only if the item is sold under a licensed doctor's written recommendation when it sells for more than $100.

Q: Can I rely on this letter for my products?
A: No. It's a General Information Letter — general guidance only, not binding, and it deliberately did not classify the specific products. A private letter ruling gives a binding answer.

Citations and references

Statutes and publications:

• § 39-26-104(1)(a), C.R.S. — imposition of Colorado sales tax on sales/leases of tangible personal property
• § 39-26-717(1)(a), C.R.S. — medical exemption (wheelchairs, hospital beds, therapeutic devices sold per a doctor's written recommendation if over $100)
• Department FYI Sales 68 — Medical and Dental Equipment and Supplies
• Department FYI Sales 5 — sales tax for businesses located outside Colorado

Related Colorado medical-exemption letters:

• [[gil-08-014-taxability-of-medical-equipment]] — the "does it leave with the patient" test; surgical laser taxable
• [[gil-08-026-sales-tax-exemption]] — orthopedic implants exempt via doctor-furnished materials
• [[gil-08-013-taxability-of-name-products]] — visco-elastic mattresses/pillows held NOT exempt therapeutic devices
• [[gil-08-021-sales-tax-re-supplements-etc]] — supplements taxable; TENS units exempt only if designed to treat a disability
• [[gil-08-004-taxability-of-motorized-scooters-boot-walker-and-soft-shoe]] — scooters and orthopedic boots/shoes taxable

Source

• Landing page: https://tax.colorado.gov/sales-use-tax-letter-rulings
• Original PDF: https://tax.colorado.gov/sites/tax/files/documents/GIL-08-035.pdf

Original ruling text

Office of Tax Policy
P.O. Box 17087
Denver, CO 80217-0087
[email protected]

GIL-2008-035
December 16, 2008
XXXXXXXXXXXXXXX
Attn: XXXXXXXXXXX
XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX
Re: medical supplies and equipment
Dear XXXXXXXXX,
Your company has submitted a request for guidance on the taxability of certain equipment sold by your company. Issue Is the sale of Low Air Loss Therapy mattress (XXXXXXX): Pressure Reliving Mattress; Turning mattress; Bariatric Bed Frames/Mattresses; HI/LOW bed frames; and wheelchairs subject to sales tax. Discussion Colorado levies sales tax on the sale or lease of tangible personal property. §39-26104(1)(a), C.R.S. There are a number of exemptions related to medical equipment and supplies, including the sale of wheelchairs and hospital beds. §39-26-717(1)(a), C.R.S. Therapeutic devices, appliances and related accessories are also exempt, but such items must be sold in accordance with a written recommendation of a licensed doctor if such item sells for more than $100. The Department has a number of resources and publications that address sales tax issues. Department FYI Sales 68 specifically addresses medical supplies and equipment. I have enclosed a copy for your convenience. This and other publications can be viewed on our wed site at: www.revenue.state.co.us and go to Taxation > Resources/Publications.

The Department does not make a determination in a general information letter regarding whether the specific products you describe fall within these exemptions. If you would like a determination regarding these specific products, you must submit a request for private letter ruling. I also note that you are located outside of Colorado. You may wish to review Department FYI Sales 5 relating to sales tax issues for business located outside Colorado. Miscellaneous Matters Please note that the department does not collect sales and use taxes for “home-rule” cities and counties. You can find a list of these jurisdictions by visiting our web site at: www.revenue.state.co.us (go to Taxation > Forms > Businesses > Sales and Use > DRP 1002) Contact those governments for information about their taxes. This general information letter represents the advice of experienced members of the Department’s staff. However, it is not binding on the department. Enclosed is a redacted version of this ruling. Pursuant to statute and regulation, this redacted version of the ruling will be made public within 60 days of the date of this letter. Please let me know in writing within that 60 day period whether you have any suggestions or concerns about this redacted version of the ruling. Sincerely, Office of Tax Policy Colorado Department of Revenue

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