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PricingService areasAll services →Accounting and Tax for Ontario Healthcare Clinics and Practitioners
HST-exempt services, professional corporations, clinic payroll and practitioner splits, handled by a CPA-led accounting firm, so you can spend your time on patients, not paperwork.
24/7 receptionist, a real person answers.
- Every return is reviewed by a CPA
- No surprise bills
- Reply within one business day
- 24/7 receptionist: a real person answers
- QuickBooks Online, Xero and Dext
- Rated 5.0 stars from 29 Google reviews (read our reviews)
T-Ledgers is a CPA-led accounting firm working with Ontario healthcare businesses: physiotherapy, chiropractic, massage therapy, optometry, psychology and multidisciplinary clinics, pharmacies and solo regulated practitioners. Wajahat Ajmal, CPA, FCCA, has been practising since 2020 and has led finance for health care businesses. We handle bookkeeping, HST, payroll and corporate and personal tax, and every return is reviewed by a CPA. (Physicians and dentists have their own page: accounting for doctors and dentists.)
Healthcare tax and bookkeeping issues we handle
Rules, rates and thresholds change. We confirm the current figure for your situation on the call before relying on it.
HST-exempt vs taxable services
Many health care services provided by regulated practitioners are exempt from HST, which means you don’t charge HST but generally can’t claim input tax credits on related costs either. Whether your profession qualifies depends on federal rules, including whether it’s regulated in at least five provinces. Cosmetic services, product sales and some services to other businesses are often taxable. Mixed clinics need to split this correctly.
Law: Excise Tax Act s.123(1) (“exempt supply”); Excise Tax Act Schedule V, Part II (exempt health care services); Excise Tax Act s.169(1) (input tax credits).
Practitioner splits and clinic agreements
When several practitioners work under one roof, rent-sharing, fee-splitting and service agreements affect who reports what, and whether HST applies to the clinic’s charges to practitioners. A clinic that bills practitioners for admin and space is often making a taxable supply even when the patient care is exempt. We review the agreements and set up the books to match.
Law: Excise Tax Act s.165 (GST/HST imposed); Excise Tax Act s.148(1) (small supplier, $30,000); Excise Tax Act s.240(1) (registration).
Independent contractor or employee?
Associates and therapists are often paid as contractors. If the clinic controls their schedule, tools and patients, the CRA may see them as employees and assess CPP, EI and tax you didn’t withhold. We help you document the relationship and run payroll where it’s needed.
Professional corporations
Ontario allows many regulated health professionals to practise through a professional corporation, subject to their college’s rules. Professional corporations can access the small business rate on active income, but income splitting with family members is limited by the tax on split income (TOSI) rules.
Law: Business Corporations Act (Ontario) s.3.1 (professional corporations); Income Tax Act s.125(1) (small business deduction); Income Tax Act s.120.4 (tax on split income).
Salary, dividends and passive income
Salary creates RRSP room and CPP; dividends don’t. Money left in the corporation can be invested, but if passive investment income is more than $50,000 in a year, the small business limit is reduced the following year, and eliminated at $150,000. We plan the mix each year.
Law: Income Tax Act s.125(5.1) (business limit reduction); Income Tax Act s.146 (RRSPs); Income Tax Act s.15(1) (shareholder benefits).
Pharmacies
Prescription drugs are generally zero-rated while many front-store items are taxable at 13% HST, so point-of-sale tax codes and inventory counts matter. Inventory is valued at the lower of cost and market at year-end.
Law: Excise Tax Act Schedule VI, Part I (zero-rated prescription drugs); Income Tax Act s.10(1) (inventory valuation).
Payroll and Employer Health Tax
Clinics with staff remit CPP, EI and income tax, and Ontario Employer Health Tax generally applies only above the Employer Health Tax exemption for eligible employers (currently $1 million; see Ontario’s EHT page).
Law: Income Tax Act s.153(1) (source deductions); Employer Health Tax Act s.2.1(2) ($1,000,000 exemption for 2020 to 2028).
Equipment and leasehold improvements
Treatment tables, diagnostic equipment, computers and clinic build-outs go into CCA classes rather than being written off at once. We keep a fixed-asset register and compare leasing with buying.
Law: Income Tax Act s.20(1)(a) (capital cost allowance); Income Tax Regulations s.1100(1) and Schedule II (CCA classes).
Records, privacy and CRA reviews
Keep billing, receipts and payroll records for six years. We keep financial records separate from patient health information, so you can answer a CRA review without sharing clinical files.
Law: Income Tax Act s.230(1) and 230(4) (books and records, six years); Excise Tax Act s.286(1) and 286(3) (records, six years); Income Tax Act s.231.1(1) (CRA audits).
Who we work with
- Physiotherapy, chiropractic and massage therapy clinics
- Psychologists, psychotherapists and counselling practices
- Optometrists, dietitians and occupational therapists
- Multidisciplinary and wellness clinics
- Pharmacies
- Solo regulated practitioners, incorporated or not
Services for healthcare clinics and practitioners
- Bookkeeping, from $350/month (quarterly); monthly bookkeeping from $500/month. Bookkeeping Reviews of complex books start from $450 (see bookkeeping).
- Bookkeeping Review, $195/month or $295/quarter. For solo practitioners who keep their own books.
- GST/HST returns, $150 per return. For clinics and practitioners with taxable services.
- Catch-up bookkeeping, from $1,800 per year (see catch-up bookkeeping).
- Corporate tax (T2), from $800, and personal tax (T1) from $110 (see corporate tax and personal tax).
- Incorporation, from $499 plus government fees, subject to your college's professional corporation rules.
- Payroll. Quoted after a free call (see payroll services).
- Virtual CFO, from $2,500/month. For growing and multi-location clinics (see Virtual CFO).
Prices are + HST/GST. Anything without a listed price is quoted after a free call, and you get the price in writing before any work starts.
How we work with clinics
- Free call. We ask about your services, practitioners, agreements and how far behind you are.
- Written price. You get the scope and price in writing before any work starts.
- Setup. Exempt and taxable revenue separated in QuickBooks Online or Xero, practitioner splits mapped and Dext for receipts.
- Monthly rhythm. Books closed monthly, HST and payroll filed on time.
- Year-end. Financial statements, T2 and T1, all reviewed by a CPA, with a salary and dividend plan.
Why healthcare clinics and practitioners choose T-Ledgers
- We know exempt from taxable. We map every service and practitioner agreement so HST, input tax credits and splits are right from day one.
- CPA-led, start to finish. T-Ledgers was founded by Wajahat Ajmal, CPA, FCCA. Every return is reviewed by a CPA before it's filed.
- No surprise bills. You get the scope and the price in writing before we start. If the work changes, we agree the new price with you first.
- Price matching, agreed up front. Have a comparable written quote? Bring it to us before you sign your proposal. We can only match a price when it's agreed before the proposal is signed.
- Fast, human answers. We reply within one business day, and our 24/7 receptionist means a real person answers when you call 866-254-5368.
- In person or online. Meet us in person, by appointment only, at our Etobicoke office (102-89 Skyway Ave, Etobicoke, ON M9W 6R4) or our Mississauga office (100 Matheson Blvd E #204, Mississauga, ON L4Z 3P8), or work with us entirely online.
- Your software, set up properly. We work in QuickBooks Online and Xero, and use Dext so receipts go in with a photo.
Meet your CPA
Wajahat Ajmal, CPA, FCCA, Founder, T-Ledgers Accounting. Verify my CPA Ontario membership.
I started my career as an audit associate at KPMG. Since then I’ve worked as an independent contractor for a tax filing company, preparing returns and handling client questions. I hold a BSc in Applied Accounting from Oxford Brookes University and an MSc in Professional Accountancy from University College London. I’m a Chartered Professional Accountant in Ontario and a Fellow of the ACCA. I started taking on my own clients in 2020 and founded T-Ledgers in 2023.
Every return the firm files is reviewed by a CPA. You can read more about the firm on our About page.
What our clients say
Read more on our client reviews page.
DIY vs a generalist firm vs T-Ledgers
← Swipe to compare →
| DIY | Generalist firm | T-Ledgers BEST VALUE | |
|---|---|---|---|
| Exempt vs taxable services | Easy to get wrong | May treat the clinic like any other business | ✓Mapped service by service |
| Practitioner splits and contractors | Agreements rarely match the books | Varies | ✓Agreements reviewed and books set up to match |
| Professional corporation planning | Guesswork | Varies | ✓Salary, dividends and passive income planned each year |
| Who checks the return before it's filed | You do | Depends on the firm and who's assigned | ✓Every return is reviewed by a CPA |
| How you're billed | Software fees plus your own time | Often hourly; the final bill can vary | ✓Scope and price in writing up front. No surprise bills |
| Getting an answer | Search online or wait on CRA phone lines | Varies by firm | ✓Reply within one business day; 24/7 receptionist, a real person answers |
| Software | Whatever you set up yourself | May ask you to switch to their system | ✓QuickBooks Online, Xero and Dext |
| Meeting face to face | Not applicable | Varies | ✓In person by appointment in Etobicoke or Mississauga, or fully online |
| Price matching | Not applicable | Rare | ✓Available if agreed before you sign your proposal |
Frequently asked questions: Healthcare
Many services by regulated health practitioners are exempt. Cosmetic services, products and some business-to-business services are usually taxable. We map your services one by one.
Not on costs that relate to exempt services. Clinics with both exempt and taxable revenue claim input tax credits only for the taxable share.
Only if your taxable supplies go over $30,000. Many solo practitioners with only exempt services don’t need to register.
Generally no. Prescription drugs are zero-rated, while many front-store items are taxable at 13%.
Often yes. Fees a clinic charges practitioners for space, admin and billing are usually taxable, even when the patient service is exempt.
It depends on the actual working relationship: control, tools, chance of profit and risk of loss. We review your agreements.
Yes. We track each location separately so you can see which ones make money.
Many Ontario regulated health professions can, subject to college rules and the Business Corporations Act. We set it up and handle the annual filings.
Usually a mix. Salary creates RRSP room and CPP; dividends can cost less in corporate payroll. We plan it each year.
A reasonable salary for real work is fine. Dividends to family are generally caught by the TOSI rules unless an exception applies.
Passive income over $50,000 a year reduces the small business limit the following year. We keep an eye on it.
Active business income may qualify for the small business rate on the first $500,000. We confirm the current combined rate on the call.
Generally only on Ontario payroll above the exemption for eligible employers, currently $1 million.
Six years from the end of the tax year they relate to.
Through CCA, over several years. We plan larger purchases so the tax effect is clear before you buy.
No. We work from billing summaries, bank records and receipts, not clinical records.
Monthly bookkeeping starts from $500/month (quarterly bookkeeping from $350/month), the Bookkeeping Review is $195/month or $295/quarter, GST/HST returns are $150 per return, corporate T2 returns start from $800, personal T1 returns from $110, incorporation from $499 plus government fees and catch-up work from $1,800 per year. Payroll is quoted after a free call. Prices are + HST/GST. You get the price in writing before any work starts.
Yes. Many of our healthcare clients are solo, and the Bookkeeping Review suits practitioners who keep their own books.
Both, with Dext for receipts.
Yes, by appointment at our Etobicoke or Mississauga office, or we can work entirely online.
Spend your time on patients, not paperwork
Book a free call about your clinic’s HST, payroll or corporation. We reply within one business day; call 866-254-5368 and a real person answers 24/7.
Reviewed by Wajahat Ajmal, CPA, FCCA. Updated October 15, 2026.
Related services: Bookkeeping · Catch-up bookkeeping · Corporate taxes · Personal tax · Payroll · Virtual CFO · Contact us
Rates and thresholds change, so we link to the official sources for current figures.