Updated November 5, 2026. Quick answer: Worksheet A in Publication 502 turns the cost of a home improvement made for medical care into the amount you can include in medical expenses. It subtracts the increase in your home’s value from what you paid; if the value went up by as much as the cost or more, the amount is zero.
What Worksheet A is for
The publication says “You can include in medical expenses amounts you pay for special equipment installed in a home or for improvements if their main purpose is medical care for you, your spouse, or your dependent.” “The cost of the improvement is reduced by the increase in the value of your property.” “The difference is a medical expense.” It points you to the sheet: “Use Worksheet A to figure the amount of your capital expense to include in your medical expenses.” The sheet is marked “Keep for Your Records”, so it is not attached to the return.
The five lines
| Line | What it asks |
|---|---|
| 1 | “Enter the amount you paid for the home improvement” |
| 2 | “Enter the value of your home immediately after the improvement” |
| 3 | “Enter the value of your home immediately before the improvement” |
| 4 | “Subtract line 3 from line 2. This is the increase in the value of your home due to the improvement” |
| “If line 4 is more than or equal to line 1, you have no medical expenses due to the home improvement; stop here.” “If line 4 is less than line 1, go to line 5.” | |
| 5 | “Subtract line 4 from line 1. These are your medical expenses due to the home improvement” |
When the improvement is not reduced
The publication says “If the value of your property isn’t increased by the improvement, the entire cost is included as a medical expense.” For improvements that accommodate a disabled condition: “Certain improvements made to accommodate a home to your disabled condition or that of your spouse or your dependents who live with you don’t usually increase the value of the home and the cost can be included in full as medical expenses.” Its list includes “Constructing entrance or exit ramps for your home.” and “Widening doorways at entrances or exits to your home.” It also limits the amount: “Only reasonable costs to accommodate a home to your disabled condition are considered medical care.”
Two worked examples (invented numbers)
Case 1 (computed): a medical-reason improvement costs $20,000, and the home is worth $150,000 after it and $145,000 before it.
| Line | Entry | Value |
|---|---|---|
| 1 | Amount paid for the home improvement (invented) | $20,000 |
| 2 | Value of the home immediately after (invented) | $150,000 |
| 3 | Value of the home immediately before (invented) | $145,000 |
| 4 | Line 2 minus line 3 (computed) | $5,000 |
| Line 4 is less than line 1, so go to line 5 | ||
| 5 | Line 1 minus line 4 (computed) | $15,000 |
The medical expense is $15,000 (computed). The same sheet applied to a $6,000 improvement that raises the home’s value from $148,000 to $155,000 gives a line 4 of $7,000 (computed), which is more than the cost, so the answer is that there is no medical expense and you stop at line 4.
What the worksheet does not cover
Worksheet A is the improvement’s capital cost only. The publication treats upkeep separately: “Amounts you pay for operation and upkeep of a capital asset qualify as medical expenses as long as the main reason for them is medical care.” Whatever amount line 5 produces is then added with your other medical expenses on Schedule A, and only the part above the AGI threshold is deducted. The deduction is covered on the Publication 502 page.
Edition
This page reads Publication 502 (2025), the file irs.gov served on 2026-11-05. Worksheet A sits on page 6 of that edition. Check the year printed on your own copy before following a line reference.
Common mistakes
- Entering the whole cost on Schedule A. Line 5 subtracts the increase in the home’s value first.
- Using the cost, not the value change, on line 4. Line 4 is line 2 minus line 3.
- Continuing past line 4 when the increase equals or exceeds the cost. The worksheet says to stop.
- Counting aesthetic or architectural extras. Only reasonable costs of accommodating the disabled condition count as medical care.
Related: Publication 502, deducting a parent’s medical costs, and Form 1040 line 12.
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Answer againSources
- Publication 502 (2025), Medical and Dental Expenses: https://www.irs.gov/pub/irs-pdf/p502.pdf
- IRS, About Publication 502, Medical and Dental Expenses: https://www.irs.gov/forms-pubs/about-publication-502
Read from the IRS documents linked above on November 5, 2026. General information, not tax advice. Your own facts decide the outcome, and a preparer, the account provider or the IRS is the right place to confirm anything consequential.