Medical mileage rate 2026 and how to deduct it

Medical mileage rates by year

The rate follows the date of the trip. Announcement 2026-11 raised the medical rate from 20.5¢ to 23.5¢ for driving on or after July 1, 2026, and gives the reason as recent increases in the price of fuel. Trips before July 1 keep 20.5¢. Older business rates are on the IRS mileage rate history page.

What counts as medical travel

That covers driving yourself, your spouse or a dependent to medical care, and Publication 502 also lists:

• bus, taxi, train or plane fares and ambulance service;
• the travel of a parent who must go with a child who needs medical care;
• the travel of a nurse or other person who can give injections, medications or other treatment a patient needs while traveling to get medical care, when the patient can't travel alone;
• regular visits to a mentally ill dependent, if the visits are recommended as part of treatment.

It does not cover:

• going to and from work, even if your condition requires an unusual means of transportation;
• travel for purely personal reasons to another city for an operation or other medical care;
• travel that is merely for the general improvement of your health;
• the costs of running a specially equipped car for other than medical reasons.

Standard rate or actual gas and oil

For a car you can count either your out-of-pocket costs, such as gas and oil, or the standard medical rate. Depreciation, insurance, general repair and maintenance are not included. Parking fees and tolls are added under either method, so work it out both ways and use the larger figure. Publication 502's own example, with 2025's rate of 21¢:

The same 2,800 miles driven in 2026, half before July 1 and half after: 1,400 × 20.5¢ = $287.00 and 1,400 × 23.5¢ = $329.00, plus $100 of tolls and parking, comes to $716.00.

The 7.5% floor and Schedule A

Medical expenses are an itemized deduction on Schedule A, and Publication 502 says you can deduct only the part of your medical and dental expenses that is more than 7.5% of your adjusted gross income. With an AGI of $60,000 the first $4,500 of medical costs gives no deduction. If the medical driving above ($716.00) and $4,000 of other medical bills make $4,716.00, then $216.00 is deductible. If you take the standard deduction instead of itemizing, medical mileage does not reduce your federal tax.

HSA, FSA and HRA reimbursements

An HSA can pay you back tax-free for qualified medical expenses, which Publication 969 defines as medical care under section 213(d) of the tax code, the same definition behind the medical expense deduction. A health FSA pays the expenses its plan covers, and Publication 969 says the FSA needs a written statement from an independent third party that the expense was incurred, so keep the appointment record with the trip log. To hand in a claim, the mileage reimbursement form prices medical trips at the medical rate for their dates.

Count each mile once. Publication 969 says you can't deduct on Schedule A the expenses your HSA paid tax-free, and Publication 502 says expenses reimbursed by a health reimbursement arrangement can't be included in your medical expenses.

Records to keep

Publication 502 tells you to keep records of your medical expenses to support the deduction and not to send them with a paper return. For driving, write down each trip: the date, the provider you went to and the miles, and keep parking and toll receipts. The free mileage log generator takes medical trips and applies 20.5¢ or 23.5¢ by date.

Rates for 2027

The IRS has not published the 2027 standard mileage rates (checked October 17, 2026). In each of the last five years it announced the next year's rates between December 14 and December 29: December 17, 2021 (IR-2021-251), December 29, 2022 (IR-2022-234), December 14, 2023 (IR-2023-239), December 19, 2024 (IR-2024-312) and December 29, 2025 (IR-2025-128).