Taxable or Exempt Healthcare Services
Exempt healthcare services
Most healthcare services are exempt from GST and QST. Accordingly, healthcare services provided by the following licensed or otherwise certified healthcare professionals are generally exempt:
- registered nurses, registered nursing assistants, licensed or registered practical nurses, or registered psychiatric nurses
- speech-language pathologists
- occupational therapists
- social workers
- dental hygienists
Also exempt from GST and QST are institutional healthcare services provided by operators of hospitals, private surgical facilities, nursing homes and other healthcare facilities when these services are rendered to patients or residents of the facilities. In addition, ambulance services provided by a person that is in the business of supplying such services are exempt.
The exemptions generally apply to basic healthcare services rendered to individuals, that is, services that maintain health or that prevent disease or treat the injury, illness or disability of an individual. Such services include physical examinations and treatment supplied by licensed or certified healthcare professionals, within the scope of their professions, to address a medical or health symptom or condition of their patients or individual clients.
Finally, a healthcare service, whether or not it is listed above, is exempt to the extent that the service is insured by a province or territory under its public health insurance plan to provide for healthcare services for all insured persons of the province or territory. Note that this exemption applies only if, and to the extent that, the fee for the service is paid for or reimbursed by the plan.
Other services provided by regulated healthcare professionals
The following professional services are not exempt:
- management and administrative services provided by regulated healthcare professionals
- a service provided by a physician overseeing research activities of a healthcare facility or educational institution
- research services, project consultation and facilitation services (such services provided by a registered nurse to a government, an association or a healthcare facility are also taxable)
Cosmetic services as well as any separate supplies of property and services related to cosmetic service supplies are taxable. They include both surgical and non-surgical procedures generally aimed at enhancing one’s appearance, and not provided for the purpose of treating a medical condition or for reconstructive purposes, such as:
- hair replacement procedures
- botulinum toxin injections
- teeth whitening
Any separate supply of property is also taxable when the property or service relates to a cosmetic service, such as:
- the use of an operating room, drugs, and medical or surgical prostheses
- any separate supply of a service such as a diagnostic service, an institutional healthcare service or a nursing service
However, any procedure, cosmetic or otherwise, is exempt to the extent that the service is insured by a province or territory under its public health insurance plan.
Taxable healthcare services
Some examples of therapists and other healthcare workers whose services are generally taxable are:
- assistants such as physiotherapy and occupational therapy assistants
- social service workers (this is a separate profession from social workers)
- laboratory technicians
- nursing care aides
- polysomnographic technologists
- massage therapists
- reiki therapists
- sports therapists
- rolfing therapists
- traditional Chinese medicine providers
- personal support workers
However, the services may qualify for exemption if they are included in another more general exemption. For example, services rendered in a nursing home by nursing care aides are exempt when they form part of an exempt institutional healthcare service rendered to a resident of the nursing home.
In addition, services similar to those rendered by the providers listed above may be exempt when rendered by an identified exempt healthcare provider. For instance, if physiotherapists were entitled under the provincial law that regulates physiotherapy services to perform acupuncture on their clients in the course of providing physiotherapy services, then their physiotherapy services that involve acupuncture would be exempt.