Tuition for Special Education in Medical Expenses Deduction

[Michael16]

My wife and I (MFJ) have a child who is severely medically disabled (both physical and cognitive disabilities). During a portion of 2022, we sent her to a child development center with early intervention services where she received a number of her routine therapies among other programs directed at her medical conditions. The center included both typically developing and neurodivergent students. Around mid-year, we moved her to a more traditional school but pay double the tuition for a one-on-one aid who works directly with her on her developmental needs while helping to include her in typical activities.

I've read IRS publication 502 to determine if the cost of tuition for one or both schools could be included as a medical expense deduction (assuming we meet the 7.5% AGI requirement for medical expenses, which we would with the tuition). It's unclear to me if these circumstances qualify for eligibility and if so what documentation we might need to ensure we meet this special education requirement.

Any advice or expert opinion on this matter would be greatly appreciated.

[Bsch4477]

As all parents with special needs children know, addressing a child’s physical and learning disabilities can be a huge financial burden. Educating these children so that they are able to achieve the maximum level of independence is both difficult and costly. Previously the IRS had allowed parents of special needs children to deduct the cost of tuition or other programs designed to help disabled children succeed, but the entire tuition could not be deducted. In 2011 that rule changed.

As of 2011, the IRS has ruled that tuition for a special school designed to help students manage or overcome disabilities can be counted as a deductible medical expense if the child’s primary reason for attending that school is its medical benefit. The school may offer subjects included in an ordinary school curriculum, but it must differ from an ordinary school in that it utilizes specialized education techniques to address handicaps.

In order to qualify for the medical tax deduction, the child’s doctor must recommend attending the specialized school. If the child does not qualify to attend this kind of school or if no such school is available in the geographical area, a doctor can recommend tutoring by a qualified teacher who is trained to work with children who have mental and/or physical impairments. In this case, the cost of tutoring counts as a medical deduction.

[Michael16]

If I've paid for qualifying tuition through a dependent care FSA, does it still qualify as a medical expense deduction?

[xmasbaby0]

You cannot double dip.  The money you put into a FSA was not taxed.  You cannot then claim that same money as a deduction.