2022-0923441E5 Virtual medical services

Principal Issues: METC - The meaning of the the phrase “the jurisdiction in which the service is rendered” in paragraph 118.4(2)(a).

Position: It is a question of fact where the service is rendered.

Reasons: Paragraph 118.4(2)(a) allows fees paid for virtual medical services to be eligible for the METC provided the medical practitioner is ‘authorized’ to practice their profession in a particular province. This will be dependant on the relevant laws of each jurisdiction.

Author: Underhill, Cynthia
Section: ITA: subsections 118.2(2); 118.4(2); paragraph 118.4(2)(a), and subsection 400(2) of the IT Regulation 5700.

XXXXXXXXXX                                                        2022-092344
                                                                                C. Underhill

June 29, 2022

Dear XXXXXXXXXX:

Re: Virtual medical services

We are writing in response to your correspondence received on January 12, 2022, and our subsequent telephone conversation (Underhill/XXXXXXXXXX), concerning the meaning of the phrase “the jurisdiction in which the service is rendered” in paragraph 118.4(2)(a) of the Income Tax Act (the Act).

You have asked for clarification of where virtual medical services are rendered for purposes of paragraph 118.4(2)(a) of the Act when the health care professional and the patient are in different jurisdictions. You have asked us to clarify whether the virtual medical services are considered to be rendered in the jurisdiction where the health care professional or the patient is located at the time those services are rendered.

Our comments:

This technical interpretation provides general comments about the provisions of the 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 70-6R12, Advance Income Tax Rulings and Technical Interpretations.

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.

As explained in paragraph 1.22 of Income Tax Folio S1-F1-C1, Medical Expense Tax Credit, an individual 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 individual 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 health care professional qualifies as a medical practitioner under the Act, one must look to the relevant provincial or territorial legislation to determine whether the particular health care professional is authorized under the laws of that jurisdiction.

It is a question of fact whether a virtual medical service is considered rendered at the location of the health care professional, the location of the patient, or both. Many governing bodies regulate virtual medical services performed within their province. This can include licensing requirements for professionals performing virtual medical services within their province, licensing requirements for professionals in their province performing virtual medical services for a patient in another province, licensing requirements for professionals performing virtual medical services from outside their province for an individual within their province, and so on. Each of these requirements must be considered before a determination can be made.

We trust that these comments will be of assistance to you.

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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