Who We Help · Physiotherapists · Bookkeeping
Physiotherapist bookkeeping: OHIP, insurers, private pay — one clean ledger
A physio clinic can be funded three ways at once: OHIP episode-of-care payments if you hold a community physiotherapy contract, extended-health insurers billed on assignment, and private patients paying at the desk. The books only work when each stream keeps its own lane — and when kinesiology, which is taxable where physiotherapy is exempt, is tracked separately for HST. We build ledgers that keep the payers, the tax status, and the treatment rooms straight.
By the AnalytIQ Accounting team · Last reviewed: August 12, 2026
Three funding worlds, three reconciliation cycles
Clinics holding an OHIP community physiotherapy contract treat eligible patients — seniors 65 and over, patients 19 and under, people discharged after an overnight hospital stay, and social-assistance recipients — under episode-of-care funding that arrives on the ministry's schedule, not yours. Insurer work flows through Telus eClaims on assignment, with the patient covering the balance at the visit. Private patients, WSIB programs of care, and auto-insurance treatment plans round out the mix. Each stream needs its own revenue account and its own receivable, because each one fails differently: an episode billed but not yet remitted, a claim an insurer rejected, a copay the desk never collected.
We reconcile Jane or Cliniko outward monthly — payment reports to processor payouts, payouts to deposits, open insurer and ministry balances to receivable accounts that get aged and chased. Split invoices get special attention: an assigned claim leaves the insurer portion as a receivable while the patient portion should have been collected at the desk, and the two halves fail independently. WSIB programs of care add a third wrinkle — block-fee billing at scheduled rates that rarely match your private fee, so the difference is recorded as a visible rate concession rather than vanishing into a blended average. The clinic platform is the visit record; the ledger is where money becomes true.
Kinesiology is taxable — the books have to know it
Physiotherapy delivered by a licensed physiotherapist is HST-exempt. Kinesiology is not on the federal exempt list, so conditioning programs, personal training, and most group classes delivered by your kinesiologists are taxable services — inside the same clinic, on the same schedule, often for the same patient. That mix has consequences the schedule never shows:
| Revenue stream | HST status | What the books must do |
|---|---|---|
| Physiotherapy sessions | Exempt | No tax charged, no ITCs recovered — record costs gross |
| OHIP episode funding | Exempt | Reconcile remittances to episodes opened and closed |
| Kinesiology and conditioning | Taxable | Track against the $30,000 threshold; charge HST once registered |
| Retail: braces, bands, tape | Taxable | Separate sales account; inventory counted, not guessed |
Once taxable revenue crosses the $30,000 small-supplier threshold, the clinic registers, charges HST on the taxable side only, and claims input tax credits only for the portion of costs that support taxable activity. That allocation is a bookkeeping design problem — provider-level and stream-level accounts make it defensible; one blended income line makes it a guess.
What a treatment room actually costs
Rent, utilities, laundry, linens, and equipment depreciation are clinic-level costs, but decisions get made room by room: whether to add a fourth treatment room, whether the gym floor earns its square footage, whether a kinesiologist's wage is covered by the programs they run. We allocate occupancy and equipment costs across rooms and the gym, then report each provider's revenue beside the space and wage cost they consume. The result is a per-visit overhead number — the figure you actually need when a WSIB or insurer fee schedule makes you wonder whether that stream still pays for itself.
The same allocation settles contract questions before they become disputes. Physiotherapists on percentage splits, kinesiologists on wages, and any practitioner renting a room off-hours each interact with clinic costs differently, and per-room numbers show what each arrangement really contributes after its share of overhead. Clinics discover surprising things here — a fully booked room at insurer rates sometimes nets less than a half-booked room of private patients.
Year-end without archaeology
Books split by payer and tax status make year-end an assembly job. Exempt and taxable streams flow to your T2125 or your professional corporation's T2 already separated, the GST34 return draws on running totals rather than reconstruction, and receivables from the ministry and insurers are supported by an aging report rather than optimism. Because physio costs are mostly gross — no ITCs on the exempt side — equipment purchases are capitalized and depreciated through capital cost allowance, so a year of clinic buildout does not crater the tax picture the way the bank balance suggests. Monthly, you get a short package: revenue by stream and provider, receivable aging by payer, taxable-sales running total, and per-room overhead.
If US work is on your horizon — travel-PT contracts on TN status, or US continuing education — the filings and withholding questions live on our cross-border tax page for physiotherapists. For the mechanics of our monthly close itself, see our bookkeeping services page.
Common questions.
Is physiotherapy subject to HST?
No — physiotherapy delivered by a licensed physiotherapist is exempt, so you charge no tax and recover no input tax credits. Kinesiology, training programs, and retail sales are taxable, and they are what push a clinic past the $30,000 registration threshold.
How is OHIP community physiotherapy funding recorded?
As its own exempt revenue stream, reconciled monthly against episodes opened and closed so ministry remittances match what the clinic actually delivered. Blending it with private revenue hides both timing gaps and shortfalls.
Can the books show whether my kinesiology program makes money?
Yes — if kin revenue, kin wages, and an allocated share of space costs each have their own accounts. We report the stream side by side so the answer is a number, not a feeling.
Related reading
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