IRS Medical Mileage: What Qualifies and How to Calculate It

Medical expenses can add up quickly, but the IRS allows certain deductions to help offset these costs. One often-overlooked deduction is medical mileage, which lets taxpayers deduct travel expenses related to eligible medical care. This can provide meaningful savings for those who frequently visit doctors, specialists, or treatment centers.

Understanding how to track and calculate this mileage correctly is essential to maximizing deductions while staying compliant with IRS rules.

Qualifying Medical Mileage

The IRS permits taxpayers to deduct mileage costs for travel related to medical care, but not every trip qualifies. The travel must be primarily for obtaining medical services necessary for diagnosing, treating, or preventing a physical or mental condition. This includes trips to doctors, dentists, hospitals, and other licensed medical providers. Visits to alternative health practitioners, such as acupuncturists or chiropractors, may also qualify if the treatment meets IRS guidelines.

Transportation to pharmacies for prescription medications is deductible if prescribed by a licensed provider. However, travel to pick up over-the-counter drugs, even if recommended by a doctor, does not qualify. Similarly, mileage for general wellness activities, such as gym visits or elective procedures, cannot be deducted.

If a patient is unable to drive, mileage for a caregiver or family member providing transportation is deductible when the person being transported cannot travel alone due to their medical condition. If public transportation is used instead of a personal vehicle, those costs may be deductible but are categorized separately.

Calculation Methods

To determine the deductible amount for medical mileage, taxpayers must apply the standard mileage rate set by the IRS. For 2024, the rate is 21 cents per mile. This rate is updated annually, so taxpayers should verify the applicable rate when preparing their returns. To calculate the deduction, multiply the total medical miles driven by the IRS-approved rate. For example, driving 500 miles for eligible medical purposes in a year results in a $105 deduction (500 miles × $0.21).

Most taxpayers use the standard mileage rate because it is simpler, but an alternative method allows deduction of actual vehicle expenses related to medical travel, such as gas, oil, and maintenance. However, only the portion of these costs directly tied to medical travel can be deducted. Depreciation, lease payments, and insurance are not included. Since tracking these expenses separately can be complex, most individuals opt for the standard mileage rate.

If multiple medical trips occur on the same day, each leg of the journey should be recorded separately. If a taxpayer combines medical travel with personal errands, only the portion of the trip directly related to medical care is deductible. For example, if a person drives 10 miles to a doctor’s appointment, then another 5 miles to a grocery store before returning home, only the initial 10-mile trip qualifies.

Combining Mileage with Other Deductions

Medical mileage is one of several deductible healthcare expenses. The IRS allows taxpayers to deduct qualified medical expenses that exceed 7.5% of their adjusted gross income (AGI). Mileage alone may not surpass this threshold, but when combined with other deductible costs—such as out-of-pocket payments for doctor visits, surgeries, prescription medications, and medical equipment—the total deduction can become significant.

Long-term care expenses can also contribute to reaching the deduction threshold. Payments for nursing home care, in-home medical assistance, and specialized treatments for chronic conditions qualify if the primary reason for the care is medical. Additionally, self-employed individuals can deduct health insurance premiums, though those with employer-sponsored coverage cannot.

Taxpayers using a Health Savings Account (HSA) or Flexible Spending Account (FSA) should be careful when claiming deductions. Expenses reimbursed through these accounts cannot be deducted again, as this would result in double-dipping, which is not allowed under IRS rules. Only unreimbursed expenses should be included in the total medical deduction calculation.

Recordkeeping Requirements

Accurate recordkeeping is essential to substantiate medical mileage deductions in case of an IRS audit. Taxpayers should maintain a mileage log that includes the date of each trip, the starting and ending locations, the number of miles driven, and the specific medical purpose of the travel. While handwritten logs are acceptable, digital tracking through apps or spreadsheets can provide a more organized and verifiable record.

Additional documentation strengthens the legitimacy of claimed expenses. Appointment confirmations, medical provider invoices, and payment receipts create a direct link between the travel and necessary medical care. For those using rideshare services, taxis, or other paid transportation, keeping copies of fare receipts is just as important. If a caregiver provides transportation, any reimbursement arrangements should be well-documented.

Handling Adjustments in Mileage Rates

The IRS periodically updates the medical mileage rate to reflect changes in fuel prices, vehicle maintenance costs, and other economic factors. Adjustments typically occur annually, but mid-year changes have been made in response to significant inflation or fuel cost fluctuations. Taxpayers must use the correct rate for each portion of the year to ensure accurate calculations.

When a rate change occurs mid-year, mileage records must be divided into two periods: one for the months before the adjustment and another for the months after. For example, in 2022, the IRS increased the medical mileage rate from 18 cents per mile to 22 cents per mile starting in July. Taxpayers who drove for medical purposes in both halves of the year had to apply the lower rate for trips taken before July and the higher rate for trips afterward. Keeping clear records of travel dates ensures accurate calculations and prevents errors when filing tax returns.