A pharmacy offering a blood test as a Selbstzahlerleistung, a service the customer pays for directly, sets the price itself, because the Arzneimittelpreisverordnung (AMPreisV) governs medicine prices and not services.
The tax question is the one that gets answered wrongly. The conservative position is 19 percent Umsatzsteuer, because the Heilbehandlung exemption in § 4 Nr. 14 Buchstabe a UStG reaches pharmacies in two named cases only.
Self pay is also the only route open, because the expanded catalogue of pharmazeutische Dienstleistung entries reaches insurers only on 1 January 2027, after a pay negotiation running to 1 November 2026.
The AMPreisV governs medicine prices and not service prices
ABDA states the scope in one line: the AMPreisV "regelt die Preisbildung aller verschreibungspflichtigen Arzneimittel". Outside it a pharmacy can "ihre Preise eigenverantwortlich kalkulieren", meaning price on its own responsibility.
The permission sits in § 1a Abs. 11 ApBetrO, the list of apothekenübliche Dienstleistung entries, which since the Apothekenversorgung-Weiterentwicklungsgesetz includes "die Vorbereitung und Durchführung von Blutentnahmen". That list governs the offer and not the fee. The law is set out in the ApoVWG guide.
Free pricing is not unlimited pricing, because the Preisangabenverordnung requires a Gesamtpreis including Umsatzsteuer and the Berufsordnung of the chamber governs the presentation.
Three different things get called a pharmacy service
The three overlap in conversation and separate in law, which is where owners lose money. The apothekenübliche Dienstleistung is the permission, the pharmazeutische Dienstleistung is a defined service paid from the pDL Topf, and the Selbstzahlerleistung is how the customer pays. A blood test is the first, sold as the third.
| | pharmazeutische Dienstleistung | apothekenübliche Dienstleistung | Selbstzahlerleistung |
|---|
| Who pays | The pDL Topf via the Notdienstfonds | Whoever commissions it | The customer, directly |
|---|
| What sets the price | A Schiedsspruch, 11,20 euro netto | Nothing, because ApBetrO regulates the offer | The pharmacy, within PAngV and HWG |
|---|
| When it is available | Insurers, from 1 January 2027 | Now, under § 11c ApoG | Now |
|---|
| What the customer sees | A signature and no invoice | Depends on the commission | A priced invoice |
|---|
The VAT exemption is narrow and the default is wide
§ 4 Nr. 14 Buchstabe a UStG exempts a Heilbehandlung im Bereich der Humanmedizin. Two conditions hold together: a therapeutic aim has to be in the foreground, which the Umsatzsteuer-Anwendungserlass states directly, and the provider has to hold the professional qualification the exemption assumes.
For pharmacies the second condition is where it stops. UStAE 4.14.4 names pharmacists among the similar health professions in two situations only: "Apothekerinnen und Apotheker, die im Rahmen des Modellvorhabens nach § 132j SGB V Grippeschutzimpfungen durchführen", and those handing over Substitutionsmittel for immediate use. That wording comes from the BMF-Schreiben of 12 March 2021, and a blood draw under § 11c ApoG does not appear.
The pDL side points the same way. The Notdienstfonds "kalkuliert den Auszahlungsbetrag als Bruttobetrag der im Schiedsspruch ausgewiesenen Netto-Honorare mit dem aktuell gültigen Mehrwertsteuersatz von 19%", and cannot show the tax separately, because as a non-entrepreneur it would expose the pharmacy to § 14c Abs. 2 UStG.
Two points belong with a Steuerberater. Whether the Finanzverwaltung widens that list now that § 11c ApoG exists is [team to confirm]. The treatment of the bought in laboratory analysis is the second, because an exempt input carries no Vorsteuerabzug, also [team to confirm]. Self pay Corona tests are the precedent, because advisers found the exemption there rested on a ministry FAQ rather than on statute.
The price gets anchored against numbers the market already set
The number to work from is 11,20 euro netto, what the Schiedsspruch pays for the standardisierte Risikoerfassung hoher Blutdruck. Because the Notdienstfonds adds 19 percent it arrives as 13,33 euro. ABDA president Preis called it "uninteressant", and roughly 475 million euro sits unclaimed in the pDL Topf.
Three further points frame the range. The Grippeimpfung honorar rises to 11 euro from September 2026 and is exempt under that same BMF-Schreiben, so the pharmacy keeps all of it. The dm pilot with Aware Health in Karlsruhe puts a großes Blutbild at around 10 euro, with profiles up to about 70 euro. The Fixum is 9,00 euro since 1 July 2026 and 9,50 euro from 1 January 2027, as the post on pharmacy pay and the Fixum sets out.
Each of those numbers prices one act, and a blood test is not one act. It contains the Aufklärung and the Anamnese, which may never be delegated, the venöse Blutentnahme by an approbierter Apotheker after a confirmed ärztliche Schulung, the Präanalytik, the laboratory analysis, and the Befund conversation. Precision reads better than roundness, because 49,00 euro looks calculated where 50 euro looks chosen.
Competing with dm on price is a position a pharmacy loses
The dm pilot runs blood analysis through Aware Health with an employed phlebotomist in the store, a partner laboratory under RiliBÄK, and results in about two working days by app. Around 10 euro for a großes Blutbild is not a margin but a reason to walk into a drugstore.
A pharmacy cannot match that, because § 11c ApoG binds the draw to an approbierter Apotheker in their own öffentliche Apotheke, the room may not be used for anything else, a Standardarbeitsanweisung sits in the QMS, and the authority is notified a week ahead.
What a pharmacy sells instead is the part dm cannot assemble, because the person explaining the Befund also dispenses the medicine, holds the Medikationsplan and is reachable next week without an appointment. That is worth a multiple of 10 euro, and worth nothing once the pharmacy agrees to be compared on price, as the post on self pay services in the pharmacy sets out.
The Heilmittelwerbegesetz limits how the price may be presented
A blood test falls inside the Heilmittelwerbegesetz, because § 1 Abs. 1 Nr. 2 HWG covers "andere Mittel, Verfahren, Behandlungen und Gegenstände" whenever the claim relates to the Erkennung of an illness. Diagnostics are recognition, so the law applies to the whole offer.
§ 3 HWG rules out attributing a therapeutic effect the service does not have, and rules out the false impression that a success can be expected with certainty, so copy promising certainty is the exposure. In § 11 Abs. 1 HWG, Nr. 3 on Krankengeschichten and Nr. 11 on Äußerungen Dritter bite where the presentation is missbräuchlich, abstoßend or irreführend, which makes customer testimonials risky, and Nr. 13 rules out Verlosungen. Nr. 1 and Nr. 4 are weggefallen, so older guidance on Gutachten and Berufskleidung no longer holds.
The customer receives an invoice and not an ärztliche Liquidation
A self payer receives an invoice in their own name showing the pharmacy, the date, the service, the Gesamtpreis and the tax rate. That is the sharpest difference from the pDL route, where a pDL for a privately insured person is settled between the pharmacy and the Notdienstfonds, and the PKV-Verband confirmed that "Privatversicherte keine Zahlung in der Apotheke zu leisten haben und somit auch keine Rechnung ausgestellt bekommen".
Privately insured customers do ask for something they can submit, and the honest answer is qualified. § 4 Abs. 2 MB/KK grants the free choice "unter den niedergelassenen approbierten Ärzten und Zahnärzten", and § 6 Abs. 1 MB/KK makes payment depend on the Nachweise the insurer requires. Reimbursement follows the individual Tarif, so a pharmacy promising it cannot keep the claim.
The GOÄ is a reference point and not a billing basis
The GOÄ prices the blood draw at 40 Punkte under Ziffer 250, which is 2,33 euro at the einfacher Satz and 4,20 euro at the 1,8-fach Regelhöchstsatz. A pharmacy does not bill under it, because the Gebührenordnung für Ärzte applies to doctors while a pharmacy price is a contract price. The figure still answers a customer comparing with a practice invoice, and shows how little value sits in the draw.
Questions pharmacy owners ask about pricing a blood test
Is a blood test in the pharmacy umsatzsteuerpflichtig?
The conservative position is 19 percent. UStAE 4.14.4 and the BMF-Schreiben of 12 March 2021 reach pharmacies only for Grippeschutzimpfungen and the Sichtvergabe of Substitutionsmitteln. A Steuerberater decides the individual case.
Can a privately insured customer submit a pharmacy invoice to their insurer?
They can submit it, and reimbursement depends on their Tarif. The Musterbedingungen build the entitlement around treatment by niedergelassene approbierte Ärzte, so no pharmacy should promise reimbursement.
May a pharmacy advertise a price for a blood test?
Yes, and the price shown to a consumer is the Gesamtpreis including Umsatzsteuer. The HWG restricts the surrounding claim, so no promise of certainty, no misleading testimonials, and no prize draws.
Should a pharmacy match the dm price of around 10 euro?
That price reflects a drugstore using a blood test to bring people in, not the cost of the service under § 11c ApoG. A pharmacy carrying an approbierter Apotheker, a dedicated room and a Standardarbeitsanweisung competes on interpretation instead.
What a pharmacy does before it sets a price
The sequence that works starts with cost rather than with the competition. A pharmacy adds up the pharmacist minutes for Aufklärung, Anamnese, draw and Befund conversation, the laboratory invoice, the consumables and the room out of use, then decides what that hour has to earn against dispensing. The tax treatment is settled with a Steuerberater before the price is published. The technical side is covered in the post on point of care testing in the pharmacy.
This article is general information about German pharmacy law and business practice, not legal advice and not tax advice. The responsible Apothekerkammer, a lawyer or a Steuerberater decides individual cases.
