TaxTMI 
TaxTMI 
2025 (7) TMI 537
X X X X Extracts X X X X
X X X X Extracts X X X X
....e applicant: 4.1. The profile of the applicant is detailed above. They are providing healthcare services through various departments of modern medicine such as Cardiology, Emergency Medicine, Gastroenterology, Oncology, Pulmonology, Radiology, etc. They are also running several pharmacies through which medicines and other allied items are supplied to both inpatients and outpatients. These items are supplied to the inpatients during the course of treatment. In certain cases, the patients have options to choose brand or type from available items and the tax invoice as per GST Law will be prepared accordingly, for the supply of both, medicines and non-medicinal items through pharmacy. 4.2. The applicant is also supplying medicines to outpatients as well as patients not admitted but undergoing treatment as outpatients. There is a restriction on the supply of medicines and other items to outpatients. The patients must be registered in the hospital and supply is made to patients only against prescription from the doctors who treat them. In such cases, tax is levied at appropriate rates as per GST Law for both the supply of medicine and non-medicinal items through pharmacy. 4.3. ....
X X X X Extracts X X X X
X X X X Extracts X X X X
....alysis, chemotherapy, etc and medicines and other allied supplies. 4.5. The applicant submits that as per Serial No. 74 of Notification No. 12/2017 Central Tax (Rate), Dated.28.06.2017, healthcare services are exempted from GST. The relevant part of Notification is extracted as under. SI.No. Chapter Description of Service Rate Conditions 74 Heading 9993 Services by way of - a) health care services by a clinical establishment, an authorised medical practitioner or paramedics; b) services provided by way of transportation of a patient in an ambulance, other than those specified in (a) above Nil Nil 4.6. The applicant submits that the supply of medicines and other allied goods made to inpatients are exempted from GST, since these supplies are in the nature of composite supply of healthcare services. GST Law identifies composite supply and mixed supply and provides certainty in respect of tax treatment under GST for such supplies. The term 'composite supply' could be resorted to only if the components of supply are not clearly identifiable. 4.7. The applicant relied on paragraph No.2.2 of Circular No. 47/21/2018-GST, . Da....
X X X X Extracts X X X X
X X X X Extracts X X X X
....lies made to outpatients are clearly identifiable and therefore each supplies made to outpatients are billed separately and taxed at their respective GST rates. The representative filed additional submission including bill copies for supplies made to inpatients as well as outpatients for procedures such as dialysis, chemotherapy, etc, for making clarity on their billing method. 7. Discussion and Findings: 7.1. On carefully reviewing the advance ruling application, the statement of facts and the submissions made during the personal hearing, we have found that the questions for which the advance ruling is being sought fall within the scope of clause (b) & (e) of sub-section (2) of section 97 of the CGST Act, which pertain to the "applicability of a notification issued under the provisions of this Act" and the "determination of the liability to pay tax on any goods or services or both". Therefore, the application has been accepted for further consideration based on its merits. 7.2. In this regard, 1. The first is a situation where a wholesome package is offered to the patients. The applicant has requested for advance ruling on whether GST is leviable in case where a ....
X X X X Extracts X X X X
X X X X Extracts X X X X
....ts. Such package covers room rent, scanning charges, lab tests etc., but the other items are separately charged depending on the brand and type of the items. The same logic as applicable to the above issue squarely applies to this case as well. The package excludes only those items where the price can vary depending on the brand of the supplied medicines and items. But there is paucity of material to decide whether the 'other supplies' included in the package form part and parcel of supply which are naturally bundled and supplied in conjunction with each other in the ordinary course of business. Hence it is possible that even supplies which are not naturally bundled with health care service can be supplied in this model. Hence, a general ruling regarding the taxability of such supplies cannot be issued. 3. The third is a situation where a package is not offered and the treatment, room rent, scanning charges, lab tests, medicines, implants and other required supplies are charged separately to the patient at actuals. In this case as well, without knowing the exact nature of 'other required supplies', it cannot be determined whether they can be treated as natu....