16 October 2003 GST/HST Interpretation 37663 - Application of the GST/HST to Chelation Therapy

Dear XXXXX:

This is in reply to your letters XXXXX concerning the application of the Goods and Services Tax ("GST")/Harmonized Sales Tax ("HST") to the supply of chelation therapy.

Please accept our apologies for the delay in responding to your letters. This delay was due to the fact that XXXXX we undertook an extensive review of our position regarding the tax status of the supply of chelation therapy under the Excise Tax Act (the "ETA"). We have just completed our review and can now respond to your letters.

You are asking us to reconsider XXXXX that the supply of chelation therapy is taxable and subject to the GST/HST at the rate of 7% or, where the supply is made in a participating province (Nova Scotia, Newfoundland or New Brunswick), the supply of chelation therapy is taxable at the rate of 15%. As noted above, we re-examined the issue and based on new information brought to our attention during our review, we have revised our position regarding the tax status of the supply of chelation therapy when made by a medical practitioner.

This letter summarizes the results of our review and sets out our position on the tax status of chelation therapy when supplied by medical practitioners to treat their patients with various medical conditions.

XXXXX

Please note that this position regarding supplies made by medical practitioners is effective January 1, 1991[.]

XXXXX.

Based on the information you provided, we understand that chelation therapy involves the intravenous ("IV") administration of the chemical ethylene diamine tetracetic acid (referred to as "EDTA"), combined with other chemicals, that is used for various purposes as well as to address a variety of symptoms, such as:

•   A preventative measure to avoid coronary artery surgery;

•   A preventative measure to avoid amputation in cases of leg ulceration and gangrene;

•   Hardened or blocked arteries;

•   Angina pain;

•   Leg cramp pain;

•   Elevated blood pressure;

•   Elevated blood cholesterol;

•   Diabetes; and

•   Macular degeneration of the eye.

We understand that medical practitioners charge their patients directly for chelation therapy services. Under section 5 of Part II of Schedule V to the ETA, supplies made by medical practitioners, as defined in the ETA, of consultative, diagnostic, treatment or other health care services rendered to individuals are exempt from GST/HST, other than surgical or dental services performed for cosmetic purposes and not for medical or reconstructive purposes. The term "medical practitioner" is defined in section 1 of Part II of Schedule V as a person who is entitled under the laws of a province to practise the profession of medicine or dentistry.

We would consider the supply of chelation therapy services to meet the criteria in the exemption when the medical practitioner is using chelation therapy within the scope of his or her medical practice to address a symptom or condition of his or her patient. Accordingly, when a medical practitioner renders chelation therapy services to his or her patient to address the symptoms noted above, the supply of those services is exempt from the GST/HST.

Should you have any further questions or require clarification on the above matter, please do not hesitate to contact me at (613) 952-6761.

Yours truly,

Susan Eastman
Municipalities and Healthcare Services Unit
Public Service Bodies and Governments Division