GST Invoice Format for Doctors and Clinics in India — Exempt vs Taxable Services 2026

For doctors, dentists, physiotherapists, and clinic owners, understanding GST invoicing is not straightforward. Most healthcare services are GST-exempt — but not all. Cosmetic procedures, some wellness services, and medicines sold from a clinic carry GST. Issuing the wrong invoice (or no invoice at all) can attract scrutiny from GST authorities and create problems for patients who need proper bills.

In this guide, we break down exactly which medical services are exempt from GST, which are taxable, what SAC codes to use, and how to structure an invoice that covers both exempt and taxable services on the same bill.

Are Medical Services GST-Exempt in India?

Yes — for the most part. As per Notification No. 12/2017-Central Tax (Rate), healthcare services provided by clinical establishments and authorised medical practitioners are exempt from GST. This exemption applies to services by doctors registered under the Medical Council Act, dentists, physiotherapists, Ayurvedic practitioners, and hospitals.

Which Medical Services Are GST-Exempt?

• General physician / family doctor consultation fees
• Specialist consultation (cardiologist, orthopaedic, neurologist, etc.)
• Dental treatments — fillings, extractions, root canal
• Diagnostic services — blood tests, X-rays, MRI, CT scans
• Physiotherapy and occupational therapy
• Ayurveda, Unani, Siddha, Homeopathy (AYUSH) treatments
• Inpatient hospital charges — room rent, nursing charges, OT charges
• Ambulance services
• Vaccination services by a registered medical practitioner

Which Medical Services Are Taxable Under GST?

Not all services provided in a clinic or hospital are exempt. Services that are considered elective or non-therapeutic attract GST at 18%:

• Cosmetic surgery or plastic surgery (purely aesthetic — nose jobs, lip fillers, breast augmentation)
• Hair transplant procedures
• Cosmetic dental procedures — teeth whitening, veneers (aesthetic, not therapeutic)
• Slimming/beauty treatments at wellness centres or spas
• Sale of medicines, drugs, and pharmaceutical products from the clinic (HSN 3004 — 12% GST)
• Sale of medical devices and equipment to patients — syringes, glucometers, wheelchairs

SAC Codes for Healthcare Services

SAC (Services Accounting Code) codes identify the type of service for GST purposes. Use these codes on your clinic's invoices:

HSN Code for Medicines Sold by a Clinic

If your clinic dispenses or sells medicines to patients, you are essentially running a pharmaceutical retail operation for those items. Medicines sold — even from a clinic — attract GST at the applicable rate. The most common HSN code for medicines is:

• HSN 3004 — Medicaments / pharmaceutical preparations (formulated): 12% GST
• HSN 3002 — Blood products, vaccines, immune sera: 5% or 12% depending on product
• HSN 9018 — Medical instruments (syringes, needles, catheters): 12% GST
• HSN 9021 — Orthopaedic appliances, implants, hearing aids: 12% GST

How to Issue a Clinic Invoice Covering Both Exempt and Taxable Items

A single clinic visit can include both exempt services (consultation) and taxable items (medicines sold). Here is how to structure the invoice correctly:

1. 1List exempt services first — consultation fee, procedure charges. Show 0% GST against each.
2. 2List taxable items separately — medicines with HSN 3004, devices with HSN 9018. Show 12% GST against each.
3. 3Show the tax breakup clearly — CGST and SGST (or IGST for inter-state) separately.
4. 4Total the invoice showing both the exempt portion and the taxable portion.
5. 5Include your clinic's GSTIN if you are GST-registered (required if turnover exceeds ₹20 lakh or ₹10 lakh in special category states).
6. 6Include patient's name and address. For B2B (company employees, insurance cashless), include the company GSTIN.

Do Small Clinics Need to Register for GST?

Since most clinical services are GST-exempt, even a busy doctor may not need to register for GST. The rule is: if your aggregate turnover from taxable supplies exceeds ₹20 lakh (₹10 lakh for special category states), GST registration is mandatory. Since exempt services are not counted as taxable supplies for this threshold, most solo practitioners do not need GST registration.

However, if you sell medicines, run a diagnostic lab, or offer cosmetic procedures — those taxable revenues do count. Once your taxable revenue from such services crosses ₹20 lakh, registration becomes mandatory.

What Should a Clinic GST Invoice Contain?

• Clinic name, address, and GSTIN (if registered)
• Invoice number and date
• Patient name and address
• Description of each service with SAC code and GST rate (0% for exempt, 18% for cosmetic)
• Medicines sold with HSN code (3004), quantity, and 12% GST
• Separate CGST and SGST columns (or IGST for interstate/insurance claims)
• Total amount including GST
• Doctor's name and signature

Sample: What a Clinic Invoice Looks Like

Input Tax Credit (ITC) for Clinics

If your clinic is GST-registered but primarily provides exempt services (consultations), you cannot claim Input Tax Credit on your business expenses like medical equipment, furniture, or clinic renovation. ITC is only available for inputs used to provide taxable outputs. However, if you have a mix — like a clinic that also sells medicines and does cosmetic procedures — you can claim ITC proportionally (on the portion related to taxable supplies).

GST for Hospitals vs Independent Practitioners

Large multi-specialty hospitals are often GST-registered because they have revenue from taxable sources (cafeteria, pharmacy, car parking, cosmetic surgery). Independent practitioners (solo doctors, small clinics) usually fall below the threshold and do not need to register. However, if a doctor also runs a diagnostic lab (blood tests, X-rays), that is a separate business activity and may need separate consideration.