Are a MedSpa's hormone therapy, Botox, and wellness services subject to Illinois sales tax, and how do bundled memberships get taxed?

Plain-English summary

A wellness-based MedSpa offering hormone therapy, Botox and dermal fillers, IV therapy, weight-loss medications, nutraceuticals, and bundled membership plans submitted a detailed Private Letter Ruling request with TWELVE specific questions -- essentially asking the Department to confirm, item by item, which of its many offerings are taxable and which aren't, building on an earlier general GIL it had already reviewed.

The Department chose not to give individualized, binding answers to each of the twelve questions. Instead, it responded with a GIL restating the SAME general framework already published in a prior GIL (ST 25-0046-GIL): pure services with no tangible personal property transferred to the patient aren't taxed at all; but if drugs, medicines, medical appliances, or other products ARE transferred to the patient as part of a service, those items are taxed -- generally at the reduced 1% rate if they qualify as medicine/drugs/medical appliances, or at the standard 6.25% rate otherwise -- calculated under one of the four standard serviceperson methods (separately-stated price, 50% of the bill, or a de minimis cost-price method). The Department was explicit that it's the TAXPAYER'S OWN responsibility to apply this framework to its specific facts, rather than something the Department will pre-certify service-by-service through a GIL.

One genuinely new and timely piece of information did come through: starting January 1, 2026, Illinois exempts food for human consumption meant to be eaten off the premises from state Occupation and Use taxes (with carve-outs for alcohol, cannabis-infused food, soft drinks, candy, and food prepared for immediate consumption) -- a change enacted by P.A. 103-781. This could bear on a MedSpa's nutraceutical/supplement sales, though a MUNICIPALITY or COUNTY may separately impose its own Grocery Occupation Tax on the same items at the same rate, so the state exemption doesn't necessarily mean zero tax at checkout.

What this means for you

MedSpas, wellness clinics, and similar hybrid medical/retail businesses

Don't expect the Department to individually pre-certify every service and product line in a facility with a mixed medical/cosmetic/retail model -- the Department will point you back to the SAME general pure-service vs. transferred-property test rather than issue 12 separate binding answers. Do the item-by-item analysis yourself (or with a tax professional), itemizing invoices to separate genuinely nontaxable professional services from any transferred products or incidental supplies.

Businesses selling nutraceuticals, supplements, or food-adjacent products

Starting January 1, 2026, off-premises food for human consumption is exempt from STATE Occupation and Use tax under P.A. 103-781 -- but check whether your municipality or county has adopted its own local Grocery Occupation Tax on the same items, since that local tax can still apply even where the state exemption now zeroes out the state-level charge.

Accountants and tax professionals for medical/wellness practices

When a client's ruling request essentially restates a prior published GIL's fact pattern with more specificity, expect the Department to point back to that same GIL rather than issue a fresh determination -- factor that into whether a formal ruling request is worth the effort versus simply applying the existing published guidance directly.

Common questions

Q: Did the Department individually confirm which of the MedSpa's 12 specific services are taxable?
A: No. It declined to answer service-by-service and instead restated the general pure-service vs. transferred-property framework already published in a prior GIL, leaving the specific application to the taxpayer.

Q: What's the basic rule for whether a medical/wellness service is taxed?
A: A pure service transaction with NO tangible personal property transferred to the patient isn't taxed at all. If tangible property (drugs, medicine, supplies) IS transferred as part of the service, that property is taxed under the Service Occupation Tax framework, generally at 1% if it qualifies as a medicine/drug/medical appliance or 6.25% otherwise.

Q: What changed for food/grocery sales starting January 1, 2026?
A: Food for human consumption meant to be eaten off the premises became exempt from STATE Occupation and Use tax (excluding alcohol, cannabis-infused food, soft drinks, candy, and food prepared for immediate consumption), per P.A. 103-781 -- but local Municipal or County Grocery Occupation Tax may still apply.

Q: If I bundle taxable and non-taxable items into one membership charge, does the whole thing become taxable?
A: The Department's general framework (and the prior GIL it cites) emphasizes itemized billing to separate taxable and non-taxable components -- an un-itemized bundle risks the whole charge being treated as taxable.

Q: Can I rely on this letter for my own MedSpa or wellness business?
A: No. This is a General Information Letter -- not binding on the Department, and it deliberately didn't resolve the taxpayer's specific fact patterns. Apply the general framework to your own facts with a tax professional's help.

Citations and references

Statutes:

• 35 ILCS 120/2-10 (reduced 1% rate for food, drugs, and medical appliances)
• 35 ILCS 115/3-5(37); 35 ILCS 120/2-5(49); 35 ILCS 105/3-5(44) (2026 off-premises food exemption, P.A. 103-781)
• 65 ILCS 5/8-11-24; 55 ILCS 5/5-1006.9 (local Municipal/County Grocery Occupation Tax option)

Regulations:

• 86 Ill. Adm. Code 130.101; 150.101 (Retailers' Occupation Tax; Use Tax imposition)
• 86 Ill. Adm. Code 140.101 (Service Occupation Tax Act imposition)

Prior rulings referenced:

• ST 25-0046-GIL (the prior GIL whose general framework this letter reapplies rather than issuing new per-item determinations)

Source

• Landing page: Illinois 2026 Sales Tax Letter Rulings
• Original PDF: ST26-0006-GIL.pdf

Original ruling text

ST 26-0006-GIL

2/24/2026

SALES OF SERVICE

Sales of service, where tangible personal property is transferred incident to the service, are
not exempt from taxation. Servicepersons must calculate their tax liability using one of the
four methods prescribed in 86 Ill. Adm. Code Part 140. (This is a GIL).
February 24, 2026
NAME
COMPANY
ADDRESS
EMAIL
Dear NAME:
This letter is in response to your letter dated November 10, 2025, in which you
requested information. The Department issues two types of letter rulings. Private Letter
Rulings (“PLRs”) are issued by the Department in response to specific taxpayer inquiries
concerning the application of a tax statute or rule to a particular fact situation. A PLR is
binding on the Department, but only as to the taxpayer who is the subject of the request for
ruling and only to the extent the facts recited in the PLR are correct and complete. Persons
seeking PLRs must comply with the procedures for PLRs found in the Department’s
regulations at 2 Ill. Adm. Code 1200.110. The purpose of a General Information Letter (“GIL”)
is to direct taxpayers to Department regulations or other sources of information regarding
the topic about which they have inquired. A GIL is not a statement of Department policy and
is not binding on the Department. See 2 Ill. Adm. Code 1200.120. You may access our
website at https://tax.illinois.gov/ to review regulations, letter rulings and other types of
information relevant to your inquiry.
The nature of your inquiry and the information you have provided require that we
respond with a GIL. In your letter you have stated and made inquiry as follows:
Pursuant to 2 Ill. Adm. Code 1200.110, COMPANY, doing business as
COMPANY (“COMPANY”), respectfully submits this request for a Private
Letter Ruling (PLR) regarding the Illinois sales and use tax treatment of specific
medically supervised treatments, wellness services, products, and bundled
memberships offered at our MedSpa located at ADDRESS. This request
concerns whether specific medically supervised treatments, wellness
services, and product sales are subject to the Retailers’ Occupation Tax Act
(35 ILCS 120/1 et seq.) and related regulations (86 Ill. Adm. Code Part 130). All
facts provided herein are complete and accurate, and we certify compliance
with the PLR procedures under 2 Ill. Adm. Code 1200.100.
Statement of Facts

COMPANY
Page 2
February 24, 2026
COMPANY operates a wellness-based MedSpa providing medically
supervised treatments and wellness services. Licensed Nurse Practitioners
will administer all prescription-based services. Our location opened in DATE
and serves adult clients seeking hormone therapy, aesthetic treatments,
wellness therapies, and related products. All prescription-based injectables
and therapies are administered exclusively by licensed Nurse Practitioners in
a clinical setting, with no tangible personal property transferred for off-site
use unless separately sold as retail products. Key operational details:
•

Staffing and Administration: All hormone therapies, Botox,
dermal fillers, IV therapies, and weight-loss medications are
prescribed and administered by licensed Nurse Practitioners.
Non-prescription services such as Hydrafacials and skin peels
are performed by licensed estheticians under Nurse
Practitioner supervision. Related consultations are conducted
by licensed Nurse Practitioners.

•

Invoicing Practices: All invoices are itemized to separately state
charges for professional services, any incidental tangible
personal property (such as serums used in procedures), and
retail products. For example, a Botox session invoice lists:
“Professional Administration Service” (non-taxable) and “Botox
Units (Rx)” (incidental tangible personal property). Bundled
memberships itemize components to distinguish taxable and
non-taxable elements. Records are maintained to track cost
price of tangible personal property for any applicable Service
Occupation Tax calculations.

•

Memberships: Offered as monthly plans including: initial
hormone consultation, semi-annual lab assessments,
customized hormone optimization and treatment plan, and
discounts on other services and products. Memberships do not
include automatic tangible personal property transfers;
members pay separately for any products or incidental tangible
personal property.

•

Sales Volume and De Minimis Status: Based on projections,
annual gross receipts from services will exceed DOLLAR
AMOUNT, with tangible personal property transferred incident
to services comprising less than PERCENTAGE of total receipts
(primarily from aesthetic procedures). We intend to register as

COMPANY
Page 3
February 24, 2026
a de minimis serviceman under Service Occupation Tax if
applicable.
•

Location-Specific Taxes: Sales occur in CITY (COUNTY
County), with applicable local taxes (such as approximately
%%% municipal Retailers’ Occupation Tax, subject to
confirmation). No on-site food consumption facilities exist; all
nutraceuticals/supplements are sold for off-premises
consumption.

•

A La Carte Offerings: Include hormone therapies (such as
Testosterone Therapy), aesthetic services (such as
Hydrafacial), wellness therapies (such as IV Therapy), and retail
products (such as vitamins).

•

Specific Offerings by Category:

1. Hormone-Based Therapies and Related Services:
   Hormone Optimization Plans (Rx), Testosterone
   Therapy, Female Hormone Replacement Therapy (HRT),
   Bioidentical Hormone Replacement Therapy, Hormone
   Nutraceuticals (if Rx-ties), Hormone Consultations.
2. Aesthetic Medical Services: Botox Injections (Rx),
   Dermal Fillers (such as Juvederm, Sculptra) (Rx),
   Hydrafacial,
   Skin
   Peels,
   Hair
   Restoration,
   Microneedling, Body Contouring / CoolSculpting,
   EMSculpt NEO, Cooltone.
3. Wellness-Based Therapy Services: IV Therapy, Red Light
   Therapy Bed, Hyperbaric Oxygen Therapy, NAT+
   Therapy.
4. Nutraceuticals, Vitamins, and Supplements: Serotonin
   Nutraceuticals, Weight Control Nutraceuticals,
   Aesthetic Nutraceuticals, Immunity Nutraceuticals,
   Therapeutic-Grade Vitamins, Retail Skin Care Products.
5. Weight Control and Exercise Services: Weight Loss
   Plans, Muscle Development Programs, Exercise and
   Nutrition Guidance, Weight Loss Medication (Rx).

COMPANY
Page 4
February 24, 2026

6. Lab Testing and Consultations: Monthly Lab Panels,
   Initial Medical Consultations, Hormone and Wellness
   Assessments.
   This request builds on the general guidance in the DATE GIL (Exhibit B),
   seeking binding rulings for our specific facts. Questions Presented
   Based on our particular fact situation:
7. Are hormone-based therapies (such as Testosterone Therapy,
   Female HRT) non-taxable when prescribed and administered by
   licensed Nurse Practitioners, with any tangible personal
   property (such as hormones) incidental to the service?
8. Are related hormone consultations non-taxable pure services?
9. Are aesthetic medical services (such as Botox Injections,
   Dermal Fillers) non-taxable when Rx-based and administered
   by Nurse Practitioners, versus taxable for non-Rx cosmetic
   procedures (such as Hydrafacials, Skin Peels) involving tangible
   personal property?
10. Does the use of topical serums, creams, or equipment in
    aesthetic procedures create a taxable event under Retailers’
    Occupation tax or Service Occupation Tax?
11. Are wellness therapies (such as IV Therapy, Red Light Therapy)
    non-taxable services when no separate tangible personal
    property is transferred beyond incidental use?
12. Do nutraceuticals, vitamins, and supplements qualify for the
    1% reduced rate as “food for human consumption” under 35
    ILCS 120/2-10 when sold for off-premises use?
13. How should taxation apply to retail skin care products?
14. Are weight control services (such as Weight Loss Plans with Rx
    medications) non-taxable, and how should taxation apply if
    bundled with supplements?
15. Are lab testing and consultations non-taxable pure services?

COMPANY
Page 5
February 24, 2026

10. For bundled memberships, if itemized, do non-taxable
    components remain exempt?
11. When applicable, should Service Occupation Tax be calculated
    on cost price of incidental tangible personal property (as de
    minimis serviceman), and at what rates (including local)?
12. Confirm effective date of any changes (such as food exemption
    starting January 1, 2026).
    Relevant Law
    •

Retailers’ Occupation Tax Act (35 ILCS 120/1 et seq.), including
35 ILCS 120/2-10 (reduced rate for food, drugs, and medical
appliances).

•

Service Occupation Tax Act (35 ILCS 115/1 et seq.).

•

86 Ill. Adm. Code 130.101 (general Retailers’ Occupation Tax
application); 130.310 (food and drug taxability); 130.311
(medical appliances and services); 130.1920 (barbers,
cosmetologists, and similar operators – taxable cosmetic
services); 140.101 et seq. (Service Occupation Tax methods).

•

Amendments per P.A. 103-781 (food exemption effective
January 1, 2026).

Taxpayer’s Analysis and Understanding
Informed by the DATE GIL:

1. Hormone-Based Therapies and Related Services: These
   treatments involve prescription drugs administered by licensed
   Nurse Practitioners in a clinical setting. Based on 86 Ill. Adm.
   Code 130.311, we believe these are non-taxable services, with
   any tangible personal property considered incidental and
   subject to Service Occupation Tax at the provider level. GIL
   pages 5-6 explain Service Occupation Tax for incidental
   tangible personal property and de minimis thresholds; page 6
   notes pure services are not taxable; pages 6-8 discuss drugs at
   1% rate.

COMPANY
Page 6
February 24, 2026

2. Aesthetic Medical Services: Injectables like Botox and Fillers,
   administered by prescription, are likely non-taxable under 86 Ill.
   Adm. Code 130.311. Cosmetic services such as Hydrafacials
   and Skin Peels that involve tangible personal property are likely
   taxable under 86 Ill. Adm. Code 130.1920, with Service
   Occupation Tax on tangible personal property (such as serums)
   at cost for 50% of bill if not separated. GIL page 5 discusses
   calculation methods; pages 5-8 on drugs/medical appliances
   and Service Occupation Tax.
3. Wellness-Based Therapy Services:
   These services are
   administered by licensed personnel and do not involve a
   separate sale of tangible personal property. They are not
   interpreted as non-taxable services per 86 Ill. Adm. Code
   130.310. GIL page 6 on pure services not taxable; pages 5-6 on
   Service Occupation Tax only for incidental tangible personal
   property.
4. Nutraceuticals, Vitamins, and Supplements:
   These
   supplements are consumed off-site and are not tied to a
   prescription. As such, we believe the 1% rate applies under 35
   ILCS 120-2-10 and 86 Ill. Adm. Code 130.310. Retail skin care
   products are taxable at the standard state plus local Retailers’
   Occupation Tax rate. GIL pages 6-8 on food/drugs; page 8 on
   non-qualifying items. Potential state exemption post-1/1/2026
   for qualifying food per GIL page 7.
5. Weight Control and Exercise Services: These are service-based
   offerings. However, when supplements are included and not
   itemized separately, the full charge may be taxable. Proper
   invoicing is essential. Non-taxable services under 86 Ill. Adm.
   Code 130.310; Rx medications incidental/non-taxable under
   130.311. GIL page 6 on pure services; pages 5-8 on Rx meds;
   pages 6-8 on supplements at 1%; page 5 on bundling.
6. Lab Testing and Consultations: These services do not involve
   the transfer of tangible personal property and are considered
   non-taxable under 86 Ill. Adm. Code 130.310. GIL page 6
   explicitly states pure services not subject to tax.
   Overall: As projected de minimis, pay Service Occupation Tax on cost
   price (including local rates approximately PERCENTAGE in CITY); provide

COMPANY
Page 7
February 24, 2026
resale certificates to suppliers per GIL pages 5-6. For bundles/memberships:
If taxable and exempt items are bundled into one charge, the entire amount
may become taxable. To avoid this, itemized billing is essential per GIL page
5.
Conclusion
We seek confirmation that: prescription-based medical services are
non-taxable; cosmetic procedures are taxable with Service Occupation Tax
on incidental tangible personal property; nutraceuticals qualify for 1% rate
(exempt post-2026); and itemized bundles preserve exemptions. This will
guide compliant sales practices. Declaration
I declare that the facts stated in this request are true and correct to the
best of my knowledge and belief, and no material facts have been omitted.
DEPARTMENT’S RESPONSE:
The Retailers’ Occupation Tax Act imposes a tax upon persons engaged in this State
in the business of selling tangible personal property at retail to purchasers for use or
consumption. See 86 Ill. Adm. Code 130.101. Use Tax is imposed on the privilege of using,
in this State, any kind of tangible personal property that is purchased anywhere at retail from
a retailer. See 86 Ill. Adm. Code 150.101. These taxes comprise what is commonly known
as “sales tax” in Illinois.
As stated in ST 25-0046-GIL, Retailers’ Occupation Tax and Use Tax do not apply to
sales of service. Under the Service Occupation Tax Act, businesses providing services (i.e.,
servicemen) are taxed on tangible personal property transferred as an incident to sales of
service. See 86 Ill. Adm. Code 140.101. If there is no tangible personal property being
transferred (a pure or standalone service), there is no tax liability as services alone are not
taxed in Illinois. A serviceman’s liability may be calculated in one of four ways:
(1)

Service Occupation Tax on the separately stated selling price of tangible
personal property transferred incident to service;

(2)

Service Occupation Tax on 50% of the serviceman’s entire bill;

(3)

Service Occupation Tax on the serviceman’s cost price if the serviceman is a
registered de minimis serviceman; or

(4)

Use Tax to the supplier on the serviceman’s cost price if the serviceman is de
minimis and is not otherwise required to be registered under the Retailers’
Occupation Tax Act.

COMPANY
Page 8
February 24, 2026
It is the responsibility of the taxpayer to determine their taxability using one of the
aforementioned methods, and ST 25-0046-GIL offers more detailed information on how to
determine which of the four methods would be best applicable to that serviceman. It is
important to note that local tax rates also may be applicable, and vary depending on the tax
rate imposed by the local government in a particular jurisdiction. For local tax rates, see the
Department’s Tax Rate Database and the Tax Rate Finder on the Department’s website at
www.tax.illinois.gov.
As stated in ST 25-0046-GIL items such as food, prescription and non-prescription
medicines, drugs and medical appliances, for human use, are generally subject to tax at a
rate of 1% (low-rate). Whether the items are offered via prescription, administered by
licensed professionals, involved in either medical or cosmetic services, or are more or less
incidental to the sale of service, has no bearing on the taxability of these items. If any of
these items are sold at retail to customers, they will be subject to Retailer’s Occupation Tax
liability. See ST 25-0046-GIL, 35 ILCS 120/2; 86 Ill. Adm. Code 130.101. If any of these items
are transferred as an incident to a sale of service, the items will be subject to Service
Occupation Tax liability. See ST 25-0046-GIL, 35 ILCS 115/3; 86 Ill. Adm. Code 140.101.
For determining whether certain products would fall under either the low-rate (1%) or
the high-rate (6.25%) tax for both Retailers’ Occupation Tax and Service Occupation Tax, ST
25-0046-GIL offers a detailed explanation for making those determinations. It is important
to note that beginning January 1, 2026, food for human consumption that is to be consumed
off the premises where it is sold (other than alcoholic beverages, food consisting of or
infused with adult use cannabis, soft drinks, candy, and food that has been prepared for
immediate consumption) will be exempt from state Occupation and Use taxes. See 35 ILCS
115/3-5(37), 35 ILCS 120/2-5(49), and 35 ILCS 105/3-5(44), as amended by P.A. 103-781.
However, it is the responsibility of the taxpayer to determine if their municipality or county
has enacted a Municipal or County Grocery Occupation Tax imposing tax on these items at
the same rate. See 65 ILCS 5/8-11-24; 55 ILCS 5/5-1006.9; Informational Bulletin FY 202603.
I hope this information is helpful. If you require additional information, please visit
our website at https://tax.illinois.gov/ or contact the Department’s Taxpayer Information
Division at 800-732-8866.
Very truly yours,

GLE:sce

Printed by the authority of the state of Illinois.
Electronic Only - One Copy
Issued 02/24/2026; Redacted 03/05/2026

George L. Encarnacion, Jr.
Associate Counsel