The IRS has not yet announced the official 2027 medical mileage rate. The agency typically releases the following year's standard mileage rates in mid-December, so the 2027 medical rate will not be confirmed until December 2026. Based on the last five years of data, the medical mileage rate has moved in a narrow band between 16 and 22 cents per mile, and it sat at 20.5 cents per mile for 2026. Given current fuel prices and vehicle operating costs, a reasonable projection for 2027 falls somewhere between 20 and 22 cents per mile, though this is an estimate, not an official figure.
This article walks through how the medical mileage rate works, why it changes every year, what the historical pattern suggests about 2027, and how to actually use the deduction once the new rate is published.
What the Medical Mileage Rate Is Used For
The medical mileage rate lets taxpayers deduct the cost of driving for medical care when they itemize deductions on Schedule A. It also applies to reimbursements for medical travel paid through Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs), and it is the reference point many state Medicaid programs use when calculating non-emergency medical transportation (NEMT) mileage reimbursement for patients who drive themselves to appointments.
Qualifying medical travel includes:
- Trips to doctors, dentists, and other medical providers
- Trips to pick up prescriptions
- Trips to physical therapy or mental health appointments
- Mileage driven to receive treatment for a dependent or spouse
- Travel to medical conferences related to a chronic condition (with limits)
Commuting to a job and general wellness trips, like a gym membership drive, do not count.
Why the Rate Changes Every Year
Unlike the business mileage rate, which factors in fixed costs like depreciation, the medical and moving mileage rate is based only on variable costs of operating a vehicle. That includes:
- Gasoline and fuel prices
- Oil changes and routine maintenance
- Tires and repairs
- Vehicle insurance premiums tied to usage
Because this rate excludes depreciation, it tends to be lower than the business rate and moves more directly with fuel and maintenance cost swings. The IRS commissions an independent cost study each year (historically compiled with data from firms like Motus) and uses that data, combined with a look at the prior 12 months of average fuel prices, to set the new rate.
Historical Medical Mileage Rates
| Year | Medical/Moving Rate | Change from Prior Year |
|---|
| 2018 | 18 cents | +1 cent |
| 2019 | 20 cents | +2 cents |
| 2020 | 17 cents | -3 cents |
| 2021 | 16 cents | -1 cent |
| 2022 (Jan-Jun) | 18 cents | +2 cents |
| 2022 (Jul-Dec) | 22 cents | +4 cents (mid-year adjustment) |
| 2023 | 22 cents | no change |
| 2024 | 21 cents | -1 cent |
| 2025 | 21 cents | no change |
| 2026 | 20.5 cents | -0.5 cent |
The mid-year jump in 2022 is worth noting. When gas prices spiked sharply in the first half of that year, the IRS took the unusual step of raising the medical and business mileage rates mid-year through Notice 2022-13, the first mid-year adjustment since 2011. That shows the rate is not purely mechanical: if fuel or insurance costs move sharply enough, the IRS can and will adjust outside the normal December announcement cycle.
2027 Medical Mileage Rate: What a Realistic Projection Looks Like
Because the 2026 rate already reflects a small downward adjustment from 21 to 20.5 cents, the 2027 rate will likely depend on three factors that are still developing through the second half of 2026:
- Fuel prices. If average gas prices hold steady or dip slightly through the back half of 2026, expect the medical rate to stay flat or drop again, similar to the 2025-to-2026 pattern.
- Auto insurance costs. Insurance premiums have been rising nationally for several years and are a real input into the variable cost study. Continued increases in insurance costs could offset falling fuel prices and keep the rate from dropping much further.
- Maintenance and repair costs. Parts and labor costs have also trended upward, which tends to push the medical rate up rather than down.
Given these competing pressures, a reasonable range for the 2027 medical mileage rate is approximately 20 to 22 cents per mile. This is a projection based on historical patterns and current cost trends, not an official IRS figure. The confirmed rate will be published in an IRS notice in December 2026, ahead of the 2027 tax filing season.
2026 Rate Comparison: Medical vs Business vs Charitable
| Purpose | 2026 Rate | Set By | Basis |
|---|
| Business | 72.5 cents | IRS annual cost study | Fixed + variable costs |
| Medical/Moving | 20.5 cents | IRS annual cost study | Variable costs only |
| Charitable | 14 cents | Set by Congress (statutory) | Unchanged for over 20 years |
The charitable mileage rate is fixed by law rather than adjusted annually by the IRS, which is why it has stayed at 14 cents per mile for decades regardless of fuel prices. The business and medical rates, by contrast, are recalculated every year.
How to Claim the Medical Mileage Deduction
Once the 2027 rate is confirmed, the process for claiming medical mileage stays the same as prior years:
- Track your medical mileage. Keep a log with the date, destination, purpose of the trip, and miles driven. A simple spreadsheet or mileage tracking app works.
- Add up total medical expenses for the year. This includes mileage (at the applicable rate), plus other unreimbursed medical costs like copays, prescriptions, and insurance premiums not paid pretax.
- Compare total medical expenses to 7.5% of your Adjusted Gross Income (AGI). Only the amount above that threshold is deductible.
- Itemize on Schedule A. The medical mileage deduction only helps if you itemize rather than take the standard deduction, so run the math both ways before filing.
- Keep records for at least three years. The IRS can request documentation for mileage claims during that window.
For many taxpayers with modest medical expenses, the 7.5% AGI floor means the deduction only becomes worthwhile in years with significant medical bills, a new diagnosis, a hospitalization, or ongoing treatment requiring frequent travel.
How This Affects People on Medicaid or Medicare
People enrolled in Medicaid may already have access to free non-emergency medical transportation (NEMT) benefits that cover rides to appointments, so mileage reimbursement is less relevant for that group. However, some state Medicaid programs reimburse mileage directly for beneficiaries who drive themselves to appointments, and those reimbursement rates are often pegged to or influenced by the IRS medical mileage rate. When the IRS rate moves, some state Medicaid mileage reimbursement schedules follow with a delay.
Medicare does not generally cover mileage reimbursement for beneficiaries driving to their own appointments, so the itemized deduction route above is typically the only federal option available for out-of-pocket medical travel costs under Medicare.
If you are unsure whether you qualify for Medicaid, Medicare Savings Programs, or other assistance that could reduce your overall medical costs, it is worth checking your eligibility across multiple programs at once rather than assuming you do not qualify.
Frequently Asked Questions
When will the IRS announce the 2027 medical mileage rate?
The IRS typically announces standard mileage rates for the upcoming year in mid-December. The 2027 rate should be published in a notice around December 2026, in time for the 2027 tax filing season.
What is the current 2026 medical mileage rate?
The 2026 medical and moving mileage rate is 20.5 cents per mile, a half-cent decrease from the 2025 rate of 21 cents per mile.
Is the medical mileage rate projection official?
No. Any figure for 2027 discussed before the IRS notice is published is a projection based on historical trends and cost data, not an official rate. Always confirm the final rate against the IRS notice once it is released.
Who can use the medical mileage rate?
Taxpayers who itemize deductions on Schedule A and have unreimbursed medical travel expenses can use it, as long as total medical expenses exceed 7.5% of their Adjusted Gross Income. It is also used by HSA and FSA administrators to calculate qualified mileage reimbursements.
Why is the medical mileage rate lower than the business rate?
The medical mileage rate only accounts for variable costs like fuel, maintenance, and insurance. The business mileage rate also factors in fixed costs like vehicle depreciation, which is why it is set significantly higher.
Does the medical mileage rate apply to moving expenses too?
Yes, but only for active-duty members of the Armed Forces moving due to a permanent change of station. The 2017 Tax Cuts and Jobs Act suspended the moving expense deduction for everyone else through at least 2025, and this restriction has continued in subsequent years.
Can I still deduct medical mileage if I take the standard deduction?
No. The medical mileage deduction is only available if you itemize deductions on Schedule A. If your total itemized deductions, including medical expenses above the 7.5% AGI threshold, do not exceed the standard deduction, itemizing will not reduce your tax bill.
