LR 8406
Taxability of Durable Medical Equipment
August 26, 2026
August 26, 2026
Dear Applicant:
This is a letter ruling issued by the Director of Revenue under Section 536.021.10, RSMo, and Missouri Code of State Regulations 12 CSR 10-1.020, in response to your letter dated July 27, 2026.
The facts presented in your letter ruling request are summarized as follows:
Applicant is a Missouri limited liability company based in Saint Louis, Missouri. Applicant wishes to verify whether a list of items fall under exemptions from Missouri sales taxes as applied to durable medical equipment ("DME"). The list of items consists of the following:
1. Lift chairs 9. Wheelchair cushions
2. Shower chairs 10. Cane tips
3. Transfer benches 11. Sock aids
4. Bedside commodes 12. Sliding boards
5. Toilet seats/risers 13. Hoyer lifts
6. Shoe horns 14. Ramps
7. Walker baskets 15. Gait Belts
8. Walker accessories 16. Reachers
ISSUE:
Do the listed items qualify for the sales tax exemption contained in Section 144.030.2(18), RSMo?
RESPONSE:
No. The listed items do not qualify for the sales tax exemption contained in Section 144.030.2(18), RSMo.
Section 144.020.1, RSMo, provides that "[a] tax is hereby levied and imposed upon all sellers for the privilege of engaging in the business of selling tangible personal property or rendering taxable service at retail in this state."
Section 144.030.2(18), RSMo, provides, in relevant part:
"There are . . . specifically exempted from the provisions of the local sales tax law . . . all sales, rentals, repairs, and parts of durable medical equipment . . . as defined on January 1, 1980, by the federal Medicare program pursuant to Title XVIII of the Social Security Act of 1965 . . . "
§ 144.030.2(18), RSMo Cum. Supp. 2025.
42 U.S.C. § 1395X(s)(6), as it read on January 1, 1980, clarified that "durable medical equipment" includes, in relevant part:
[I]ron lungs, oxygen tents, hospital beds, and wheelchairs (which may include a power-operated vehicle that may be appropriately used as a wheelchair, but only where the use of such a vehicle is determined to be necessary on the basis of the individual's medical and physical condition and the vehicle meets such safety requirements as the Secretary may prescribe) used in the patient's home (including an institution used as his home), whether furnished on a rental basis or purchased . . .
42 U.S.C. § 1395x(s)(6) (1976) (current version at 42 U.S.C. § 1395x(n) (2024)).
The language used in legal statutes may be primarily construed by their plain and ordinary meaning. Tax credits and exemptions "are construed strictly and narrowly against the taxpayer."
None of the items listed by Applicant can be classified as iron lungs, oxygen tents, hospital beds, or wheelchairs by their plain and ordinary meanings. Therefore, none of the items meet the definition of DME as provided in Section 144.030.2(18), RSMo. Because the items do not meet the definition of DME, Applicant may not sell the listed items under the state sales tax exemption for DME.
This letter ruling is binding upon the Department of Revenue with respect to the Applicant for three (3) years from the date of this letter and is subject only to statutory changes by the General Assembly and to changes in the interpretation of law by the courts or administrative tribunals. If a change occurs, the taxpayer who relies upon an outdated interpretation may be subject to additional taxes, interest and penalties, which may be imposed prospectively from the date of the change. For this reason, the interpretation set forth above should be reviewed on a regular basis. Please note that any change in or deviation from the facts as presented will render this ruling inapplicable.
Should?additional?information be needed, please contact Legal Counsel Justin Dussold, General Counsel's Office, Post Office Box 475, Jefferson City, Missouri 65105-0475, phone (573) 751-0961.
Sincerely,
Trish Vincent