GTA option to pay GST alters input tax credit treatment and requires a pre year Annexure V declaration to opt in. The notification amends the State GST rate schedule to reclassify transport and related services, adds ropeway passenger and goods transport entries, revises rates and input tax credit treatment for passenger, goods transport and supporting services, introduces a taxable entry for clinical establishment room charges above a per day threshold, inserts bio medical waste treatment services, expands key definitions, and prescribes an Annexure V procedure for GTAs to opt to pay GST under forward charge with a transitional filing deadline and annual validity.