Updates from EIM

IRS Recognizes Exercise as Medical Treatment | Guidance For Healthcare Providers

April 22, 2024 by Cayce A. Onks, DO, FACSM

Doctor smiling and speaking with a patient. overliad with the text: How To Guide, IRS Code Section 213

In March of 2023 the IRS Code section 213, was changed to allow that exercise-based interventions can be paid for through tax-free medical spending accounts. This change is significant, as it is another step forward in gaining access to treatment options that include exercise for routine management of medical injury/illnesses.

To assist patients interested in receiving this benefit, the Exercise is Medicine® Clinical Practice Committee has created a one page “how to” guide for healthcare providers. Our intent is to provide relevant information regarding the change and a guide for successfully submitting and receiving approval for the benefit.

We are excited to provide this guidance and that exercise is increasingly recognized as not only a good thing for overall health, but also a treatment option!

Access the How To Guide here.

A template for Letter of Necessity for Reimbursement

[Include clinical practice letterhead] 


Letter of Medical Necessity for Reimbursement 2024 

To Whom It May Concern: 

[Patient Name] is under my care for the new diagnosis of [Insert new diagnosis]. As part of overall treatment for this condition, I recommend [Patient Name] begin a prescribed physical activity program through [Insert type of organization or fitness class requiring an expense]. Pursuant to Section 213 of the Internal Revenue Service Code (1), the cost of this physical activity program would not be incurred by the patient if not for the new diagnosis and my recommendation. This physical activity expense is new for the patient and not one that was in place prior to now. I recommend that this new physical activity expense be covered for [Can insert number of months, only if a specific time period is recommended]. 


[Insert provider’s signature, name and credentials and contact information] 

  1. Section 213 of the IRS Code generally allows a deduction for expenses paid during the taxable year for medical care if certain requirements are met. Expenses for medical care under section 213 of the Code also are eligible to be paid or reimbursed under an HSA, FSA, Archer MSA, or HRA. 
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Contact United States EIM Representative | 6510 Telecom Dr., Suite 200, Indianapolis, IN 46278 | 317-637-9200 © 2021 American College of Sports Medicine. All rights reserved worldwide. Exercise is Medicine® is a global health initiative managed by the American College of Sports Medicine.