Mo. Code Regs. tit. 12 § 10-110.013

Current through Register Vol. 49, No. 21, November 1, 2024.
Section 12 CSR 10-110.013 - Drugs and Medical Equipment

PURPOSE: Section 144.030.2(18), RSMo, provides an exemption for prescription drugs, orthopedic and prosthetic devices, numerous dental items, hearing aids, hearing aid supplies and certain sales of over-the-counter drugs. This rule explains the sales tax law as it applies to these exemptions.

(1) In general, sales of prescription drugs, orthopedic and prosthetic devices and certain qualifying health-related equipment, and certain sales of over-the-counter drugs, are exempt from Missouri sales tax.
(2) Definition of Terms.
(A) Orthopedic device-a rigid or semirigid leg, arm, back or neck brace and casting materials which are directly used for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body.
(B) Over-the-counter drug-a drug product which may be purchased without a physician's prescription.
(C) Prescription drug-a drug dispensed by a licensed pharmacist only upon a lawful prescription from a licensed practitioner.
(D) Prosthetic device-a device that replaces all or part of the function of a permanently inoperative or malfunctioning internal body organ and is medically required.
(3) Basic Application of Tax.
(A) Sales of prescription drugs, insulin, medical grade oxygen, drug samples and materials used to manufacture samples, which may be dispensed by a licensed practitioner are exempt from tax. Sales of over-the-counter drugs when sold to an individual with a disability or to the individual's agent are exempt from tax. When selling over-the-counter drugs to an individual with disability, the retailer should obtain a purchaser's signed statement of disability. The retailer should retain these statements for three (3) years. The statement should include the purchaser's name, type of purchase and amount of purchase, and be signed by the purchaser or the purchaser's agent. The retailer should request a form of identification, such as driver's license, credit card, etc. to verify the identity of the purchaser. Sales of prosthetic devices as defined on January 1, 1980, by the Federal Medicare Program under Title XVIII of the Social Security Act of 1965 are exempt from tax.
(B) Sales of orthopedic devices as defined by the Federal Medicare Program under Title XVIII of the Social Security Act of 1965 are exempt from tax.
(C) Also exempt from sales tax are items specified in section 1862(A)(12) of the Social Security Act of 1965. Exempt items included in this class are those used in connection with the treatment, removal or replacement of teeth or structures directly supporting teeth. Dental equipment or supplies are not exempt. The exempt items include:
1. Dentures
2. Inlays
3. Bridge work
4. Fillings
5. Crowns
6. Braces, or
7. Artificial dentistry and dental reconstructions, which are made, manufactured or fabricated from molds or impressions made by dentists of the mouths of their particular patients and sold to dentists for insertion in the patient's mouth as the direct support of, substitution for, or part of the patient's teeth.
(D) Sales of other specific health-related equipment and accessories are exempt from sales tax.
1. These specific items are-
A. Ambulatory aides
B. Braille writers
C. Electronic Braille equipment
D. Home respiratory equipment and accessories
E. Hospital beds and accessories
F. Stairway lifts
G. Wheelchairs, manual and powered
2. If purchased by or on behalf of a person with one or more physical or mental disabilities to enable them to function more independently, the following items are also exempt:
A. Electronic print enlargers and magnifiers
B. Electronic alternative and augmentative communication devices
C. Items used solely to modify motor vehicles to permit the use of such motor vehicles by individuals with disabilities
D. Reading machines
E. Scooters
(4) Examples.
(A) A retailer sells an over-the-counter drug to an individual claiming a disability. The sale is exempt if the retailer obtains from the purchaser or their agent a statement similar to the following:

Purchases of over-the-counter drugs by individuals with disabilities are exempt from sales tax. IT IS UNLAWFUL TO FRAUDULENTLY CLAIM AN EXEMPTION. I CERTIFY THAT I HAVE A DISABILITY AND AM ENTITLED TO CLAIM THIS EXEMPTION OR I AM CLAIMING THIS EXEMPTION ON BEHALF OF A PERSON OR PERSONS WITH A DISABILITY.

Type of Purchase____________

Amount___________

Type of ID___________

ID Number___________

Name (print)___________

Signature_______________

(B) Examples of exempt prosthetic devices include:
1. Breast prosthetics, including surgical brassieres for postmastectomy patients
2. Cardiac pacemakers
3. Colostomy and other ostomy bags and the necessary equipment required for attachment
4. Electronic speech aids if the patient has had a laryngectomy or his/her larynx is permanently inoperative
5. Hearing aids and hearing aid supplies
6. Hemodialysis equipment
7. Maxillofacial devices and devices which replace all or part of the ear or nose
8. Prosthetic lenses which replace the lens of an eye
9. Urinary collection systems, including Foley catheters, when replacing bladder function in cases of permanent urinary incontinence
10. Eyeglasses, contact lenses, bedpans and incontinent apparel are not considered prosthetic devices and are subject to sales tax
(C) Examples of exempt orthopedic devices include:
1. Artificial legs, arms and eyes including terminal devices such as artificial hands
2. Hoods and space shoes which replace part of a foot
3. Orthotics
4. Stump stockings and harnesses when they are essential to the effective use of an artificial limb
5. Trusses
6. Elastic braces, elastic stockings, arm slings, elastic wraps and garter belts, are not considered orthopedic devices and are subject to sales tax
(D) Examples of exempt orthopedic and prosthetic devices used in dentistry include:
1. Restorative materials.
A. Acrylics
B. Aluminum crowns
C. Amalgam
D. Bases and liners
E. Cements
F. Chrome steel crowns
G. Copper bands
H. Crown forms
I. Dentin enamel adhesives
J. Denture anchors
K. Denture repair materials
I. Denture teeth
M. Gold
N. Mercury
0. Pins
P. Pit and fissure sealants Q. Porcelains
R. Posts
S. Temporary filling materials T. Zinc oxide (Eugenol)
2. Prosthetic devices and supportive materials.
A. Acrylics
B. Bonding materials
C. Chrome alloys
D. Composed materials
E. Denture anchors
F. Denture repair materials
G. Denture teeth
H. Implant materials
I. Metal alloys
3. Orthodontic devices and materials.
A. Arch bar splits
B. Bone grafting materials
C. Cresitine
D. Endodontic materials
E. Face bow head gear
F. Gortex grafting materials
G. Gutta percha points
H. Muscosal grafts (natural and artificial)
I. Orthodontic appliances
J. Orthodontic brackets
K. Orthodontic elastics
L. Orthodontic expansion screw
M. Orthodontic resins
N. Orthodontic separators
O. Orthodontic waxes
P. Orthodontic wires
Q. Root canal sealants
R. Silver points
S. Surgical wires
(E) Sales of other specific health-related equipment and accessories are exempt from sales tax.
1. These specific items are-
A. Ambulatory aides
B. Braille writers
C. Electronic Braille equipment
D. Hospital beds and accessories
E. Home respiratory equipment and accessories
F. Stairway lifts
G. Wheelchairs, manual and powered
2. If purchased by or on behalf of a person with one (1) or more physical or mental disabilities to enable them to function more independently, the following items are also exempt:
A. Electronic alternative and augmentative communication devices
B. Electronic print enlargers and magnifiers
C. Items used solely to modify motor vehicles to permit the use of such motor vehicles by individuals with disabilities
D. Reading machines
E. Scooters

12 CSR 10-110.013

AUTHORITY: section 144.270, RSMo 1994.* Original rule filed Sept. 29, 1999, effective April 30, 2000.

*Original authority: 144.270, RSMo 1939, amended 1941, 1943, 1945, 1947, 1955, 1961.