Which of a medical distributor's dressings, IV components, diagnostic products, and other supplies were exempt from Florida sales tax?

Subject

Medical Products

Plain-English summary

The Department divided the submitted products into exempt and taxable groups, with conditions for some IV components—but its official text conflicts on the 60-cc syringe. Clear exemptions included dressing sponges, hypoallergenic cloth tape, K-Y jelly, specified infusion components, the Foley catheter, arm sling, Uristix strips, and Kodak SureCell diagnostic tests. SureCell pregnancy tests remained taxable because the ruling did not treat pregnancy as a disease, illness, or injury.

Clear taxable items included enema bags, sharps collectors, Vacutainer tubes, adult foam electrodes, the sphygmomanometer, and the Kodak Ektachem analyzer. Some one-time IV items required a completed resale certificate stating they would be used under a physician's order or only in an integrated IV system.

The response says item 12, the 60-cc syringe, is exempt as a hypodermic item and later lists item 12 among taxable products. Because both statements appear in the official text, the ruling does not provide a reliable single answer for that item.

What this means for you

Medical use alone did not make every supply exempt. The Department looked for a named household remedy, hypodermic component, catheter, brace, chemical compound, test kit, prescription use, or another specific rule, and sometimes required resale documentation.

Common questions

Q: Were all IV components automatically exempt? No. The ruling imposed use and resale-certificate conditions on several items.

Q: Were diagnostic machines treated like test kits? No. The Ektachem analyzer was taxable even though it analyzed blood samples.

Q: What is the answer for the 60-cc syringe? The official ruling contradicts itself, so this page records the conflict rather than choosing one statement.

Citations and references

• Fla. Stat. § 212.08(2)(a) — medical-product exemptions
• Fla. Admin. Code rr. 12A-1.020(2), (6), (7), (8), 12A-1.021(1)(b) — medical products and appliances
• Fla. Stat. § 213.22 — Technical Assistance Advisements

Source

• Landing page: Florida Tax Law Library
• Advisement: TAA 93A-007

Original ruling text

Feb 17, 1993

RE: TAA 93A-007
Medical Products
Section 212.08(2)(a), F.S.
Rules 12A-1.020(2)(a),(6),(7) and (8), 12A-1.021(1)(b),
F.A.C.

Dear :

This is in response to your letter of September 18, 1992, in
which you requested the issuance of a technical assistance
advisement, on behalf of XXX (hereinafter "Taxpayer"),
concerning the taxability of various products listed therein.

Your letter provides:

"The Taxpayer is engaged in the business of selling, as a
distributor, various medical products to physicians,
hospitals, veterinarians and other health care providers.
The issues raised in this letter are not involved in a
pending return of the Taxpayer, but may form the basis of
adjustments in the method of reporting tax on future
returns.

"The numbered paragraphs below set forth the identity of
the products upon which an Advisement is requested,
together with the Taxpayer's determination of the exempt
status of each item, and an explanation of the grounds and
authorities in support of the Taxpayer's claim for
exemption. Sales literature describing each item is
attached to this request.

"1. Sterile/Patient-Ready or Bulk (non-sterile) Dressing
Sponges. This product is extremely similar in function to
gauze dressings and bandaging materials, which are exempt
under Florida Statutes s. 212.08(2)(a) and Rule
12A-1.020(2)(a). Such items appear on DR-46NT. The sponge
dressing in fact perform the functions historically

performed by cotton gauze, but in a more convenient,
sterile manner. The Taxpayer claims that the product is
exempt as a common household remedy, more particularly as
gauze' and/or as abandaging material' under the abovecited authorities.
"2. Dermicel Hypo-Allergenic Cloth Tape. This product holds
gauze and sponge dressings in place, and is a type of
bandaging material. The Taxpayer asserts that the product
is exempt as a bandaging material' under the authorities cited in number 1 above. "3. K-Y Lubricating Jelly. This is apetroleum jelly' and
the Taxpayer asserts that it is exempt as such under the
authorities described in number 1 above.
"4. Enema Bags. This product consists of a bag and tubing,
but does not include any medicinal preparations. Enema
preparations appear as a common household remedy on
DR-46NT, thus are exempt under the authorities cited in
number 1 above. The Taxpayer requests an Advisement on the
exempt status of enema bags.
"5. Winged Infusion Sets. This product consists of a
hypodermic needle attached to tubing, and is used to infuse
or drip' fluids intravenously. No syringe is used toinject' the fluid. The Taxpayer claims that the product
is specifically exempt from payment of sales tax under Rule
12A-1.021(1)(b) and DR-46NT as hypodermic syringe tubing and parts, when used for medical purposes. "6. Disposable Stopocks. This product is attached to hypodermic tubing and is used to regulate the flow of fluids. The Taxpayer claims that the product is exempt ashypodermic syringe tubing and parts' under the authorities
cited in number 5 above.
"7. Non-Conductive Tubing. The Taxpayer claims that this
product is exempt as hypodermic syringe tubing' under the authorities described in number 5 above. "8. I-V Catheter Placement Units. This product consists of a needle attached to tubing, and the Taxpayer claims that it is exempt ashypodermic syringe tubing and parts' under
the authorities in number 5 above.
"9. PRN Adapter. This product is attached to hypodermic
tubing, and regulates the flow of an I-V catheter. The
Taxpayer claims that the product is exempt as `parts' for

hypodermic syringing tubing under the authorities cited in
number 5 above.
"10. Sharps Collectors. This is a new product that has been
marketed over the last year or two. The impetus behind the
development of the product is the AIDS crisis. The product
collects used needles and syringes in a secure container,
thus substantially decreases the possibility of accidental
exposure by persons handling the disposed items. The
Taxpayer understands that the product, or a similar method
of collection, is required to be used in certain health
care facilities by federal regulation. The Taxpayer does
not claim an exemption based upon any existing regulation,
but requests an Advisement on the Department's position as
to the taxability of this new product.
"11. Vacutainer Tubes. This product is attached to a
syringe and needle as a blood collector. In addition, the
tubes are sold with various chemicals already contained in
the tubes for use in testing blood and the diagnosis of
blood conditions and diseases. The Taxpayer claims that
the product is exempt on two grounds: first as hypodermic syringe tubing and parts' under the authorities cited in number 5 above; and, next, as achemical compound and test
kit' under Florida Statutes s. 212.08(2)(a) and Rule
12A-1.020(7)(a).
"12. 60 CC Syringe Only. This product is a hypodermic
syringe whose primary uses are for oral feeding and to
flush wounds. The product is not generally used for the
injection of fluids. The Taxpayer claims that the product
is exempt as a hypodermic syringe' under the authorities cited in number 5 above. "13. Adult Foam Electrodes. This product is a monitoring device used to monitor cardiac rhythm. The Taxpayer seeks and Advisement as to whether the product is exempt as aheart stimulator' under Rule 12A-1.021(1)(b).
"13. Foley Catheters. This product is a urinary catheter.
The Taxpayer claims that the product is exempt as a
catheter' under the authorities cited in number 5 above, and also as and item that istemporarily or permanently
incorporated into a patient or client by a practitioner of
the healing arts...' under Rule 12A-1.020(6)(a)1.
"14. Arm Slings. The Taxpayer claims that this product is

specifically exempt as a brace and support worn on the body to correct or alleviate a physical incapacity or injury' under Rule 12A-1.021(1)(b). "15. Uristix Reagent Strips. This product is adip and
read' test for glucose, protein, nitrite and leukocytes in
urine. Although numerous reagent strips are listed as
exempt chemical compounds and test kits' on DR-46NT, as areurine testing kits and materials' in general, this
particular product is not so listed. The Taxpayer claims
that the product is exempt as a chemical compound and test kit,' specifically, aurine testing kit,' and seeks an
Advisement in that regard.
"16. Sphygmomanometer. The Taxpayer claims that this
product is exempt as a blood pressure unit' under Rule 12A-1.020(7)(a), and alternatively as ablood pressure
testing kit and material' under the chemical compounds and
test kits heading of DR-46NT.
"17. Kodak SureCell'. The attached brochure explains the diagnostic function and process for which this group of products is used. The Taxpayer claims that these products are exempt aschemical compounds or test kits' used for
diagnosis under Florida Statutes s. 212.08(2)(a), Rule
12A-1.020(7)(a) and DR-46NT.
"18. Kodak Ektachem' Analyzer. This product analyzes blood samples and produces a printout setting forth the chemical makeup of the sample, and is used as a diagnostic tool. The Taxpayer claims that the product is exempt as atest
kit' under the authorities cited in number 17 above."

Applicable Authority

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

"(2) EXEMPTIONS; MEDICAL."(a) There shall be exempt from the tax imposed by this
chapter any product, supply, or medicine dispensed in a
retail establishment by a pharmacist licensed by the state,
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 and Rehabilitative Services, 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 from the
tax imposed by this chapter artificial eyes and limbs;
orthopedic shoes; prescription eyeglasses and items
incidental thereto or which become a part thereof;
dentures; hearing aids; crutches; prosthetic and orthopedic
appliances; and funerals...."

Rule 12A-1.020(2)(a), F.A.C., provides:

"(2)(a) Common household remedies recommended and generally
sold for internal or external use, used in the cure,
mitigation, treatment, or prevention of illness or disease,
according to a list prescribed and approved by the
Department of Health and Rehabilitative Services (which
list shall be certified to the Department of Revenue) are
exempt. A list of nontaxable common household remedies
(DR-46NT), Nontaxable Medical and General Grocery List,
dated October, 1987, which is incorporated in this rule and
made part of this rule by reference, is available without
cost, upon written request directed to the Department of
Revenue, Supply Section, Tallahassee, Florida 32399-0100."

Rule 12A-1.020(6)(a) and (b), F.A.C., provides:

"(6)(a) Medical products and supplies used in the cure,
mitigation, alleviation, prevention or treatment of injury,
illness, disease or incapacity are taxable, unless:
"1. Temporarily or permanently incorporated into a patient
or client by a practitioner of the healing arts licensed by
the State of Florida.
"2. Ordered and dispensed by or on the prescription of a

duly licensed practitioner authorized by the laws of the
state to prescribe medicinal drugs; or
"3. Ordered and dispensed by a pharmacist pursuant to the
established dispensing procedures determined by the joint
committee of medical, osteopathic and pharmacy professions
as created by section 465.186, F.S.
"(b) The sale of medical products or supplies to
physicians, dentists, veterinarians and hospitals is
taxable even though the medical products or supplies may be
used in connection with medical treatment, unless the
products and supplies are specifically exempt from tax
under this rule or in Rule 12A-1.021, F.A.C.
"(c) `Medical products and supplies' shall mean and
include, but is not limited to, such items as cotton,
knives, sewing and surgical needles, scissors, microscopes,
x-ray machines, I.V. administration sets, laboratory
apparatus, surgeons' gloves, ear syringes, and hospital
beds."

Rule 12A-1.020(7)(a) and (b), F.A.C., provides:

"(7)(a) The chemical compounds and test kits specified in
this paragraph which are used for the diagnosis or
treatment of disease, illness or injury are specifically
exempt. Examples of chemical compounds and test kits
include, but are not limited to the following: Albustix
reagent strips and tablets; blood pressure units;
cholesterol tests; clinistix reagent strips; clinitest
tablets; combistix reagent strips; dextrostix, reagent
strips; dextrotest kit and refills; diabetic test kits;
galatest; ictotest reagent tablets; sugar test tablets for
diabetics; thermometers for human use; tuberculin patch
test; urine testing kits; urograph test.
"(b) Likewise exempt is any chemical compound and test kit
used for the diagnosis or treatment of disease, illness, or
injury, ordered and dispensed in a retail establishment by
a pharmacist licensed by the State of Florida, according to
an individual prescription or prescriptions written by a
duly licensed practitioner authorized by the laws of the
state to prescribe medicinal drugs."

Rule 12A-1.020(8), F.A.C., provides:

"(8) The sale of hypodermic needles, hypodermic syringes,
hypodermic syringe tubing and parts is exempt when sold for
the diagnosis or treatment of disease, illness or injury."

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

12A-1.021 Prosthetic and Orthopedic Appliances.
"(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
assist any disabled malfunction of any part of the body, or
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 and Rehabilitative Services, which
list shall be certified to the Department of Revenue from
time to time. A list of prosthetic and orthopedic
appliances (DR-46NT), Nontaxable Medical and General
Grocery List, dated October, 1987, which is incorporated in
this rule and made part of this rule by reference, which
has been certified to the Department of Revenue by the
Department of Health and Rehabilitative Services, is
available without cost, upon written request directed to
the Department of Revenue, Supply Section, Tallahassee,
Florida 32399-0100.
"(b) 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...."
"Catheters...."

Department Response

In our telephone conversation of September 29, 1992, it was
clarified that items 5 through 9 are sold as individual items to
health care providers and are assembled by the provider to
infuse or drip fluids intravenously to a patient as provided in
Rule 12A-1.020(8), F.A.C., for hypodermic needles, hypodermic
syringes, hypodermic syringe tubing and parts.

The items that are exempt from tax are numbers 1, 2, 3, 5,
6, 7, 8, 9, 2nd item identified as 13, 14, 15, and 17.

Items 1, 2, and 3 are exempt from tax under Rule
12A-1.020(2)(a), F.A.C., and Form DR-46NT as common household
remedies used in the cure, mitigation, treatment, or prevention
of illness or disease.

Items 5 and 6, intended for one time use can be purchased
tax exempt if the health care provider extends a completed
resale certificate to the selling vendor at the time of sale
indicating that the items will only be used via a physician's
order.

Items 7 and 9, intended for one time use are exempt if they
can be used only in an integrated system of intravenous
administration and the health care provider extends a completed
resale certificate indicating that the items will be used via a
physician's order.

Item 12 is exempt from tax by Rule 12A-1.020(8), F.A.C., as
a sale of hypodermic needles, hypodermic syringe tubing and
parts when sold for the diagnosis or treatment of disease,
illness or injury.

The 2nd item identified as 13 is exempt as a result of Rule
12A-1.021(1)(b), F.A.C., as a sale of catheters.

Item 14 is exempt from tax as a brace or support worn on
the body to correct or alleviate a physical incapacity or injury
under Rule 12A-1.021(1)(b), F.A.C.

Item 15 are exempt under Rule 12A-1.020(7)(a), F.A.C., as a
chemical compound or test kits used in the diagnosis or

treatment of human disease, illness or injury.

Item 17 Kodak SureCell Diagnostic Test Kits are exempt as
noted in section 212.08(2)(a), F.S., and Rule 12A-1.020(7),
F.A.C., as chemical compounds and test kits used in the
diagnosis or treatment of human disease, illness or injury.
However, the sale of test kits for pregnancy is subject to tax
as it does not fit into an exempt use of a test kit since
pregnancy is not a disease, illness or injury.

The taxable items include numbers 4, 10, 11, 12, 13, 16 and

18. All the above items are subject to tax under Rule
    12A-1.020(6)(b), F.A.C., as medical products and supplies used
    in connection with medical treatment.

This response constitutes a Technical Assistance Advisement
under s. 213.22, F.S., which is binding on the Department only
under the 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 and your request
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 notify the undersigned in
writing within 15 days of any deletions you wish made to the
request or the response.

Sincerely,

Richard S. Harrod
Technical Assistance

RSH/bc
CON# 4565