Which items sold to physical therapy patients — crutches, braces, straps, resistive bands, cold packs, taping supplies, heel lifts — are exempt from Texas sales tax, and does each one need a doctor's prescription?

Plain-English summary

A physical therapy company asked the Comptroller how sales tax applies to ten common items it sells to patients. The Comptroller answered item by item, and the list splits into two groups:

Exempt with NO prescription required (as prosthetic devices or braces):

• Crutches
• Tennis elbow straps
• Patellar straps
• Lumbar (back) supports

Exempt ONLY with a doctor's prescription (as therapeutic devices):

• Theraband (resistive strengthening band)
• Cold packs
• Theraputty
• Over-the-door pulleys
• McConnell taping supplies
• Heel lifts

The line the Comptroller draws is between items classified as prosthetic devices or braces (which are exempt outright, no prescription needed) and items classified as more general therapeutic devices (which need a doctor's prescription to qualify for the exemption).

What this means for you

Physical therapy practices and medical supply retailers

Check which category each item you sell falls into before assuming it's tax-exempt. Braces and prosthetic-type items (crutches, elbow/patellar straps, lumbar supports) don't need a prescription on file. But therapeutic items like resistive bands, cold packs, and taping supplies do — without a prescription, expect to charge sales tax on those.

Patients purchasing PT supplies

If your provider tells you a therapeutic item (like a Theraband or cold pack) requires a doctor's prescription to be sold tax-free, that tracks with this letter — it's not an arbitrary requirement, it's tied to how the Comptroller classifies "therapeutic device" exemptions versus "prosthetic device"/"brace" exemptions.

Accountants and tax professionals

This letter is a handy item-by-item reference for the prosthetic-device/brace vs. therapeutic-device distinction in the durable medical equipment exemption space, though it doesn't cite the specific Tax Code section or rule number in the available text — confirm current statutory citations before relying on it for a new fact pattern.

Common questions

Q: Do I need a doctor's prescription to buy crutches tax-free in Texas?
A: No, according to this letter — crutches are exempt as a prosthetic device with no prescription required.

Q: Is a cold pack sold to a physical therapy patient tax-exempt?
A: Only with a doctor's prescription — cold packs are classified as a therapeutic device, which requires a prescription for the exemption to apply.

Q: What's the difference between the prescription-free items and the prescription-required items on this list?
A: The prescription-free items (crutches, elbow/patellar straps, lumbar supports) are classified as prosthetic devices or braces. The prescription-required items (Theraband, cold packs, Theraputty, over-the-door pulleys, McConnell taping supplies, heel lifts) are classified as therapeutic devices.

Citations and references

No specific statute or rule section was cited in the available text of this letter.

Source

• STAR search: https://star.comptroller.texas.gov/search?doc_type_code=L&tax_type_code=SST
• Opinion: https://star.comptroller.texas.gov/view/200007534L

Original ruling text

Date: July 28, 2000

From: Bettie Peterson

To: **

Subject: PHYSICAL THERAPY COMPANY

Thank you for your recent email. Items you ask about that are sold to patients
receiving physical therapy are restated below followed by my response.

1. Crutches - Exempt as a prosthetic device. A prescription is not required.

2. Tennis Elbow Straps - Exempt as a brace. A prescription is not required.

3. Patellar Straps - Exempt as a brace. A prescription is not required.

4. Theraband (resistive band for strengthening) - Exempt as a therapeutic
   device when sold to an individual with a doctor's prescription.

5. Cold packs - Exempt as a therapeutic device when sold to an individual with
   a doctor's prescription.

6. Lumbar supports (back) - Exempt as a brace. A prescription is not required.

7. Theraputty - Exempt as a therapeutic device when sold to an individual with
   a doctor's prescription.

8. Over-The-Door-Pulleys - Exempt as a therapeutic device when sold to an
   individual with a doctor's prescription.

9. McConnell Taping Supplies (specific taping only able to be purchased through
   a medical supply company) - Exempt as a therapeutic device when sold to an
   individual with a doctor's prescription.

10. Heel Lifts - Exempt as a therapeutic device when sold to an individual with
    a doctor's prescription.

Referenced rules are available at
.

The State Tax Automated Research system, that provides viewing and downloading
of rules, edited letter rulings, hearings, AG Opinions, etc., may be accessed
on the Internet at http://www.window.state.tx.us/.

This opinion is based on the facts you submitted and current law. Other facts,
though similar, may result in different answers.

If you have questions or need more information, I will be glad to help you.
You may call me toll free from anywhere in the United States at 1-800-531-5441,
extension 5-0330.