Rev. Rul. 63-91

Advice has been requested whether amounts paid for medical services to practitioners, such as, chiropractors, psychotherapists, and others rendering similar type services, constitute expenses for `medical care' within the provisions of section 213 of the Internal Revenue Code of 1954(1) where there is no law requiring such practitioners to be licensed or (2) where they are not licensed, even though required to be by law.

Under section 213 of the Code, a deduction in computing taxable income is allowable for expenses paid during the taxable year, not compensated for by insurance or otherwise, for medical care of the taxpayer, his spouse, or a dependent, subject to certain limitations.

Section 213(e)(1) of the Code defines the term `medical care' as amounts paid-

(A) for the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any structure of function of the body (including amounts paid for accident or health insurance), or

(B) for transportation primarily for and essential to medical care referred to in subparagraph (A).

Section 1.213-1(e)(ii) of the Income Tax Regulations provides, in part, `Amounts expended for illegal operations or treatments are not deductible.'

Revenue Ruling 55-261, C.B. 1955-1, 307, states that medical expenses include payments for services rendered by physicians, surgeons, dentists, optometrists, chiropractors, osteopaths, qualified psychiatrists and psychologists, and authorized Christian Science practitioners.

Revenue Ruling 143, C.B. 1953-2, 129, holds that amounts paid to psychologists, who are qualified and authorized under state law, for the rendition of medical services constitute expenses paid for medical care.

I.T. 3598, C.B. 1943, 157, holds that amounts paid for services rendered by licensed chiropractors and osteopaths constitute expenses paid for medical care.

The sentence in the regulation quoted above, regarding the deductibility of amounts expended for illegal operations or treatments, is intended to be applied to operations or treatments which are illegal regardless of whether they are rendered by licensed or unlicensed practitioners. The sentence was not intended to imply that amounts paid to unlicensed practitioners are not expenses for `medical care.' The determination of what is medical care depends on the nature of the services rendered, not on the experience, qualifications, or title of the person rendering them. See George B. Wendell v. Commissioner , 12 T.C. 161, at 163 (1949).

The requirements for the licensing of practitioners vary with state laws. In many cases, treatments or services rendered by unlicensed practitioners are not illegal even though such treatments or services constitute the practice of medicine and the persons rendering them are required to obtain certificates or licenses from the state in which they practice. In such cases, patients are not paying for illegal medical care or treatments notwithstanding that the practitioners rendering the care or treatments are not authorized or licensed by the state to render medical services.

The Code and the regulations do not require a taxpayer to ascertain whether a practitioner is qualified, is authorized under state law, or is licensed to practice, before obtaining his services or claiming a medical expense deduction. Where it can be shown that an individual paid an amount for a purpose defined in the Code as `medical care,' such amount qualifies as a medical expense.

Accordingly, it is held that amounts paid for medical services rendered by practitioners, such as chiropractors, psychotherapists, and others rendering similar type services, constitute expenses for `medical care' within the provisions of section 213 of the Code, even though the practitioners who perform the services are not required by law to be, or are not (even though required by law) licensed, certified, or otherwise qualified to perform such services.

I.T. 3598, C.B. 1943, 157; Revenue Ruling 143, C.B. 1953-2, 129; and Revenue Ruling 55-261, C.B. 1955-1, 307, are modified to remove the implication that amounts paid only to persons, who are licensed, qualified, or authorized under state law to practice, constitute `medical care.'