TaxTMI 
TaxTMI 
2026 (5) TMI 1152
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....xpayer bearing GSTIN 32AFTPP4186J1ZU and is owned and operated by Dr. P. Sambhu, an Ayurveda practitioner by profession. The Applicant is engaged in providing healthcare services in Ayurveda through its clinical establishment located in Thiruvananthapuram. 3.2 The Applicant submits that it provides both inpatient and outpatient healthcare services. A patient is treated as an inpatient upon undergoing the prescribed admission process and being allotted a room, wherein necessary medical care and treatment are provided. Patients who are not admitted are treated as outpatients and receive consultation and prescribed treatment without admission. 3.3 During the course of treatment, patients are administered medicines as prescribed by the attending medical practitioner. Inpatients are periodically examined by doctors, who assess and review the course of treatment and the medicines administered. The Applicant maintains follow-up records for all patients, wherein details of clinical findings, diagnosis, and treatment advice are duly recorded. 3.4 The Applicant further submits that, in the case of inpatients, treatment may involve various procedures in which medicines and consumable....
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.... construed that no proceedings are pending on the issue against the applicant. 6. Personal hearing The applicant was granted opportunity for personal hearing on 02/04/2025. Shri. Padmanabha Pillai Sambhu, Proprietor, appeared for personal hearing, which was conducted virtually. The Proprietor reiterated the contentions made in the application and requested to issue the ruling on the basis of the submissions made in the application. 7. Discussion and conclusion. 7.1. On carefully reviewing the advance ruling application sought by applicant, it is evident that the question for which 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'. Hence, the application has been admitted for further consideration based on its merits. 7.2. The applicant is an Ayurvedic clinical establishment providing healthcare services to patients through both inpatient and outpatient modes. The applicant has sought an advance ruling on whether the se....
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.... inpatient and outpatient services, wherein patients are examined by qualified medical practitioners, admitted as inpatients where necessary, administered medicines as prescribed, undergoes procedures and provided continuous medical supervision and care during the course of treatment. 7.6 The applicant has contended that the supplies made in the course of inpatient treatment constitute a single supply. In this regard, it is relevant to examine the concept of "composite supply" as defined under Section 2(30) of the CGST Act, 2017, which refers to a supply comprising two or more taxable supplies that are naturally bundled and supplied in conjunction with each other in the ordinary course of business, one of which is the principal supply. 7.7 In the context of healthcare services, where medicines, consumables, implants, dietary food, room accommodation, and other ancillary services are provided in the course of diagnosis and treatment, such supplies are ordinarily not made independently but are intrinsically linked to the provision of healthcare. In the case of inpatients, these elements are naturally bundled and supplied in conjunction with medical treatment under the supervisi....
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....n the case of outpatients, the hospital primarily provides consultation and prescribes medicines; the patient is not admitted, and there is no continuous or bundled course of treatment under the supervision or control of the hospital. In this case the applicant has admitted that he raises a consolidated bill for inpatients covering the entire course of treatment, which includes charges towards consultation, medicines, room accommodation, and other procedures provided as part of the treatment. Further, the patient is at liberty to procure the prescribed medicines from any source, and the hospital does not retain control over their subsequent administration. Accordingly, the supply of medicines or allied goods to outpatients, even if made pursuant to a doctor's prescription, cannot be regarded as naturally bundled with healthcare services. Such supplies are therefore liable to GST at the applicable rates as independent taxable supplies. 7.11 Notwithstanding the composite nature of healthcare services provided to inpatients, it is to be noted that, in terms of Notification No. 04/2022-Central Tax (Rate) dated 13.07.2022, which amends Notification No. 12/2017-Central Tax (Rate) date....