11 August 2023 External T.I. 2023-0974121E5 - Reiki practitioners

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 amounts paid for reiki treatments that are performed by reiki practitioners would be an eligible expense under the medical expense tax credit (METC) in situations where reiki is prescribed by a medical practitioner as part of a treatment plan.

Position: It seems unlikely, based on our understanding of some of the limitations that may prohibit medical practitioners from prescribing complementary or alternative modalities, as well as the fact that reiki practitioners tend to be independent practitioners. Otherwise, it is possible that the amounts in question would be eligible for the METC, provided that all of the conditions in paragraph 118.2(2)(l.9) are met; these conditions include the requirement that the therapy be prescribed by, and administered under the general supervision of a medical practitioner (within the meaning of subsection 118.4(2)) to a patient who is eligible under section 118.3 (for the disability tax credit).

Reasons: The wording in paragraph 118.2(2)(l.9).

XXXXXXXXXX									2023-097412
R. El-Kadi

August 11, 2023

Dear XXXXXXXXXX

Re: Reiki treatments and the medical expense tax credit

We are writing in response to your email of November 25, 2022, which you originally addressed to the Sudbury Tax Centre regarding the medical expense tax credit (METC). More specifically, you ask whether amounts paid for reiki treatments performed by reiki practitioners would be eligible for the METC if prescribed by a medical practitioner such as a medical doctor, physiotherapist, registered massage therapist, or psychologist, as part of a treatment plan.

It is understood, for the purpose of your query, that a reiki practitioner is someone who practices reiki exclusively, as opposed to a practitioner of a health profession that is recognized under the laws of a jurisdiction.

Our comments:

This technical interpretation provides general comments about the provisions of the Income Tax Act (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.

Medical expenses that are eligible for the METC are limited to those described in subsection 118.2(2) of the Act. If a particular expenditure is not described as an eligible medical expense in subsection 118.2(2), or if the requirements under which the expenditure would qualify are not met, the expenditure does not qualify for purposes of the METC, even though the expenditure may have been incurred for medical reasons. The Canada Revenue Agency’s (CRA) general views regarding the METC are contained in Income Tax Folio S1-F1-C1, Medical Expense Tax Credit (the Folio), which can be found on the Government of Canada website at www.canada.ca.

Reiki treatments that are performed by practitioners who are not members of a health profession

Paragraph 118.2(2)(a) of the Act allows an individual to claim as medical expenses, amounts paid to a medical practitioner, dentist, or nurse or a public or licensed private hospital for medical services. As explained in paragraphs 1.26 and 1.27 of the Folio, medical services are diagnostic, therapeutic or rehabilitative services that are performed by a medical practitioner acting within the scope of his or her professional training.

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 in the stated profession 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, for example a college or board, with the authority to determine competency, enforce discipline and set basic standards of conduct.

We are currently unaware of any legislation that authorizes the practice of reiki in any of the Canadian jurisdictions. Therefore, in our view, reiki practitioners are not considered to be medical practitioners under paragraph 118.4(2)(a) of the Act, and consequently, amounts paid to reiki practitioners would not be eligible for the METC.

We have also considered whether amounts paid for reiki treatments may qualify under paragraph 118.2(2)(l.9) of the Act, given that this provision may allow for therapy that is administered by a person other than a medical practitioner. More specifically, the provision allows certain expenses paid as remuneration for therapy provided to a patient because of the patient’s severe and prolonged impairment, where the patient qualifies for the disability tax credit (DTC). There are several other conditions that must be met, one of which is that the therapy must be prescribed by, and administered under the general supervision of a medical doctor, a nurse practitioner or an occupational therapist - in the case of a physical impairment - or a medical doctor, a nurse practitioner or a psychologist - in the case of a mental impairment. Paragraphs 1.115 and 1.116 of the Folio provide additional comments regarding the requirements under paragraph 118.2(2)(l.9) of the Act.

It is a mixed question of fact and law as to whether amounts paid for reiki treatments would qualify under paragraph 118.2(2)(l.9) of the Act. To that effect, one may want to consider, among other things, the scope of practice of the medical practitioners listed above, and the relevant regulatory body’s policies and practice guidelines regarding alternative or complementary treatment modalities. One would also need to consider whether these medical practitioners are permitted in their respective jurisdictions to recommend (or prescribe) reiki as a treatment modality for their patients. Assuming that they do, it seems generally unlikely, in our view, that a reiki practitioner would administer reiki treatments or therapy under the general supervision of a medical practitioner (as mentioned above). Another consideration is that paragraph 118.2(2)(l.9) of the Act would not apply unless the CRA has determined that the patient receiving reiki treatments is eligible for the DTC.

Reiki treatments that are performed by members of a health profession

It is our understanding that certain regulatory bodies of health professions may allow their registered members to use reiki in their professional practice, albeit to a limited extent. For example, the College of Massage Therapists of Ontario (CMTO) seems to allow registered massage therapists (RMTs) to integrate “First Degree Reiki” into massage therapy treatment plans, in which case, their services would still be considered to be registered massage therapy. (footnote 1) Accordingly, fees paid for such services in Ontario would be eligible expenses for the METC.

On the other hand, it is our understanding that RMTs who choose to offer “Second Degree Reiki” or reiki, in general, as a stand-alone “complementary modality” are not permitted by the CMTO to describe such services as registered massage therapy. When this is the case, amounts paid for reiki treatments would not be eligible for the METC given that they are outside the scope of practice for massage therapists in Ontario.

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
Business and Employment Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch

FOOTNOTES

Note to reader: Because of our system requirements, the footnotes contained in the original document are shown below instead:

1 See https://www.massagetherapyreference.com/complementary-modalities-that-massage-therapists-may-use/