VAT-ready invoicing for clinics in Egypt: a practical guide

Aesthetic clinics sit in an awkward place: part healthcare, part retail. The result is that invoicing rules that are simple for a pharmacy or a restaurant get complicated the moment a patient buys a six-session package with a deposit and a discount. This guide covers the cases that come up every week. It is a practitioner's summary, not tax advice; confirm the details with your accountant.

What the invoice must show

Whatever your software calls it, a clinic invoice in Egypt should carry:

• A sequential number per branch that never repeats or skips.
• The clinic's registered name, address and tax registration number.
• Date of issue and, where different, date of service.
• Each service or product as its own line with quantity, unit price and discount.
• The VAT line at the applicable rate, shown separately from the net.
• What was paid, how (cash, card, InstaPay, Fawry, bank), and what remains.
• The patient's name and, for corporate or insurance billing, their details.

How VAT applies to aesthetic services

Medical services delivered by a licensed physician can be exempt, while cosmetic and beauty services are generally taxable at the standard rate of 14 percent. Many clinics deliver both. The safe approach is to set the tax treatment per service in the catalog once, with your accountant, rather than deciding at the counter. Products sold over the counter (creams, sunscreens) are taxable.

Your software should let you mark each service as taxable or exempt and print the rate on the line, so a mixed invoice comes out right without anyone doing arithmetic.

Packages: invoice at sale or per session?

The two defensible approaches:

1. Invoice the full package at sale. Simple, and it matches when the money is collected. Revenue recognition is then handled in the accounts by deferring the unearned part and releasing it per session.
2. Invoice per session. Each delivered session gets its own invoice; the up-front payment sits as a deposit until then.

Either works if the accounting behind it is right. What does not work is invoicing the package at sale and invoicing sessions again as they are delivered, which double-counts revenue. Good software prevents this by linking sessions to the plan they were sold under.

Deposits are not income

A deposit collected at booking is a liability until the service happens. On the invoice it appears as an amount applied, reducing the balance due. If a patient forfeits a deposit, that is income, but under its own account so the accountant can see it. See the separate article on deposits for the operational side.

Discounts

Two rules keep discounts clean:

• Show the discount on the line or the invoice, never by quietly lowering the price. Auditors and owners both want to see how much was given away.
• Post discounts to a discount account in the ledger if you want to manage them. A clinic that discounts 12 percent of gross without knowing it is losing margin silently.

Refunds and credit notes

A refund is not a deleted invoice. Issue a credit note that references the original, refund through the same cash or bank journal, and let the ledger show both. Deleting invoices breaks the sequence, and a broken sequence is the first thing an inspector looks for.

Month end: what the accountant will ask for

• The sales journal: every invoice, in sequence, with VAT totals.
• VAT collected versus VAT paid on purchases.
• Deposits held at month end (a liability) and deposits applied during the month.
• Deferred package revenue, if you invoice packages at sale.
• Cash, card and InstaPay reconciliation against bank statements.

If these come out of your clinic system as reports rather than as a spreadsheet someone builds on the 30th, month end takes an afternoon. If not, the software is costing you a bookkeeper.

Multi-branch

Each branch needs its own invoice sequence and its own cash journals, while the tax registration and the chart of accounts stay shared. Reports should roll up by branch and in total. This is where spreadsheet-based clinics usually give up; it is also where a real ledger pays for itself.