2021-0887941E5 Registered Clinical Counsellors - METC

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the CRA. Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'ARC.

Principal Issues: Whether Registered Clinical Counsellors in BC can be added to the CRA's list of "Authorized medical practitioners by province or territory for the purposes of claiming medical expenses".

Position: No.

Reasons: RCCs do not meet the requirements of being an authorized medical practitioner for purposes of the Act.

Author: Wirag, Eric
Section: 118.4(2)

XXXXXXXXXX                                                                       2021-088794
                                                                                                 E. Wirag, CPA, CMA


July 13, 2021

Dear XXXXXXXXXX:

Re: Medical practitioners - Registered Clinical Counsellors

This is in reply to your correspondence of March 31, 2021, in which you ask us to confirm whether Registered Clinical Counsellors (RCC) in the province of British Columbia can be added to the Canada Revenue Agency’s (CRA) list titled “Authorized medical practitioners by province or territory for the purposes of claiming medical expenses” (the List).

Our comments

This technical interpretation provides general comments about the provisions of the Income Tax Act and related legislation (where referenced). It does not confirm the income tax treatment of a particular situation involving a specific taxpayer but is intended to assist you in making that determination. The income tax treatment of particular transactions proposed by a specific taxpayer will only be confirmed by this Directorate in the context of an advance income tax ruling request submitted in the manner set out in Information Circular IC 70-6R11, Advance Income Tax Rulings and Technical Interpretations.

The CRA has implemented a process that allows only provincial or territorial governing bodies of a health profession, such as a college or board, or the provincial or territorial government responsible for such matters to request changes to the List for the purposes of the METC.

For the purpose of claiming an amount for the medical expense tax credit, paragraph 118.4(2)(a) of the Act provides that where the reference to a medical practitioner is used in respect of a service rendered to an individual, that reference is to a person authorized to practice as such pursuant to the laws of the jurisdiction in which the service is rendered. In our view, a person is authorized by the laws of the jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers the person to perform medical services. Generally, such specific legislation would provide for the licensing or certification of the practitioner as well as for the establishment of a governing body (e.g., a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct.

Therefore, in order to determine whether a particular medical practitioner qualifies as such under the Act, one must look to the relevant provincial or territorial legislation to determine whether the particular practitioner is authorized under the laws of that jurisdiction.

It is our understanding that there is currently no legislation in British Columbia that authorizes the practice of clinical counsellors. It is also our understanding that medical practitioners in that province include those practitioners of health professions regulated by the Health Professions Act (HPA). Based on our review, it appears that clinical counselling is not listed as a regulated health care profession in the HPA.

Accordingly, we are of the view that persons who provide clinical counselling in British Columbia cannot be said to meet the authorization requirement that is contemplated under subsection 118.4(2) of the Act. As such, we cannot at the present time add certified Registered Clinical Counsellors in British Columbia to the list of “Authorized medical practitioners by province or territory for the purposes of claiming medical expenses.”

While we regret that we could not give you a more favourable response, we hope that the foregoing comments will be of assistance in clarifying our position.

Yours truly,


Lita Krantz, CPA, CA
Manager, Tax Credits and Ministerial Issues
Business and Employment Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch

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