SLP cross-border tax: US teletherapy clients and the licensure question underneath

Tax first: US teletherapy income usually stays Canadian

When you deliver a session by video from your Ontario office, the service is performed where you are physically located, not where the client sits, so a US family or a US-based teletherapy staffing agency paying you generally does not create US-source business income under the Canada-US treaty as long as you have no US permanent establishment. If a US payer withholds tax anyway or asks for documentation, a W-8BEN or W-8BEN-E on file tells them you are a Canadian resident entitled to treaty benefits and stops the default 30 percent withholding before it happens rather than requiring a recovery claim afterward — see what Form W-8BEN is and when a Canadian needs one. The income still lands on your Canadian T2125 or corporate return in the ordinary way, converted from USD at the transaction-date rate. A US-based teletherapy staffing platform that routes clients to you and pays you directly does not change this analysis on its own — what matters is where you physically deliver the service, not which country the payer is incorporated in.

Licensure is the flag, not the tax question

Practising speech-language pathology across a US state line is a licensing matter decided state by state, and it sits entirely outside CASLPO's authority — your Ontario registration lets you practise in Ontario, full stop. A new interstate compact for audiologists and speech-language pathologists began issuing cross-state practice privileges to US-licensed clinicians in late 2025, but it only extends privileges to someone who already holds a base license in a compact member state; it does nothing for a CASLPO-registered clinician with no US state license at all. In practice, seeing a client physically located in a given state generally still requires that state's own licence or an applicable exemption, and we flag this as a compliance question for you or your legal advisor to confirm — it is not something an accountant can clear on your behalf. Some practices sidestep the question by keeping telepractice limited to clients physically in Canada and treating any US-resident inquiry as a referral out rather than a session to schedule, which is a simpler answer than tracking licence status state by state.

US-trained SLPs relocating face a shorter credentialing path than most

An SLP trained and certified in the United States moving to Ontario usually has an easier registration path than many internationally trained clinicians, since American graduate-level SLP programs and the ASHA Certificate of Clinical Competence line up reasonably closely with CASLPO's own standards — the assessment is typically a credential and supervised-practice review rather than a full re-training. The costs that do apply are ordinary relocation costs: a T1-M claim for the move itself if it is at least 40 kilometres closer to new work and tied to starting Canadian employment or self-employment, and any CASLPO application and assessment fees, which are not moving expenses but are worth tracking as professional costs from day one. The transition year itself is worth planning around separately if there is a gap between winding down a US caseload and building a Canadian one — a lower-income year is a reasonable time to top up RRSP contributions or realize a capital loss, not just something to get through.

A US retirement account does not travel with you into an RRSP

A 401(k) or IRA left in the United States keeps its US tax character after you move — it does not convert into an RRSP, and Canada begins taxing its growth and withdrawals as a resident, with treaty relief available in the specific situations it covers. It also becomes reportable on a T1135 once your total foreign property, including that account, crosses $100,000 CAD. Leaving the account in place while you settle into a new practice is usually fine on its own; the risk is in the paperwork nobody files once the reporting threshold has quietly been crossed. If you are a US citizen rather than a permanent resident who moved north, remember that citizenship carries its own annual US filing obligation regardless of where you live or practise — a separate matter from anything above, and one we coordinate alongside your Canadian return rather than treating as an afterthought.