16 October 2003 GST/HST Interpretation 38100 - Application of the GST/HST to Chelation Therapy

Dear XXXXX:

This is in reply to your letter 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 letter. This delay was due to the fact that the Canada Customs and Revenue Agency ("CCRA") had undertaken an extensive review of its position on the status of the supply of chelation therapy under the Excise Tax Act (the "ETA"), which is the federal legislation governing the GST/HST. We have just completed our review and can now respond to your letter.

Interpretation Requested

You are asking about whether there is GST/HST charged on chelation therapy services when medical practitioners (i.e., licensed physicians) provide these services to treat their patients with various medical conditions, such as leg pains and strokes.

Interpretation Given

This interpretation 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.

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 medical practitioners may use to for a variety of purposes and 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 the chelation therapy services. An exemption from the GST/HST for services supplied by medical practitioners is provided in section 5 of Part II of Schedule V to the ETA. This section exempts supplies made by medical practitioners of consultative, diagnostic, treatment or other health care services rendered to individuals, other than surgical or dental services performed for cosmetic purposes and not for medical or reconstructive purposes. The term "medical practitioner" is defined in the ETA as a person who is entitled under the laws of a province to practise the profession of medicine or dentistry.

We consider the supply of chelation therapy to meet criteria in the ETA 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 and therefore no GST/HST is charged on the consideration for this supply.

The foregoing comments represent our general views with respect to the subject matter of your letter. Proposed amendments to the ETA, if enacted, could have an effect on the interpretation provided herein. These comments are not rulings and, in accordance with the guidelines set out in section 1.4 of Chapter 1 of the GST/HST Memoranda Series, do not bind the CCRA with respect to a particular situation.

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