Do I need to register for HST as a chiropractor in Ontario?

If your only revenue is from HST-exempt chiropractic services, you are not required to register for HST. Registration becomes mandatory only if your taxable supplies (product sales, room rentals) exceed the $30,000 small-supplier threshold under CRA timing rules.

Can I claim input tax credits (ITCs) as a chiropractor?

No — expenses related to your HST-exempt chiropractic services cannot be claimed as ITCs. However, if you also earn taxable revenue (product sales, room rental), you can claim ITCs proportional to that taxable activity.

Are orthotics sales HST taxable for chiropractors?

It depends on the orthotic. Custom-made orthotics, or orthotics supplied on a practitioner's written order, are generally zero-rated (0% HST) as medical devices under Schedule VI, Part II of the Excise Tax Act — so you charge no HST on them. Off-the-shelf insoles and other retail products are taxable at 13%. Either way, both zero-rated and 13%-taxable product sales count toward the $30,000 registration threshold; only your exempt chiropractic services do not.

What happens if a chiropractor also offers massage therapy?

Registered massage therapy is NOT HST-exempt — RMT services are taxable at 13% HST. This is different from chiropractic: if a CMTO-registered RMT practices within your chiropractic clinic, their services are taxable at 13% HST once the RMT is required to register under CRA's small-supplier timing rules. Your chiropractic services remain exempt. A multi-practitioner clinic with both chiropractors and RMTs must track each practitioner's revenue separately and apply the correct HST treatment to each.

Is Chiropractic Care HST-Exempt in Ontario?

The Short Answer

Chiropractic services in Ontario are HST-exempt when provided by a chiropractor registered with the College of Chiropractors of Ontario (CCO). This is not a choice — it is a tax classification set out in federal legislation. You do not charge HST on your treatment fees, and your patients do not pay HST on chiropractic care.

The trade-off is that you also cannot claim input tax credits (ITCs) on the expenses you incur to deliver those exempt services. HST paid on clinic rent, supplies, and equipment related to your chiropractic services is not recoverable.

The Full Explanation

Why Chiropractic Is Exempt

The HST exemption for chiropractic care comes from Schedule V, Part II of the federal Excise Tax Act. Services performed by a licensed chiropractor within their regulated scope of practice are categorized as exempt health care services. This applies in all provinces that participate in the HST, including Ontario.

The key requirement is registration with the CCO. If the service is performed by a CCO-registered chiropractor delivering chiropractic care, the exemption applies automatically — no special filing or election is required.

What Is and Is Not Exempt

The exemption covers your core chiropractic services: adjustments, assessments, consultations, and other treatments within the CCO-regulated scope of practice.

The following are not exempt and are taxable at 13% HST:

Physical products — foam rollers, pillows, supplements, or other retail products you sell at your clinic (note: custom-made or prescribed orthotics are an exception — they’re generally zero-rated at 0% as medical devices, even though they still count toward the registration threshold; off-the-shelf insoles are taxable at 13%)
Room rentals — if you rent a treatment room to another practitioner, that rental income is taxable
Non-regulated services — any service outside the CCO scope of practice
Gift cards — sold for future services may have different HST treatment depending on their structure

Most chiropractic clinics have at least some taxable revenue from product sales. If taxable supplies exceed the $30,000 small-supplier threshold under CRA timing rules, you are required to register for HST.

Input Tax Credits and the Trade-Off

Because your core services are exempt, you cannot claim ITCs on expenses related to delivering those services. This includes:

Clinic rent (the portion used for chiropractic services)
Treatment table, adjustment tools, therapy equipment
Professional supplies used in treatment
Portions of phone, internet, and administrative costs related to exempt services

If you have both taxable and exempt revenue streams, you may be able to claim ITCs on expenses related to your taxable activities (such as the portion of your rent attributable to a retail display area for product sales). A proper allocation calculation is required.

Mixed-Supply Clinics

Many chiropractic clinics generate revenue from both exempt and taxable sources. For example, a clinic might earn $200,000 from adjustments (exempt) and $15,000 from orthotics sales (taxable). Once taxable supplies exceed the $30,000 small-supplier threshold, HST registration is mandatory, and the clinic must:

Charge HST on all taxable sales
File HST returns on the required schedule (quarterly or annually)
Remit net HST collected (HST charged minus eligible ITCs)
Allocate expenses correctly between exempt and taxable activities

Getting this split wrong is one of the most common accounting errors in chiropractic practices — and it attracts CRA attention.

WSIB Revenue

WSIB reimbursements for chiropractic services are HST-exempt, consistent with your other chiropractic revenue. WSIB follows the same exemption as extended health insurance payments for chiropractic care.

What This Means for Your Clinic

The HST exemption means your fees are more competitive — patients pay your listed price with no tax added. But it also means your bookkeeping needs to clearly separate exempt service revenue from any taxable revenue you generate.

If your clinic sells products or rents space to other practitioners, you need a proper mixed-supply accounting setup from day one. The HST allocation between your exempt and taxable activities affects both your compliance obligations and your expense deductibility.

Wellspring Accounting works with chiropractic clinics across Ontario — from solo practitioners to multi-associate practices — to ensure HST is handled correctly from the first month. See our chiropractic accounting services, or read our bookkeeping guide for Ontario wellness clinics.