2025 Clinical Trial Payment Tax Implications Explained

For many clinical trial participants, the question of whether payments are taxable isn’t just a technicality; it’s a deciding factor. In the U.S., most flat-rate payments like stipends or honoraria are considered taxable income, while reimbursements for documented expenses (like travel or meals) are not. But the nuances—especially for those receiving government benefits—can be confusing and intimidating. Participants may worry that accepting compensation could jeopardize their eligibility for programs like SSI or Medicaid, or trigger unexpected tax bills. That uncertainty can lead to hesitation, dropouts, or even participants declining payments altogether.

Sites are often caught in the middle, fielding tax-related questions they’re not equipped to answer. Meanwhile, sponsors risk enrollment delays and retention issues if these concerns aren’t addressed clearly and proactively. Read on to see the latest IRS rules, including 2025 updates to 1099-MISC thresholds, and highlights of ongoing policy efforts to reduce the tax burden on participants. Clear communication, transparent reporting, and thoughtful payment design should keep the focus where it belongs: on research and patient care.