parties required since 2019 to transmit data to the Sistema Tessera Sanitaria

Who must send data to the Sistema TS in 2026?

All healthcare professionals and medical facilities must send data to Sistema TS by precise monthly deadlines.

Since 2019 the list of parties under the obligation has expanded significantly. In 2026 the rules remain in force and binding for hundreds of thousands of professionals in Italy.

The obligation covers all private healthcare expenses recorded. Transmission to the Sistema Tessera Sanitaria is essential for the pre-filled Italian tax return of the Agenzia delle Entrate (Italian Revenue Agency).

Full list of those required to comply in 2026

The list includes doctors, dentists and many other healthcare professionals entered on professional registers.

Medical and healthcare professions covered by the obligation

• Medical doctors and surgeons registered with the Ordine.
• Dentists and dental surgeons registered with the Ordine.
• Psychologists registered with the professional register.
• Physiotherapists registered with the professional register.
• Speech therapists registered with the professional register.
• Nurses registered with the Ordine.
• Midwives registered with the Ordine.
• Opticians registered with the professional register.
• Biologists registered with the professional register.
• Dietitians registered with the professional register.
• Veterinary surgeons registered with the Ordine.
• Podiatrists registered with the professional register.
• Dental hygienists registered with the professional register.
• Biomedical laboratory technicians registered with the professional register.
• Audiometric technicians registered with the professional register.
• Hearing aid technicians registered with the professional register.
• Orthopaedic technicians registered with the professional register.
• Neurophysiopathology technicians registered with the professional register.
• Neuro and psychomotor therapists registered with the professional register.
• Psychiatric rehabilitation technicians registered with the professional register.
• Occupational therapists registered with the professional register.
• Professional educators registered with the professional register.
• Prevention technicians registered with the professional register.
• Healthcare assistants registered with the professional register.

Healthcare facilities required to comply

• Pharmacies public and private.
• Parapharmacies authorised.
• Medical centres private.
• Multi-specialty clinics private.
• Dental practices private.
• Military health facilities.
• Farmacia ANMIG (war wounded and disabled veterans).

Deadlines and submission methods in 2026

Data is sent to Sistema TS on a strictly monthly basis. Transmissions cannot be deferred or brought forward.

When to send the data

• Monthly submission by the the 10th of the following month.
• For example, January data must be transmitted by 10 February.
• If the 10th falls on a public holiday, the deadline moves to the next working day.
• Transmissions take place through the portal www.sistemats.it.
• Alternatively, you can use certified practice management software such as BeebeeDoc.

How to send the data

Sistema TS (Italy's Health Card System) offers two transmission methods.

• Manual submission: filling in directly on the sistemats.it site, document by document.
• Automatic submission: through integrated practice management software such as BeebeeDoc, which transmits in bulk.
• Synchronous transmission: each individual expense is sent immediately, at the moment it is recorded.
• Asynchronous transmission: expenses are accumulated and sent together in a single transmission.
• Both methods require authentication with SPID digital identity.

Penalties for failing to send data

The Agenzia delle Entrate (Italian Revenue Agency) imposes severe administrative penalties on those who do not transmit the data.

Penalty amounts in 2026

• Base penalty: €100 for each document not transmitted.
• Minimum penalty: €500 for each month of omission.
• Maximum penalty: €50.000 for multi-year periods of evasion.
• The penalties apply to each individual professional or facility in default.
• The Agenzia delle Entrate (Italian Revenue Agency) can carry out checks by looking for discrepancies between self-declared expenses and those sent to Sistema TS.

Penalties are not negotiable and are served through a formal settlement notice.

Link with the Electronic Health Record 2.0

From June 2026, Sistema TS (Italy's Health Card System) is connected to the national FSE 2.0. All the data transmitted flows automatically into the patient's electronic record.

This ensures full traceability of the private healthcare costs borne by the citizen.

• The patient sees all the expenses in their own FSE 2.0.
• The data remains available for five years.
• The Ministry of Health oversees that the data is fed in correctly.
• Doctors can look up the history of the private services received.

How to check that the data was received

Every transmission generates an official receipt confirming delivery.

• Sistema TS issues a unique protocol number of receipt.
• The receipt is available on the sistemats.it portal immediately.
• With BeebeeDoc, the receipt is archived automatically in the platform.
• If the file is rejected for formal errors, the system discards it without acquiring it.
• If the submission is rejected, you must correct the data and send it again.

Receipts must be kept for tax records.

Who supervises Sistema TS?

Three bodies monitor correct operation and compliance with the obligations.

• Ministry of Health: it sets the clinical rules and the lists of authorised services.
• Agenzia delle Entrate: checks data transmission and applies penalties.
• Garante della Privacy (Italy's data protection authority): oversees the protection of personal data on the platform.

Practical tips for compliance

To avoid penalties and problems, follow these good practices.

• Record every service at the moment it is delivered.
• Check the data before transmitting it to Sistema TS (Italy's Health Card System).
• Always send by the 10th of each month.
• Keep the transmission receipts for at least 5 years.
• Use certified software to automate the processes.
• Add a reminder at least a week before the deadline.
• Check the Ministry of Health announcements regularly.

Conclusion

In 2026, the obligation to send data to Sistema TS (Italy's Health Card System) applies to dozens of categories of healthcare professionals and medical facilities.

Monthly transmission by the 10th is non-negotiable. The penalties are severe and range from €100 per document up to €50,000 for prolonged evasion.

Automating the process with certified management software such as BeebeeDoc removes the risk of mistakes and omissions. The software sends the data correctly and on time, keeping you compliant with the rules.