Regulatory updates - Italy

The Milleproroghe Decree 2025, converted into Law No. 15/2025, extends the ban on issuing healthcare e-invoices to natural persons (B2C) for those required to send data to the Health Card System (Sistema Tessera Sanitaria) for processing the pre-filled tax return until December 31, 2025.

This exemption applies to healthcare services provided directly to end consumers by doctors, dentists, private healthcare facilities, and other healthcare providers.

The exemption for B2C healthcare e-invoices addresses concerns regarding compliance with privacy regulations, such as the EU General Data Protection Regulation (GDPR), and the risks associated with transmitting sensitive patient data through the SDI (Sistema di Interscambio).

On December 19, 2024, the Council Implementation Decision 2024/3150, allowing Italy to continue with mandatory e-invoicing, was published. Compared to the Proposal Decision, this Decision includes updated information and extends the timeline until December 31, 2027. The deadline will apply unless the Council implements a new general electronic invoicing system based on Article 113 or any other relevant provision of the Treaty on the Functioning of the European Union (TFEU).

Article 113 of the TFEU addresses harmonizing legislation concerning indirect taxation within the EU. Specifically, it authorizes the EU Council to adopt measures for aligning the laws, regulations, and administrative actions of the Member States related to turnover taxes, excise duties, and other forms of indirect taxation. This harmonization aims to ensure the internal market's proper functioning and prevent distortion of competition.

Following the European Union’s cross-border SME scheme and Legislative Decree 180/2024, the Revenue Agency’s (Agenzia delle Entrate) Provision outlines the criteria for this category of small businesses and the information that must be included in the notification to the Revenue Agency before businesses may benefit from this regime.

Pre-requisites for businesses and notification submission

• Businesses established in the European Union with a total annual turnover in the European territory below 100,000 EUR;

• The annual turnover of the enterprise in each Member State where SMEs want to make use of the VAT exemption must not exceed the national annual threshold (currently 85,000 EUR in Italy) or sectoral threshold;

• From January 1, 2025, it’s possible for businesses to transmit the required notification via the Revenue Agency’s web services to obtain a so-called EX identification number.

Once the EX identification number is received from the Revenue Agency the business can start applying the exemption regime.

More details are listed on the Revenue Agency’s website (in Italian).