Specialists and equipment leases, next to what you bill each ASL and fund.
Every month FiscalPulse reads your centre’s Cassetto Fiscale: costs, ASL and fund contracts, tax payments, letters.
€29 a month · no patient data · read-only, revocable
Sample company · illustrative dataThree figures on specialist centres
47.5% of private spending
Specialist visits and procedures: almost half of private healthcare spending.
Read more
The figure covers what Italian households pay at the front desk, and those invoices do not pass through SDI, the national e-invoicing exchange.
Source: Ragioneria Generale dello Stato, healthcare spending monitoring on Tessera Sanitaria data (2024 data)
41 deals in 2025
Acquisitions in Italian health services, against 30 in 2024.
Read more
About six in ten were made by private equity funds, and buyers ask for numbers they can check.
Source: PwC Italia, Health Industries Outlook 2026; GC Advisory, interview published by Innlifes (2026)
86.91 since 1 April 2025
Analysis laboratories and diagnostic imaging have a new code, replacing the old one.
Read more
Under the ATECO 2025 classification (the Italian activity codes) they moved from 86.90 to 86.91, and outpatient centres moved to 86.22.03.
Source: ISTAT, ATECO 2025 classification (in force since 1 April 2025)
The centre read as a business
Equipment leases, and the next machine
Ultrasound scanners, X-ray units and analysers sit in different leases.
Read more
They are paid in instalments, and the report spots the lease payments in the invoices and lines them up with the month’s other outgoings. For a new machine it calculates the lease payment, the monthly services needed to break even and the cash left, with VAT treated as a cost.
What each specialist costs
A centre often works with dozens of self-employed specialists.
Read more
Each one has their own invoices and periods. The report adds them up by professional and by month and shows how much the top ones weigh on total fees. You see in advance what happens if one of them cuts their hours.
Reagents, materials, service contracts
In laboratories and diagnostic centres, a few suppliers make most of the spending.
Read more
Price rises arrive one contract at a time. The report splits spending by category, tells you the share of the top supplier and compares categories with centres under the same ATECO code, never by individual name.
For banks and leasing companies
The tax score on six dimensions and tax payment regularity, up to last month.
Read more
It is ready when you ask for credit for new equipment.
Technical and administrative staff
The cost comes from F24 contributions, checked against the CU and the Modello 770.
Read more
F24 is the Italian tax payment form, the Certificazioni Uniche (CU) are annual income statements and the Modello 770 is the annual withholding tax return.
Agenzia letters and the month’s F24
Every Agenzia letter arrives by email the day it appears.
Read more
Each letter from the Agenzia delle Entrate (the Italian Revenue Agency) comes with amount and deadline, and F24 payments are lined up before the 16th.
How much each payer weighs
Each payer’s share and the concentration index.
Read more
ASL, funds and companies are all counted, with an alert when one of them sends you less work.
Year-to-date billing to the ASL
For accredited centres, invoices to each ASL since January.
Read more
Accredited centres are authorised under accreditamento to work for the regional health service, and the total is set against the assigned budget.
The fiscal credit score is a complementary tool based on declared tax data. It is not a regulated credit rating within the meaning of Regulation (EC) No 1060/2009.
Giulia shows what is inside and what reaches you every month.
Front-desk takings stay out of the Cassetto; costs land in it
A diagnostic centre has three revenue sources.
Read more
They are the front desk, agreements with funds and insurers, and the ASL (local health authority) budget. The Cassetto sees the last two, and invoices to the ASL arrive as FatturaPA, the public-sector e-invoice format. The front desk stays out. Costs, on the other hand, almost all arrive as e-invoices: specialists, reagents, maintenance, equipment leases. That is why the report is strongest exactly where a centre struggles to see: what it costs to deliver a service and who the cash that comes in by invoice depends on.
The centres we read
- Outpatient and specialist medical centresATECO 86.22.03
- Diagnostic imaging centresATECO 86.91.01
- Clinical analysis laboratoriesATECO 86.91.02
- Physiotherapy and rehabilitation centresATECO 86.95
Getting started
Set up in about half an hour, then it runs on its own
- 01
You give us access to the Cassetto Fiscale.
The company’s Entratel or Fisconline credentials are enough: these are the logins an Italian company uses with the Agenzia delle Entrate.
Read more
If you do not have them, we request them together through the company’s PEC, its certified email address, and they arrive in four to seven days. You can also appoint one of our partner accountants in Italy for read-only access.
- 02
We read the full history.
Invoices, F24 payments, LIPE, tax returns, letters from the Agenzia and credit registers: twenty-two document types, joined into a single reading.
- 03
You receive the report every month, in English.
A provisional version on the 3rd and the final one on the 18th, archived and ready to download.
Read more
You also get an email every time the Agenzia writes to the company.
Your accountant in Italy keeps doing their job. If you like, they receive the report in copy.
€29 a month per Italian company, with the company’s own credentials
for companies with up to 2,000 invoices a year · cancel whenever you like
Cancel whenever you like, with no penalty. The yearly plan is paid in one instalment.
- Full monthly report, provisional on the 3rd and final on the 18th
- An email for every letter from the Agenzia, with the original attached and explained in English
- A reminder before every deadline
- Alerts on out-of-scale invoices and on customers who are buying less
- A version of the report to present to Italian banks and confidi (credit guarantee consortia)
- Archive of every past report, always available to download
By subscribing you accept the Terms of Service.
A hundred companies or more. Banks, leasing and factoring companies, credit guarantee consortia, networks and groups that follow at least a hundred Italian companies: we show you the engine in a demo on real positions from your portfolio.
An Italian company spends between €5,000 and €50,000 a year on its accountant, admin staff and software to produce the data that lands in the Cassetto Fiscale. For €29 a month, that data works for you too.
Questions
Does the report see front-desk takings?
No. Services to individuals cannot be e-invoiced under D.Lgs. 81/2025, so they are not in the Cassetto Fiscale. The report sees invoices to the ASL, funds, insurers and companies, all invoices from suppliers and specialists, F24 payments and letters from the Agenzia. No patient data enters the report.
Can an accredited lab see its ASL billing?
Yes, because invoices to the ASL are electronic and land in the laboratory’s Cassetto. The report adds them up per body from the start of the year and updates them every month. Set against the budget assigned by the Region, it tells you how much room is left for the remaining months.
How do I read specialists’ costs?
The report adds up the invoices each specialist sends you, by professional and by month. You see each one’s share of total fees and how it changes over time. The Italian withholding tax paid on their fees appears in the month’s F24 payments, together with the centre’s other tax payments.
Does it help decide on a new machine?
Yes, through the investment simulation. For a new machine the report calculates the lease payment, the monthly services needed to break even and the cash left after the instalment, alongside existing leases. VAT on the purchase is treated as a cost, because healthcare services are exempt.
Do several sites need several reports?
You need one report per VAT number. Sites of the same company share one Cassetto and so one report. If the group has several companies, each company has its own report and you see them side by side, one per business.
Does the centre’s accountant receive the report?
Yes, if you wish they get it in copy every month. The report adds to their work: when the Agenzia writes you both know the same day, and you discuss the same numbers with the deadlines already in view. They keep handling the centre’s returns, F24 payments and financial statements as before.