March 22, 1982

You inquire whether the Massachusetts sales tax applies to sales of the ********** Dorsal Cord Stimulation System, the Brain Stimulation System, and the ********** Spinal Cord Stimulation System ("Stimulation Systems"). Each system is designed to control chronic, intractable pain by electrical stimulation of nerve structures; the stimulation produces nerve impulses that directly or indirectly inhibit the perception of pain. Each system consists of a receiver and related items that are surgically implanted in the patient, tools and accessories used in the implantation, and an external transmitter and antenna used by the patient and his physician to control the electrical character of the stimulation.

The systems differ primarily in the state of implantation. In one system the receiver is implanted in the chest, in another, it is implanted in the spinal cord, and in the third it is implanted in the brain.

The external components of each system are worn or carried about the body during treatment. Treatment varies among patients only in the implantation sites and the setting of controls; the systems need not be modified to suit the needs of particular patients.

The Stimulation Systems may be sold only by or on the order of a physician.

Massachusetts General Law Chapter 64H, Section 6(1) provides that the sales tax does not apply to

"[s]ales of medicine…on prescriptions of registered physicians…; sales of artificial devices individually designed, constructed or altered solely for the use of a particular crippled person so as to become a brace, support, supplement, correction or substitute for the bodily structure including the extremities of the individual; [and] sales of artificial limbs, artificial eyes, hearing aids and other equipment worn as a correction or substitute for any functioning portion of the body."

Based on the foregoing, it is ruled that the Massachusetts sales tax applies to sales of the Stimulation Systems.

Very truly yours,

/s/L. Joyce Hampers

L. Joyce Hampers
Commissioner of Revenue

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LR 82-24