TaxTMI 
TaxTMI 
2022 (8) TMI 1239
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....epartments. In addition, the applicant also provides utility articles and services to patients, and provide quality nursing care services including physiotherapy, ventilator care, CPR, emergency home care, ambulance services etc and all kinds of supporting and monitoring services to patients at their home by licensed or registered health care professionals. 2. At the outset, it is clarified that the provisions of the Central Goods and Services Tax Act, 2017 (hereinafter referred to as CGST Act) and the Kerala State Goods and Services Tax Act, 2017 (hereinafter referred to as KSGST Act) are the same except for certain provisions. Accordingly, a reference hereinafter to the provisions of the CGST Act, Rules and the notifications issued thereunder shall include a reference to the corresponding provisions of the KSGST Act, Rules and the notifications issued thereunder. 3. The applicant had requested an advance ruling on the following: 3.1. Whether the health-care services provided to patients at their residence by the applicant through qualified nurses and other technically qualified persons are taxable in GST? 4. Contentions of the applicant: 4.1. The applicant submits that they ....
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....shment" means a hospital, nursing home, clinic, sanatorium or any other institution by, whatever name called, that offers services or facilities requiring diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognized system of medicines in India or a place established as an independent entity or a part of an establishment to carry out diagnostic or investigative services of diseases. 4.5. The term "paramedics" is not defined either in the CGST / SGST Acts or in any GST notifications. However, the term "paramedics" is explained by the Central Board of Indirect Tax and Customs, while explaining the scope of the exemption from service tax for healthcare services, in Taxation of services; An Education Guide issued on 20-06-2012. The relevant part of the education guide is extracted below:- "7.2.2 Who all are covered as paramedics? Paramedics are trained health care professionals, for example, nursing staff, physiotherapists, technicians, lab assistants etc. Services by them in a clinical establishment would be in the capacity of employee and not provided in independent capacity and will thus be considered as services by such clinical est....
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....alth Services 999314 - Nursing and Physiotherapeutic services. This service code includes;- i. Services in the field of nursing case (without admission), advice and prevention for patients at home, the provision of maternity care, children's hygiene, etc. ii. Services in the field of physiotherapy, ergotherapy, occupational therapy etc. Note: These services are provided by qualified practitioners, other than medical doctors. " 4.10. The applicant submits that the following service classification is also relevant to the facts of the case;- "999319 - Other human health services including homoeopathy, Unani, Ayurveda, naturopathy, acupuncture etc. This service code includes: i. Other paramedical human health services not elsewhere classified such as acupuncture, aromatherapy, speech therapy, homoeopathy, nutrition therapy etc. Note: These services are provided by qualified practitioners, other than medical doctors." 4.11. As per Serial No.74 of Notification No.12/2017 Central Tax (Rate) dated 28-06-2017, healthcare services falling under Chapter Heading 9993 are exempted from GST. It can be seen from the Explanatory Note on Scheme of Classification of Services ....
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....services provided by way of transportation of a patient in an ambulance, other than those specified in (a) above. NIL NIL 7.2. As per the above entry healthcare services provided by a clinical establishment or authorised medical practitioner or paramedics is exempted from GST. The issue to be decided is whether the services rendered by the applicant qualify for the exemption under the above entry. 7.3. The term "healthcare services" is defined in Para 2 (zg) of Notification No. 12/2017 Central Tax (Rate) dated 28.06.2017 as follows;- "healthcare services" means any service by way of diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognized system of medicines in India and includes services by way of transportation of the patient to and from a . clinical establishment, but does not include hair transplant or cosmetic or plastic surgery, except when undertaken to restore or to reconstruct anatomy or functions of body affected due to congenital defects, developmental abnormalities, injury or trauma." 7.4. The term "clinical establishment" is defined in Para 2(s) of the said notification as follows;- "clinical establishment mean....