GST/HST for Health Professionals in Canada (2026): Exempt or Taxable

Most regulated health services in Canada are GST/HST exempt, but only the ones Parliament listed, and only when a licensed practitioner renders them to a patient for a health purpose. Massage therapy, kinesiology and athletic therapy are taxable. Manual osteopathy became taxable for supplies after 5 June 2025. Psychotherapy and counselling therapy became exempt on 20 June 2024. Products, insurer reports and cosmetic work are taxable in every clinic and count toward the $30,000 small-supplier threshold.

This page is for practitioners and clinic owners who want one answer per profession with the law behind it. Every row was checked against the consolidated Excise Tax Act and CRA publications in July 2026.

What is the GST/HST rule for health services in Canada?

The service is on the list. Schedule V, Part II of the Excise Tax Act names them: physicians and dentists (s. 5), nurses (s. 6), the s. 7 professions, dietitians (s. 7.1), social workers (s. 7.2), pharmacists' clinical services (s. 7.3), dental hygienists (s. 8), and anything a provincial plan pays for (s. 9). Unlisted professions are taxable.

A licensed practitioner renders it to an individual. The "practitioner" definition requires that the person, "where the person is required to be licensed or otherwise certified to practise the profession in the province in which the service is supplied, is so licensed or certified", and, in an unregulated province, "has the qualifications equivalent to those necessary to be so licensed or otherwise certified in another province".

The purpose is health care. Since 21 March 2013, s. 1.2 deems a supply that is not a "qualifying health care supply" out of Part II: maintaining health, preventing disease, treating or relieving an injury, illness, disorder or disability, helping someone cope with one, or palliative care. An insurer's report is not health care, even from a physician. Section 1.1 removes cosmetic supplies the same way.

Fail one test and the fee is taxable (see the GST/HST registration guide).

Which health professions are GST/HST exempt? Profession by profession

Sections are in Part II of Schedule V unless stated. "Licensed" means licensed or certified where the service is supplied, or equivalent qualifications where the province does not regulate the profession.

Two rules cross every row. Section 9 exempts whatever a provincial plan pays, whoever renders it. Section 7.4 exempts a multidisciplinary program as a whole when all or substantially all of the fee (the CRA reads this as 90% or more) is attributable to services exempt on their own; CRA's examples fail a program at 82% and pass one at 92%.

What changed: psychotherapy in 2024, osteopathy in 2025

Psychotherapy and counselling therapy. Bill C-59 added paragraphs 7(j.1) and 7(j.2) for supplies made on or after 20 June 2024. CRA Memorandum 25-3 lists psychotherapy as regulated in Ontario and Quebec, counselling therapy in New Brunswick, Nova Scotia and PEI; the equivalence rule applies elsewhere. If everything you sell is now exempt you may close the GST/HST account; the change-in-use rules can recover ITCs claimed earlier on equipment.

Osteopathy. Paragraph 7(f), "osteopathic services", was written for osteopathic doctors, who are now licensed physicians exempt under s. 5. When New Brunswick began regulating manual osteopathy on 6 June 2025, manual osteopaths there met the practitioner test by accident. Budget 2025 repealed 7(f) for supplies after 5 June 2025, with relief up to Budget Day (4 November 2025) where no tax was charged; Bill C-15 enacted it on 26 March 2026 (S.C. 2026, c. 3, s. 163).

How does the $30,000 threshold work when most of your revenue is exempt?

Only taxable supplies count. CRA's rule looks at revenue "from your worldwide taxable supplies", including zero-rated ones, and Memorandum 2-2 says to exclude "any consideration for exempt supplies". A psychologist billing $400,000 of therapy and $12,000 of court reports is a small supplier; associated businesses share one threshold.

Cross $30,000 of taxable supplies in a single calendar quarter and you are a registrant from the sale that crossed the line. Cross it over the last four consecutive quarters without any single quarter doing so, and you stop being a small supplier at the end of the month after that quarter. Either way you have 29 days to register.

Should a mostly exempt practitioner register voluntarily?

Only a person making some taxable supplies can register. CRA's page is blunt: "You generally cannot register for a GST/HST account if you provide only exempt supplies." With a small taxable stream you may register, but below the threshold it is usually a mistake: you charge 5% to 15% on reports and products, file returns, stay registered at least a year, and recover tax only on the share of costs tied to that stream. It pays when the taxable share is large, such as an RMT clinic.

Can you claim input tax credits when most of your revenue is exempt?

No ITC is allowed on property or services acquired to make exempt supplies. Costs serving only the taxable stream are fully creditable. Shared costs such as rent are split on a fair and reasonable basis used consistently; a revenue split is the simplest defensible method. Receipt capture with Dext (our Dext review covers the setup) makes the split auditable rather than estimated.

What is always taxable: products, third-party reports, cosmetic work, services to a business

Products. CRA Bulletin B-109 says product sales by a naturopathic doctor "are generally separate supplies" and "generally subject to the GST/HST". The same holds for every profession. Zero-rated exceptions sit in Schedule VI, Part II: prescription eyewear (s. 9), hearing aids (s. 12), custom or prescribed orthotics (s. 23).

Reports for someone other than the patient. Policy P-256 lists them: insurer medical examinations, disability certificates, employment and driver's licence medicals, sick notes, and litigation damage assessments. None is a qualifying health care supply.

Cosmetic supplies. Section 1.1 removes anything "made for cosmetic purposes and not for medical or reconstructive purposes". Botox for wrinkles is taxable; Botox for migraine is medical.

Services sold to a business. Section 7 requires a service "rendered to an individual"; wellness contracts sold to an employer are taxable.

Telehealth across provinces: which rate applies to a taxable service?

The rate matters only for taxable fees. CRA Memorandum 3-3-6-1 (April 2026) defines a personal service as one "all or substantially all (90% or more) performed in the presence of the individual to whom it is rendered" and taxes it where it is performed. A video session is not performed in the client's presence, so the general rule in Memorandum 3-3-6 applies: the province of the home or business address you obtain in the ordinary course of business. An Alberta coach selling a taxable online session to an Ontario client charges 13%.

Quebec QST, BC PST, Saskatchewan PST and Manitoba RST

Quebec. The QST mirrors the GST list. Revenu Quebec's health services page states that GST and QST must be collected on services that are not exempt, naming kinesiology, massage therapy, homeopathy and fasciatherapy, and confirms the psychotherapy exemption applies to the QST from 20 June 2024.

British Columbia. PST at 7% applies to goods, software, accommodation, related services to goods, legal, telecommunication and online marketplace services, and from 1 October 2026 to accounting and bookkeeping, non-residential real estate services, and 30% of architecture, engineering and geoscience fees (Notice 2026-001). Health services are on neither list; products a clinic sells are PST-taxable unless exempt under Bulletin PST 207.

Saskatchewan. Bulletin PST-36 states that "charges for personal services are not subject to tax" and lists healthcare and personal care services, massage, personal counselling and fitness training. PST at 6% applies to retail goods.

Manitoba. Bulletin RST 030 states that "sales tax is generally not payable on services unless the service is specified as a taxable service in the Act"; its Section 4 list contains no health service. RST at 7% applies to goods.

How to set this up in Jane, Practice Better, Xero and QuickBooks

Clinic software. In Jane App, taxes are created under Settings, then Taxes, with a name, a rate and the locations that use it; each treatment and each product then carries its own tax setting, included in the price or added on top. That per-service design is what a mixed clinic needs: physiotherapy at no tax, reports and retail at the HST rate. Jane runs no free trial and publishes no coupon codes of its own; through our link you get one month free with the code LEDGERLOGIC1MO, entered in the Grace code field at signup. Pricing: Jane App review, clinic software price index. Practice Better takes a default rate under Invoice and Payments settings, with overrides per product or per invoice line.

Accounting software. In Xero, open one revenue account per stream (exempt services, taxable services, products) and default the exempt account to a 0% exempt rate; 80% off for 6 months runs through our partner link, plans are $25, $60 and $80 CAD a month with unlimited users. In QuickBooks Online, code exempt fees as Exempt, not Out of scope: line 101 of the GST/HST return is total revenue including exempt supplies. See the accounting software comparison and Jane bookkeeping guide.

Worked example: an Ontario physio clinic with exempt and taxable revenue

The clinic crossed $30,000 over four quarters, not in one, so it stopped being a small supplier at the end of the month after that quarter and had 29 days to register. It charges 13% on $32,000: $4,160 collected. Product cost of sales was $4,000 plus $520 HST, fully creditable. Overhead was $60,000 plus $7,800 HST; the taxable share of revenue is $32,000 of $282,000, or 11.35%, so the overhead ITC is $885. Net remittance: $4,160 less $520 less $885 = $2,755.

An RMT clinic is taxable on every treatment, registers early and recovers ITCs on everything. A psychotherapist who also runs information workshops is exempt on clients, taxable on the workshops, and a small supplier until those pass $30,000. If your mix is unusual, ask us before you set the tax codes.