The main Entry No: 82 of Exemption List of Services from GST covers the main area of medical sector for Medical Practitioners. The Entry hereby is as follows:
a. Health care services by clinical establishment, an authorized medical practitioner or Para - medics;
b. Services provided by way of transportation of a patient in an ambulance, other than those specified in above.
In the above clarification is not given regarding the definition for the words:
a. Health care services
b. Clinical Establishment
c. Authorized Medical Practitioner
Thus, the same definition of service tax is considered so accordingly, GST shall be liable for services provided by medical practitioner for purpose of Care and not for any curing of disease or disorders but for beautification or improving physical appearance.
Generally, the services provided in the Hospital Sector consists of:
a. Out-patient Department
b. In-patient Department
c. Various tests conducted
d. Sale of medicine
Medical consultancy for Out-patient including regular checks- up and small treatment. It also includes medical consultancy and treatment without admitting a patient in the Hospital. These services are exempted from GST.
Sale of owned medicine while doing treatment or consultancy directly in shop or through doctor is not exempted from GST.
In-patient includes the various surgeries conducted on the patient, charges for room rent, consultancy charges, food & beverages, bed charges, operation theater rent, equipment charges, Doctor fees, pharmacy consumed. (All the charges are recovered from IPD for purpose of curing of disease or disorder)
The above services are exempted from GST as per SR No 82: Health care services by a Clinical Establishment, an authorized medical practitioner or para-medics.
Various Tests conducted by Hospital
Various test in a hospital may include charges collected directly by Hospital or charges collected by Centre and then proportionate charges are shared between doctor and Centre owner OR monthly fixed payment is made to the Doctor by such center.
GST is exempted under both the situation as such services either directly or indirectly is given as health-care services and thus is covered under Sr.No.82 of Exemption List.
Sale of medicine
Sale of medicine by medical practitioner itself to the patient will be chargeable to GST at the rate specified. Also if the sale is done through the medical shops owned by such practitioners, such sale will also be liable to GST on MRP basis. MRP based taxation is the system where the MRP includes the GST rates inclusive on such product and thus the GST will be paid by such medical shops to the Government of India.
GST cannot be levied separately on the medicine bills by the medical shops to the customers.
Medical services not for the purpose of curing disease but for the purpose of enhancement of beauty or physical appearance of the person are not covered under Sr.No.82 of the exemption list and thus such services are liable to GST.
Bio -medical waste Treatment
Bio-medical waste means 'Any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological'.
Bio-medical waste cannot be disposed off anywhere and thus bio-medical waste operator are appointed by Government who collects such wastages and dispose it off accordingly to the guidelines. Thus when the services are provided by the Bio-medical waste treatment operator to the clinical establishment for treatment of Bio-medical waste, NO GST will be levied on such services according to the Entry No.11 of the Exemption list.
Blood Bank Services
According to Entry No.60 of Exemption list of Services from GST list, services provided by Cord Blood banks by way of preservation of stem cells or any other services in relation to such preservation. Thus the services provided by blood bank and other services needed by blood bank for such preservation are covered in above entry and are exempt.
Restriction on Input Tax Credit
As per Section 17, Input Tax Credit is not allowed on input or input services used for following purposes:
a. Used for non-business purpose (For example Property of Hospital is used by doctor for his family purpose)
b. Used for exempted supplies (For example any Health Care Service as mentioned in Sr.No.82 of Exemption list.