Tax Guide for Elective Ultrasound Providers


Traditional two dimensional (2D) sonograms and ultrasounds are used by doctors and hospitals to ensure pregnancies progress normally and to check for potential abnormalities or health risks to expectant women and their unborn babies. Now, due to recent advancements in prenatal imaging, the growing elective ultrasound provider industry offers advanced three and four dimensional (3D/4D) imaging technologies to allow pregnant women to see images of their unborn baby and learn the baby's gender when they so choose.

In addition to imaging/scanning services, many elective ultrasound providers offer customers photo prints of their unborn babies, audio/video recordings of the ultrasound sessions, and other keepsakes such as plush animal toys with Doppler heartbeat sounds from their unborn baby. This guide is designed to assist you, the elective ultrasound provider, to understand how tax applies to your sales transactions.

General Application of Tax to Elective Ultrasound Services

Generally, charges for elective ultrasound scanning and imaging services that do not include a transfer of tangible personal property (merchandise, goods, etc.) to the customer, are not subject to tax.

However, when you provide elective ultrasound scanning and imaging services and you also transfer tangible personal property to your customers such as photos, DVD's, or other keepsake items, you are considered the retailer of those items and tax applies to the entire charge without a deduction for the ultrasound services. This is true whether you offer a lump sum price for the ultrasound services and tangible personal property, or whether there are separate charges for each. As the retailer of the photos and other keepsake items, you are required to register with the CDTFA and are responsible for reporting and paying the tax on all your transactions.

Example # 1 – Ultrasound service only

You provide an elective prenatal ultrasound (for example, a "gender reveal") that includes a 10-minute scanning session in which the customer and their family/friends can view the scan live on a large TV screen. You do not provide this customer any tangible property such as photos (whether printed or on a CD/DVD) or any other keepsake items. The charge for the ultrasound service is not subject to tax.

Example #2 – Ultrasound service with photos for one package price

You offer your customers an elective prenatal ultrasound package for a lump sum advertised price of $50. The package includes a 10-minute scanning session and 2 photo prints (whether printed or on a CD/DVD). You invoice your customer the advertised price of $50. The entire price of $50 for the ultrasound package, which includes the photos and scanning session, is subject to tax.

Example #3 – Ultrasound service with photos and/or DVD; separately itemized charges

You offer your customers an elective prenatal ultrasound that includes a scanning session, two black and white photo prints and a DVD containing all of the photos taken during the scanning session; however, you do not charge one package price for the scanning session, photo prints and DVD. Instead, you separately itemize the charges on your invoice as follows:

Scanning session
Two photo prints

Tax applies to the entire $70 charge, even though the charges for the scanning session, the photo prints, and the DVD are separately stated.

Example #4 – Ultrasound service with optional add-on keepsakes; separately itemized charges

A customer selects an elective prenatal ultrasound that you advertise for $50. Your advertised price does not include any keepsake items. However, during the scanning sessions, the customer is given an option to purchase 4 photo prints of the ultrasound session for $20 and a plush teddy bear with a heartbeat recording for $30. Your customer chooses to purchase these optional items and you invoice your customer as follows:

Scanning session
Four photo prints
Plush teddy bear

Tax applies to the entire $100 charge, even though the charges for the scanning session, the photo prints, and teddy bear are separately stated.


If you are an elective ultrasound service provider of 3D/4D imaging services who makes retail sales of tangible personal property such as that described above, you are considered a retailer and you must register with the CDTFA for a seller's permit and file and pay your sales and use tax returns. You can use our online registration system webpage to quickly and easily register for a seller's permit.

Filing and Payments

Helpful Resources

  • CDTFA Online Services – Learn about the online services CDTFA offers, including online registration for seller's permits and other accounts.
  • CDTFA Offices – A comprehensive listing of all CDTFA offices and contact information.
  • City and County Tax Rates – A listing of current and historical tax rates.
  • Contact Us – A listing of CDTFA contacts for your questions and concerns.
  • Find Your Tax Rate – You can look up the current sales and use tax rate for a specific address.
  • Get It in Writing! – The Sales and Use Tax Law can be complex, and you are encouraged to put your tax questions in writing.
  • Sign Up for CDTFA Updates – Subscribe to our email lists to receive the latest news, newsletters, tax and fee updates, and other announcements.

Other Resources

If You Need Help

If at any time you need assistance with topics included in this guide – or with topics not included – feel free to contact us by telephone or email. For contact information and hours of operation please see our How to Contact Us webpage.

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