Is physical therapy tax deductible?

What does IRS Publication 502 say about physical therapy?

Publication 502, the IRS guide to medical and dental expenses, does not have a line headed “physical therapy”. Instead, it has a general entry for therapy: amounts you pay for therapy received as medical treatment can be included in medical expenses. Physical therapy for an injury, after surgery or for a diagnosed condition sits squarely inside that description.

The current edition at the time of writing is the one for preparing 2025 returns. The IRS reissues it every year, usually early in the filing season, so the version for 2026 returns will carry its own figures. The rules on what counts have been stable for a long time; the dollar amounts, such as the mileage rate, are what change.

The deduction covers what you actually paid out of pocket. Copays, coinsurance, payments toward your deductible and self-pay visits all qualify. The part your insurer paid does not, because you did not bear that cost.

How does the 7.5% of AGI floor work in practice?

You add up every qualifying medical and dental expense for the year, for yourself, your spouse and your dependents, then subtract 7.5% of your adjusted gross income (AGI). Only the amount left over is deductible, and only if you itemize on Schedule A of Form 1040 instead of taking the standard deduction.

A simple illustration, with round numbers chosen only to show the arithmetic: with an AGI of $80,000, the floor is $6,000. If your family’s total medical spending for the year came to $7,500, including physical therapy, premiums you paid with after-tax money, prescriptions and a surgery bill, you could deduct $1,500. If the total were $5,000, you could deduct nothing.

That is why physical therapy on its own rarely produces a deduction. It tends to matter in a year that also includes surgery, a hospital stay or a long course of care, which is exactly the year someone recovering from a knee replacement or other operation might have.

Which therapy-related costs count, and which do not?

Treatment costs count; general fitness costs do not. Publication 502 is explicit that health club dues, and money spent to improve general health rather than treat a particular condition, are not medical expenses. That line separates a physical therapy visit from a gym membership or coached training after you are discharged.

Getting to appointments can count too. Publication 502 lets you include the cost of transportation for medical care, either as actual car expenses or at the standard medical mileage rate, which is 21 cents a mile for 2025, and parking fees and tolls are included under either method. The IRS changed the medical rate partway through 2026, to 20.5 cents a mile for trips from January through June and 23.5 cents from July 1, so a 2026 mileage log needs the date of each trip.

• Usually counts: copays, coinsurance and deductible payments for physical therapy visits
• Usually counts: self-pay physical therapy sessions for a diagnosed problem
• Usually counts: mileage, parking and tolls for trips to treatment
• Does not count: gym or health club dues, even if a therapist suggested exercise
• Does not count: any amount paid with tax-free HSA money or reimbursed by an FSA
• Does not count: the share of the bill your insurance plan paid

Can I deduct physical therapy I paid for with HSA or FSA money?

No. Publication 502 says you cannot include expenses you paid with a tax-free distribution from a health savings account, or expenses fully reimbursed by a flexible spending arrangement. That money was never taxed, so deducting it would count the same tax break twice.

For most people the HSA or FSA is the better tool anyway, because it works from the first dollar and has no 7.5% floor. Our page on using HSA and FSA funds for physical therapy explains how those accounts treat therapy visits. If you split payments, paying some visits from the account and some from your own pocket, only the second group can go on Schedule A.

What records should I keep from my therapist’s office?

Keep an itemized record of every payment: the date of service, the provider, what the visit was for and what you paid. Each therapist in the network is an independent practice that handles its own billing, so the receipts and statements come from the therapist’s office, not from the matching team.

Keep your insurer’s explanation of benefits statements as well, since they show what the plan paid and what was left for you. A plain mileage log with dates, the trip to Carmel City Center and back, and the miles driven is enough for transportation. If your situation is unusual, for example a large self-pay course of care or care for a dependent parent, a tax professional can tell you how it fits your return. Our cost and insurance overview explains how therapists in the network bill.