Which mattresses, pillows, and support products qualified for Florida's prescription-based orthopedic exemption?

Plain-English summary

Florida exempted the products it found therapeutically useful beyond mere comfort when bought under a qualifying physician's prescription. The exempt list was the Swedish Mattress, Swedish Neck Pillow, Support Pillow, Transit Pillow, Millennium Pillow, PC Seat Wedge, travel set, mattress overlays, lumbar support, and leg spacer.

The prescription had to be dated before the sale and identify the ailment or body part being treated. The customer's prescription met those requirements, so the adjustable-bed purchase using the qualifying mattress received the exemption.

The Classic Pillow, office chair, named recliner, and comfort cushion remained taxable with or without a prescription because the Department viewed them as more comfortable versions of standard products used throughout society.

What this means for you

A prescription did not exempt every comfort or ergonomic product. Florida required both a therapeutic product that fit the orthopedic standard and a timely, treatment-specific prescription unless the item appeared on the state's specifically exempt list.

Common questions

Q: Was the therapeutic mattress exempt? Yes, with the qualifying prescription described in the ruling.

Q: Could a prescription exempt an ordinary comfort cushion or recliner? No, not for the products reviewed here.

Q: What had to appear on the prescription? The ailment or body part to be treated, and the prescription had to predate the sale.

Citations and references

• Fla. Stat. § 212.08(2) — medical products and orthopedic appliances
• Fla. Admin. Code r. 12A-1.021(1) — prosthetic and orthopedic appliances
• Fla. Stat. § 213.22 — Technical Assistance Advisements

Source

• Landing page: Florida Tax Law Library
• Advisement: TAA 02A-036

Original ruling text

SUMMARY

QUESTION: What is the taxable status of certain orthopedic
products purchases pursuant to a physician's prescription?

ANSWER - Based on Facts Below: The Swedish Mattress, the
Swedish Neck Pillow, the Support Pillow, the Transit
Pillow, the Millennium Pillow, the PC Seat Wedge, the
[Company] Travel Set, the Mattress Overlays, the lumbar
Support, and the Leg Spacer provide therapeutic benefits
beyond mere comfort, and they would be exempt from tax when
purchased pursuant to a physician's prescription. The
prescription would need to describe the ailment or body
part that is to be treated and must be dated prior to the
sale of the product.

Sep 17, 2002

Re: Technical Assistance Advisement 02A-036
XXX ("Client")
Sales and Use Tax
Orthopedic Products
Section 212.08(2), F.S.,
Rule 12A-1.021(1), F.A.C.

Dear :

This is in response to your letter of July 5, 2000, in which you
request the issuance of a Technical Assistance Advisement
regarding the taxable status of various health related products
that your company sells. Your letter provides in part:

I am writing this letter for the purpose of requesting the
issuance of a Technical Assistance Advisement pursuant to
s, 213.22, F.S., and Chapter 12-11, F.A.C., regarding the
use taxability of a product manufactured and sold pursuant
to a valid physician's prescription and used for medical
purposes. The use taxability of several other "pain

management" products produced by XXX ("Company") and
purchased with a valid physician's prescription is also
requested.

On March 27, 2002, XXX ("Customer") purchased two long twin
[Company] adjustable beds for $4,149. The purchase of two
twin beds allows for two people to sleep side-by-side while
being able to adjust the bed to their preferences. Sales
and Use tax of $248.94 was collected by [Company] and
remitted to the state of Florida on the purchase. Shortly
thereafter, [Customer] contacted [Company] requesting a
refund of the Sales & Use tax paid on the purchase and
presented a signed physician's prescription for pain
management dated March 26, 2002 (see attachments).

The product in question is a [Company] Swedish mattress
manufactured and distributed by [Client] and Subsidiaries.
The [Company] mattress contains pressure-relieving material
composed of high-density, viscoelastic, memory cells. The
cells are temperature sensitive, causing the mattress to
conform to the contours of the body, allowing for the
person's weight to be evenly disbursed. This design makes
the mattress extremely useful in helping people with
various infirmities obtain a restful night's sleep and is
commonly recommended for people with back-pain. The
Technical Assistance and Dispute Resolution office ruled in
favor of exempt status for a "Swedish-style memory foam
mattress" in Technical Assistance Advisement 99A-029,
07/12/1999, under similar circumstances.

In addition to the mattress described above, [Company]
requests a ruling on other products sold for the purpose of
pain management with a physician's prescription. These
items include:

1. Swedish Neck Pillow - composed of visco-elastic
   material in an ergonomically correct shape to provide
   maximum support to the neck;

2. Support Pillow - designed to give pressurerelieving support to the lumbar area, under the legs

or behind the neck;

3. Transit Pillow - designed to wrap around and cradle
   the neck to relieve pressure;

4. Millennium Pillow - patented design provides proper
   neck alignment whether you sleep on your side or back;

5. Classic Pillow - traditional pillow design
   utilizing [Company] pressure-relieving material;

6. PC Seat Wedge - pushes weight forward, promoting
   proper posture and more comfortable sitting position;

7. [Company] Travel Set - includes a [Company]
   mattress overlay and support pillow;

8. Mattress Overlays - the ability to add three inches
   of pressure-relieving [Company] material to any
   sleeping surface;

9. Office Chair - contains [Company] pressurerelieving material;

10. [Company] by Lane ('Name") - incorporates
    [Company] pressure-relieving material into a recliner;

11. Lumbar Support - properly supports the mid and
    lower back;

12. Comfort Cushion - distributes weight evenly over
    its entire surface to help people sit comfortably for
    extended periods of time;

13. Leg Spacer - helps to relieve lower back and hip
    pain;

LAW AND DISCUSSION

In general, all medical products sold or dispensed to patients
pursuant to a doctor's prescription are exempt from tax.

Certain medical products and certain orthopedic equipment are
specifically exempt, regardless of whether a prescription is
involved and regardless of whether the product is sold to a
patient or to a healthcare practitioner.

Section 212.08(2), F.S., provides in part:

(2) EXEMPTIONS; MEDICAL.

(a) There shall be exempt from the tax imposed by this
chapter any medical products and supplies or medicine
dispensed according to an individual prescription or
prescriptions written by a prescriber authorized by law to
prescribe medicinal drugs; hypodermic needles; hypodermic
syringes; chemical compounds and test kits used for the
diagnosis or treatment of human disease, illness, or
injury; and common household remedies recommended and
generally sold for internal or external use in the cure,
mitigation, treatment, or prevention of illness or disease
in human beings, but not including cosmetics or toilet
articles, notwithstanding the presence of medicinal
ingredients therein, according to a list prescribed and
approved by the Department of Health, which list shall be
certified to the Department of Revenue from time to time
and included in the rules promulgated by the Department of
Revenue. There shall also be exempt . ., prosthetic and
orthopedic appliances;...

(b) For the purposes of this subsection:

1. "Prosthetic and orthopedic appliances" means any
   apparatus, instrument, device, or equipment used to replace
   or substitute for any missing part of the body, to
   alleviate the malfunction of any part of the body, or to
   assist any disabled person in leading a normal life by
   facilitating such person's mobility. Such apparatus,
   instrument, device, or equipment shall be exempted
   according to an individual prescription or prescriptions
   written by a physician licensed under chapter 458, chapter
   459, chapter 460, chapter 461, or chapter 466, or according
   to a list prescribed and approved by the Department of

Health, which list shall be certified to the Department of
Revenue from time to time and included in the rules
promulgated by the Department of Revenue. (emphasis
supplied)
...
(See the list, as contained in form 46NT, attached.)

Rule 12A-1.021(1)(a), and (b), F.A.C., provides in part:

(1)(a) Prosthetic and orthopedic appliances are exempt. The
term "prosthetic and orthopedic appliances" means any
apparatus, instrument, device, or equipment used to replace
or substitute for any missing part of the body, used to
alleviate the malfunction of any part of the body, or used
to assist any disabled person in leading a normal life by
facilitating such person's mobility. Such apparatus,
instrument, device, or equipment shall be exempted
according to an individual prescription or prescriptions
written by a duly licensed practitioner authorized by the
laws of the state to prescribe medicinal drugs, or
according to a list prescribed and approved by the
Department of Health, which list shall be certified to the
Department from time to time. . . .

The prosthetic and orthopedic appliances listed below are
specifically exempt:
...
Braces and Supports Worn on the Body to Correct or
Alleviate a Physical Incapacity or Injury....
(emphasis supplied)

The [Company] Swedish Mattress, the Swedish Neck Pillow, the
Support Pillow, the Transit Pillow, the Millennium Pillow, the
PC Seat Wedge, the [Company] Travel Set, the Mattress Overlays,
the lumbar Support, and the Leg Spacer provide therapeutic
benefits beyond mere comfort, and they would be exempt from tax
when purchased pursuant to a physician's prescription. The
prescription would need to describe the ailment or body part
that is to be treated and must be dated prior to the sale of the
product. Because the prescription from [Customer] met those
conditions, his purchase would qualify for the exemption.

With regard to the Classic Pillow, the Office Chair, the
[Company recliner, by Name], and the Comfort Cushion, these
items appear to be more comfortable versions of standard
products used throughout society (i.e., sleeping pillows, office
chairs, recliners and seating cushions). These items would not
be exempt, with or without a prescription.

This response constitutes a Technical Assistance Advisement
under s. 213.22, F.S. which is binding on the department only
under facts and circumstances described in the request for this
advice as specified in s. 213.22, F.S. Our response is
predicated on those facts and the specific situation summarized
above. You are advised that subsequent statutory or
administrative rule changes or judicial interpretations of the
statutes or rules upon which this advice is based may subject
similar future transactions to a different treatment than
expressed in this response.

You are further advised that this response, your request and
related backup documents are public records under Chapter 119,
F.S., which are subject to disclosure to the public under the
conditions of s. 213.22, F.S. Your name, address, and any other
details which might lead to identification of the taxpayer must
be deleted by the Department before disclosure. In an effort to
protect the confidentiality of such information, we request you
provide the undersigned with an edited copy of your request for
Technical Assistance Advisement, backup material and response
within fifteen days of the date of this advisement.

Sincerely,

Jonathan E. Swift
Tax Law Specialist
Technical Assistance and Dispute Resolution
(850) 922-4840

Attachment: DR-46NT
Control #50956