Claiming Therapy on Your Taxes: DTC, Medical Expense Credit, and the 2024 BCBA/RBA Recognition
Published May 12, 2026
How Canadian families can claim out-of-pocket therapy costs on income tax — including the recent change that lets you claim BCBA/RBA fees, and what to do when CRA audits your medical expense claim.
Claiming Therapy on Your Taxes
A family with an autistic child often pays significant out-of-pocket costs for therapy that isn't fully covered by insurance or provincial funding. The Canadian tax system recognizes most of those costs — but you have to know what to claim and how. This guide is what we wish someone had told us at the first tax season after diagnosis.
> Tax rules change. Always confirm current eligibility on the CRA website or with a qualified accountant. This is information, not tax advice.
The two foundations
Two things drive most of the tax savings available to autism families:
1. Disability Tax Credit (DTC) — a federal non-refundable tax credit. Once approved, it reduces your federal tax owed. It also unlocks the Child Disability Benefit (added to your CCB monthly) and the Registered Disability Savings Plan. 2. Medical Expense Tax Credit (METC) — a separate credit for out-of-pocket medical expenses above a threshold. Therapy costs typically fall here.
These stack. The DTC is automatic once approved; the METC requires you to track and claim eligible expenses each year.
Step 1: get the DTC approved
You apply with CRA Form T2201.
- Part A is yours (parent/caregiver).
- Part B is your child's "qualified medical practitioner" — typically a developmental pediatrician, family doctor, nurse practitioner, or psychologist depending on the impairment category. The DTC is most often approved under "mental functions" for autism, but other categories may apply.
Two common stumbling points:
- Doctors who refuse to fill out the online portal. Many family doctors are uncomfortable with the CRA portal. Print the form, have them fill out Part B on paper, then scan and upload via "Submit documents" on your CRA account. Or mail the paper form. Both are accepted.
- Approval is often retroactive. When the CRA approves the DTC, they typically backdate it to the year your child began to qualify (per the doctor's note in Part B). They will adjust prior tax years automatically — this can mean a large lump-sum refund.
Once approved, the DTC is yours for a fixed period (often until your child turns 18, or longer). You don't reapply each year — but you may be asked to reconfirm periodically.
Step 2: know what counts as a medical expense
Eligible expenses for the METC include:
- Out-of-pocket therapy paid to a recognized medical practitioner
- Speech-language pathology
- Occupational therapy
- Psychotherapy / psychology services
- Behaviour analysis (BCBA / RBA) — recognized since July 1, 2024 (see below)
- Dental treatment not covered by other plans
- Travel to and from medical appointments (mileage rules apply)
- Modifications to your home for accessibility
- Special equipment as prescribed
- Supplements and certain dietary items if prescribed in writing for a documented medical reason
Things that don't count: - General nutritional supplements not prescribed - Programs that aren't run by a recognized practitioner - Tutoring (with rare exceptions) - Most respite
The 2024 change you may have missed
Effective July 1, 2024, the College of Psychologists and Behaviour Analysts of Ontario (CPBAO) confirmed that behaviour analysts in Ontario are recognized by the CRA as authorized medical practitioners for the medical expense tax credit.
In practice this means:
- ABA / behaviour analysis fees paid to an RBA-licensed practitioner can be claimed under the METC, the same as fees paid to a psychologist or speech-language pathologist.
- Some private health insurers now accept BCBA/RBA claims under their psychology benefits category. Coverage varies by provider — files filed under "psychologist services" with the practitioner's RBA registration number have been processed by some providers (Canada Life and Desjardins are commonly mentioned by families). If you've previously been told ABA is "not covered," it's worth filing a claim again under psychology and seeing what happens.
What CRA looks for on a therapy invoice
A CRA-acceptable therapy invoice should show:
- The practitioner's name and credentials (e.g., RBA registration number, SLP license number)
- The practitioner's address and contact info
- Your name as the payer
- Your child's name as the patient
- Service dates and hours
- Type of service (e.g., "ABA therapy 1:1" or "Speech-language pathology")
- Amount paid
- Receipt of payment (e.g., "Paid in full")
If your invoice is missing your name and your child's name, ask the centre to reissue. CRA does flag this on audits.
The audit — what to expect
CRA frequently audits medical expense claims, especially when amounts are large. Being audited is not the same as being suspected of fraud. It's a routine document-request process.
What the notice typically asks for: - Receipts for the claimed expenses - The DTC approval letter (if applicable) - Proof of payment (bank statements, e-transfer records) - Confirmation that expenses weren't reimbursed by insurance or another program
How to respond: - You usually have 30 days to respond. - Upload everything via your CRA account (Submit documents) or mail to the address on the notice. - Keep your receipts for at least 6 years after the tax year — this is the CRA's standard retention requirement.
What happens after: - Most audits resolve cleanly. CRA will accept the documentation and confirm your return as filed. - If they disallow part of the claim, they'll explain why. You can object within 90 days.
Practical tips that save money
- Pool medical expenses on the lower-income spouse's return. The METC threshold is calculated on net income, so the lower earner's threshold is lower.
- Choose the best 12-month period ending in the tax year. You don't have to use January–December. If you spent heavily on therapy in fall 2024 through summer 2025, claim that 12-month period on the 2025 return.
- Bundle big-ticket items. Glasses, dental, equipment — sometimes worth getting in the same year as therapy expenses to clear the threshold.
- Don't double-claim. Anything reimbursed by insurance, OAP, SSAH, ACSD, or any other program is not eligible for the METC. Claim only the unreimbursed portion.
- Travel adds up. Mileage to/from therapy appointments can be claimed if the round trip is over 40 km and there's no equivalent service closer to home. Keep a log.
A note on the RDSP
Once your DTC is approved, open a Registered Disability Savings Plan at any major bank. The federal government adds:
- Canada Disability Savings Grant (CDSG) — matches your contributions up to 300% for lower-income families.
- Canada Disability Savings Bond (CDSB) — for low-income families, the government contributes even if you don't.
You can carry forward unused entitlements for up to 10 years (subject to rules), which means even small starter contributions trigger meaningful matches. The earlier you open the account, the more compounding works in your favour.
Working with an accountant
If your tax situation is straightforward, you can claim the DTC and METC yourself with software (TurboTax, Wealthsimple Tax, etc.).
If you're claiming substantial therapy expenses, consider a one-time consultation with an accountant who has worked with disability families. The fee usually pays for itself in the first year, and they'll set up your records correctly for future years.
You're not asking for a handout. You're using a credit the system was designed to provide. Use it.