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STJ Tema 217 · SPD Advocacia

Hospital rate equivalence: the clinic may pay much less IRPJ and CSLL

Clinics under the presumed profit regime that perform hospital-type procedures may calculate IRPJ (corporate income tax) on 8% and CSLL (social contribution on net profit) on 12% of revenue, instead of 32%. They may also recover what they overpaid.

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How does the reduction work?

Under presumed profit, the rule for services is to presume 32% of revenue as the IRPJ and CSLL base. Law 9,249/1995 reduces this base to 8% (IRPJ) and 12% (CSLL) for hospital services and for other healthcare services it lists.

The STJ (Brazil's Superior Court of Justice) decided in Tema 217 that what matters is the nature of the service, not whether there is inpatient admission. Simple consultations are excluded. Since Law 11,727/2008, the clinic must also be a business company (sociedade empresária) and comply with the rules of Anvisa (Brazil's health regulatory agency).

Point of attention. Changing the company registration alone is not enough: the business structure must be real. Whether dental clinics qualify will be decided by the STJ in Tema 1.427, accepted for judgment in April 2026 and still pending. Complementary Law 224/2025 increased the presumption percentages by 10% on the portion of annual gross revenue that exceeds R$ 5 million.

Requirements

Key points

Presumed profit

A clinic that calculates IRPJ and CSLL under presumed profit.

Hospital-type service

Procedures of a hospital nature, not only consultations.

Business company

A real business organization, registered with the Junta Comercial (state commercial registry).

Anvisa rules

Health license and facilities in line with the rules.

Source: Law 9,249/1995, arts. 15, § 1º, III, a, and 20, III; Law 11,727/2008; Complementary Law 224/2025; STJ, Temas 217 (REsp 1.116.399) and 1.427.

What is your case?

Situations the firm handles

Procedures

Clinics with outpatient surgery

Procedures of a hospital nature.

STJ, Tema 217
Diagnostics

Imaging and laboratories

Imaging exams and clinical analyses.

Law 9,249/1995
Therapies

Physical therapy and oncology

Treatments with their own facilities.

STJ, Tema 217
Third-party hospitals

Doctors who operate in hospitals

There are decisions both ways.

Case review
Dentistry

Dental clinics

Issue still under discussion at the STJ.

STJ, Tema 1.427
Point of attention

Consultations only

Simple consultations are excluded from the reduction.

STJ, Tema 217
This page provides general information, does not replace an analysis of the case and there is no guarantee of results.

Step by step

How the firm works

  1. Review. We check the tax regime, invoices, payment slips and tax calculations for the last 5 years.
  2. Calculation. We show how much may be recovered and how much the company stops paying from now on.
  3. Filing. Administrative request, tax offset or lawsuit in the Federal Courts, depending on the case.
  4. Follow-up. Deadlines, decision, offset and receipt of the amounts.
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Case review

Let us review your case

Answer the questions, one at a time. At the end you can attach documents, which go straight to a folder in the firm's Drive, and send the summary via WhatsApp. Everything is protected by attorney-client confidentiality.

Common questions

Frequently asked questions

Does it apply to a clinic in the Simples?

No. The reduction belongs to the presumed profit regime. We assess whether changing from the Simples Nacional (the simplified regime for small businesses) is worthwhile.

Can I recover past amounts?

Yes. If the requirements were already met, the amounts overpaid in the last 5 years may be recovered.

Do I need to change the articles of association?

If the clinic is still a non-business partnership (sociedade simples), the company may need to be reorganized. We review this before any change.

What about the tax reform?

The reform changes consumption taxes. IRPJ and CSLL remain, and the hospital equivalence reduction stays in force.

Do you work with companies from other states?

Yes. Proceedings are electronic and service is online across the country.

How much does it cost?

After the review, the firm sends a written fee proposal, before any engagement.

Lawyer for hospital rate equivalence

SPD Advocacia serves clinics across Brazil, and clients abroad, that want to apply hospital rate equivalence and recover overpaid IRPJ and CSLL.

STJ Tema 217

Hospital services are defined by the nature of the activity, excluding simple consultations.

Requirements

Business company and compliance with Anvisa rules, since Law 11,727/2008.

Informational content, in accordance with OAB (Brazilian Bar) Provision 205/2021. Each case depends on a review of the documents, and no result is promised.

Responsible lawyers

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  • Adrielle Oliveira OAB/GO 76.298 · civil, family, business and international matters
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