Does Texas sales tax apply to a dialysis re-use machine and a reverse osmosis water-purification machine used in home dialysis treatment?

Plain-English summary

A taxpayer wrote to the Texas Comptroller asking about sales tax on two pieces of medical equipment used in dialysis: (1) a Dialysis Re-Use machine, used to clean artificial kidneys after they've been used on the dialysis machine, and (2) a Reverse Osmosis machine, used to purify the water used in the dialysis process.

The Comptroller's answer was short and conditional: this equipment is not exempt unless it is used during the treatment of the patient. The letter doesn't spell out which exemption category is at issue or cite a specific statute — it simply states the "used during treatment" condition as the test, and notes that different facts, even similar ones, might lead to a different answer.

What this means for you

Medical equipment sellers and dialysis providers

If you sell, lease, or use equipment like a dialysis re-use machine or a reverse-osmosis water purifier in a dialysis setting, this letter signals that the Comptroller looks at how and when the equipment is used, not just what it is. Equipment used during the actual treatment of the patient may qualify for an exemption; the same equipment used for other purposes (cleaning, general water treatment, storage, etc.) may not.

Accountants and tax professionals

This is a very brief, fact-specific response — it does not name the underlying exemption provision or Tax Code section. If you're advising a client on similar equipment, you'll need to independently identify the relevant medical/dialysis exemption and confirm whether the equipment's use fits squarely within "during treatment," since that's the only test this letter actually gives.

Common questions

Q: Are dialysis machines exempt from Texas sales tax?
A: Based on this letter, the equipment described (a Dialysis Re-Use machine and a Reverse Osmosis machine) is not exempt unless it is used during the treatment of the patient.

Q: What if my equipment is used for a related but different purpose?
A: The letter itself warns that "different facts, though similar, might lead to different answers" — so a use that isn't during the patient's actual treatment may not qualify for the same treatment.

Q: Can I rely on this letter for my own equipment?
A: No. This letter binds the Comptroller only as to the taxpayer who requested it and the facts as presented. See the disclaimer below.

Source

• STAR search: https://star.comptroller.texas.gov/search?doc_type_code=L&tax_type_code=SST
• Opinion: https://star.comptroller.texas.gov/view/9305L1237E01

Original ruling text

May 5. 1993

Dear ***:

This is in response to your letter dated April 20,1993, regarding sales tax as
it applies to certain medical equipment.

The two items and their use as described in your letter are: 1.) Dialysis
Re-Use machine that is used to clean the artificial kidneys after they have
been used on the dialysis machine and, 2.) Reverse Osmosis machine that is used
to purify the water used in the dialysis process.

The equipment above is not exempt unless used during the treatment of the
patient.

This opinion is based on the facts presented. Different facts, though similar,
might lead to different answers. If you have any questions or need more
information please write or call me at 1 -800-531 -5441, extension 50330, or
512/463-4600.

Sincerely,

Bettie Peterson
Tax Administration Division

NOTE: Previous Accession Number 9305005L