Texas released Private Letter Ruling 201807014L July 30, 2018 detailing the documentation support required to purchase therapeutic appliances tax free (hot tubs, back braces, anything a doctor prescribes for treatment of an ailment). Basically, a prescription is required in all circumstances, a prescription and exemption certificate and signed statement from the doctor is required in some circumstances and a single document may be acceptable support as well. The importance of documenting (and being able to retrieve documents) exempt transactions cannot be stressed enough.
“The document should also specify the type of treatment or appliance needed for treating the person’s condition. See Rule 3.298(g)(7) (Amusement Services) and STAR Accession Nos. 9403195L (March 11, 1994) and 8510L0667E07 (October 7, 1985). The prescription does not need to be written on prescription pad paper to be sufficient proof that a licensed practitioner of the healing arts prescribed the item to the patient. See STAR Accession No. 8504L0642A06 (Apr. 29, 1985). The purchaser must provide the conforming prescription to the seller before or at the time of sale. See Comptroller’s Decision No. 29,776 (1993).
Rule 3.284(d)(11)(B) contains two additional documentation requirements for the purchase of a hot tub, spa, or similar appliance to qualify for exemption—an exemption certificate and a signed statement from the licensed practitioner specifying the medical requirements for the item.
The rule does not require the prescription document and the signed statement to be separate documents. A single signed document may contain the prescription information and the medical requirements for the item. For example, if the prescription pad paper includes the medical requirements for the item, it is not necessary for a patient to provide a separate signed statement. For other therapeutic appliances, Rule 3.284(d)(11)(A) only requires a prescription document, as described above, to support the exemption.”
For more detail