No, not on treatment. Chiropody and podiatry are both on Canada’s list of HST-exempt health services, so assessments, foot care, and treatment carry no tax. The twist in this profession is orthotics: custom orthotics are zero-rated rather than exempt, which changes your bookkeeping more than your patient’s bill. Add off-the-shelf products and insurer reports, which are taxable, and a foot clinic can be running three different tax treatments through one front desk.
Foot specialists have the messiest HST profile in health care, and most don’t know it. A physiotherapist has one main question: is my service exempt? A chiropodist or podiatrist has three streams flowing through the same clinic, each with its own rules, and the difference between them decides if you should be registered for HST even though your treatment income is exempt.
Treatment is exempt
Chiropodic and podiatric services are each listed in the health care exemptions of the Excise Tax Act, alongside physiotherapy, chiropractic, and dietetics. If you’re licensed with your provincial regulator and you’re treating a patient, there’s no HST on the visit. In Ontario, that covers both chiropodists and the grandfathered podiatrist class; the exemption doesn’t care which title you hold, only that you’re licensed and delivering foot care to an individual.
Exempt cuts both ways, though. Because treatment income is exempt rather than zero-rated, you can’t claim back the HST you pay on the costs behind it: clinic rent, instruments, supplies, association dues. That tax just stays in your cost base.
Orthotics are zero-rated, and that’s a different animal
Here’s the part that trips up nearly every foot clinic. Custom orthotics made to order for a specific patient aren’t exempt, they’re zero-rated. The patient still pays no tax, so from the treatment chair the two look identical. On your books they’re opposites.
Zero-rated means the sale is taxable at 0%. Registered clinics can claim back the HST on the costs of making and supplying those orthotics: lab fees, casting materials, shipping. Exempt income gives you no credits at all. So a clinic dispensing a steady flow of custom orthotics and not registered for HST is quietly donating the tax buried in its lab bills to the government.
That’s money worth going and getting.
The rules got friendlier in 2019. Since March 19, 2019, a licensed podiatrist or chiropodist counts as a professional whose written order can zero-rate off-the-shelf orthotic devices, specially designed footwear, and graduated compression stockings for a named patient. Before that, you needed a physician or physiotherapist to write the order. Sold casually off the shelf with no order, those same items are fully taxable.
Foot care and treatment
Assessments, nail and skin care, wound care, biomechanical exams, and any treatment a licensed chiropodist or podiatrist provides to a patient. No HST, but no input tax credits either.
Devices, products, reports
Custom orthotics are zero-rated with credits available. Off-the-shelf products without a written order, foot creams, and retail items are taxable, and so are reports written for insurers or lawyers.
The taxable tail: products and reports
Retail products sold without a written order, think creams, padded insoles grabbed off a display, nail care items, carry HST once you’re registered. And any report prepared for an insurer, an employer, or a lawyer rather than for the patient’s own care has been taxable since CRA’s purpose test came in. That’s the same line occupational therapists and psychologists manage on their assessment work.
Registration: the $30,000 line counts more than you think
The small-supplier threshold counts taxable and zero-rated sales over four rolling calendar quarters. Exempt treatment income never counts, but every custom orthotic does, at its full sale price. A clinic dispensing even a few orthotics a week can cross $30,000 on devices alone, and at that point registration is mandatory, not optional.
The good news is that for a foot clinic, registration usually pays. You collect nothing extra on zero-rated orthotics, you start recovering the tax on your orthotic costs, and you charge HST only on the retail and report side. The work is in the bookkeeping: three income streams, credits apportioned between them, and a clean audit trail for the written orders. It’s the same structure we build for clinics with mixed exempt and taxable income, and it’s very close to how optometrists handle exempt exams beside zero-rated eyewear.
Common questions
My patients never pay HST on orthotics. Doesn’t that mean they’re exempt?
No. Zero-rated and exempt both mean no tax on the invoice, but only zero-rated sales let the clinic recover HST on its costs, and only they count toward the registration threshold.
I’m under $30,000 in orthotic and product sales. Should I still register?
Often yes, voluntarily. Registration lets you claim credits on your orthotic costs even below the threshold. Is it worth the filing obligations? That depends on your volume, which is a half-hour conversation, not a guess.
Do I charge HST on a biomechanical assessment done for an insurance claim?
If the report’s purpose is the insurer’s decision rather than the patient’s care, treat it as taxable. Purpose decides, not who ends up paying the invoice.
Running treatment, orthotics, and retail through one clinic and not sure your HST setup is right? Send us a note and we’ll sort the streams for you.