1 activity of daily living (as so defined) or 
to the extent provided in regulations pre-
scribed by the Secretary (in consultation 
with the Secretary of Health and Human 
Services), is unable to engage in age-ap-
propriate activities. 
‘‘(B) The individual is at least 2 but not 
6 years of age and is unable due to a loss of 
functional capacity to perform (without sub-
stantial assistance from another individual) at 
least 2 of the following activities: eating, trans-
ferring, or mobility. 
‘‘(C) The individual is under 2 years of age 
and requires specific durable medical equipment 
by reason of a severe health condition or re-
quires a skilled practitioner trained to address 
the individual’s condition to be available if the 
individual’s parents or guardians are absent. 
‘‘(e) QUALIFIED EXPENSES.—For purposes of this 
section— 
‘‘(1) IN GENERAL.—Subject to paragraph (4), 
the term ‘qualified expenses’ means expenditures for 
goods, services, and supports that— 
‘‘(A) assist a qualified care recipient with 
accomplishing activities of daily living (as de-
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fined in section 7702B(c)(2)(B)) and instru-
mental activities of daily living (as defined in 
section 1915(k)(6)(F) of the Social Security 
Act (42 U.S.C. 1396n(k)(6)(F))), and 
‘‘(B) are provided solely for use by such 
qualified care recipient. 
‘‘(2) ADJUSTMENT
FOR
OTHER
TAX
BENE-
FITS.—The amount of qualified expenses otherwise 
taken into account under paragraph (1) with respect 
to an individual shall be reduced by the sum of any 
amounts paid for the benefit of such individual for 
the taxable year which are— 
‘‘(A) taken into account under section 21 
or 213, or 
‘‘(B) excluded from gross income under 
section 129, 223(f), or 529A(c)(1)(B). 
‘‘(3) GOODS, SERVICES, AND SUPPORTS.—For 
purposes of paragraph (1), goods, services, and sup-
ports (as defined by the Secretary) shall include— 
‘‘(A) human assistance, supervision, cuing 
and standby assistance, 
‘‘(B) assistive technologies and devices (in-
cluding remote health monitoring), 
‘‘(C) environmental modifications (includ-
ing home modifications), 
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‘‘(D) health maintenance tasks (such as 
medication management), 
‘‘(E) information, 
‘‘(F) transportation of the qualified care 
recipient, 
‘‘(G) non-health items (such as inconti-
nence supplies), and 
‘‘(H) coordination of and services for peo-
ple who live in their own home, a residential 
setting, or a nursing facility, as well as the cost 
of care in these or other locations. 
‘‘(4) QUALIFIED
EXPENSES
FOR
ELIGIBLE 
CAREGIVERS.—For purposes of paragraph (1), the 
following shall be treated as qualified expenses if 
paid or incurred by an eligible caregiver: 
‘‘(A) Expenditures for respite care for a 
qualified care recipient. 
‘‘(B) Expenditures for counseling, support 
groups, or training relating to caring for a 
qualified care recipient. 
‘‘(C) Lost wages for unpaid time off due to 
caring for a qualified care recipient as verified 
by an employer. 
‘‘(D) Travel costs of the eligible caregiver 
related to caring for a qualified care recipient. 
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‘‘(E) Expenditures for technologies, as de-
termined by the Secretary, that assist an eligi-
ble caregiver in providing care for a qualified 
care recipient. 
‘‘(5) HUMAN ASSISTANCE.—The term ‘human 
assistance’ includes the costs of a direct care worker. 
‘‘(6) DOCUMENTATION.—An expense shall not 
be taken into account under this section unless the 
eligible caregiver substantiates such expense under 
such regulations or guidance as the Secretary shall 
provide. 
‘‘(7) MILEAGE RATE.—For purposes of this sec-
tion, the mileage rate for the use of a passenger 
automobile shall be the standard mileage rate used 
to calculate the deductible costs of operating an 
automobile for medical purposes. Such rate may be 
used in lieu of actual automobile-related travel ex-
penses. 
‘‘(8) COORDINATION WITH ABLE ACCOUNTS.— 
Qualified expenses for a taxable year shall not in-
clude contributions to an ABLE account (as defined 
in section 529A). 
‘‘(f) PHASE OUT BASED ON ADJUSTED GROSS IN-
COME.—For purposes of this section— 
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‘‘(1) IN GENERAL.—The amount of the credit 
allowable under subsection (a) shall be reduced (but 
not below zero) by $100 for each $1,000 (or fraction 
thereof) by which the taxpayer’s modified adjusted 
gross income exceeds the threshold amount. 
‘‘(2) MODIFIED
ADJUSTED
GROSS
INCOME.— 
The term ‘modified adjusted gross income’ means 
adjusted gross income increased by any amount ex-
cluded from gross income under section 911, 931, or 
933. 
‘‘(3) THRESHOLD AMOUNT.—The term ‘thresh-
old amount’ means— 
‘‘(A) $150,000 in the case of a joint re-
turn, and 
‘‘(B) $75,000 in any other case. 
‘‘(4) INDEXING.—In the case of any taxable 
year beginning in a calendar year after 2025, each 
dollar amount contained in paragraph (3) shall be 
increased by an amount equal to the product of— 
‘‘(A) such dollar amount, and 
‘‘(B) the cost-of-living adjustment deter-
mined under section 1(f)(3) for the calendar 
year in which the taxable year begins, deter-
mined by substituting ‘calendar year 2024’ for 
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