Dialysis is exempt health care
Dialysis treats kidney failure and is health care by a clinical establishment. All elements of a session, including consumables, injections given during the session and nursing, are part of the exempt composite service. A standalone dialysis centre with only exempt income need not register. Bills to patients, insurers and government schemes carry no GST. Room charges at a dialysis unit are rarely above ₹5,000 a day, so the room-rent tax that applies to some hospitals does not usually arise, but day-care beds should still be priced as part of the session.
Consumables: inside the session, not separately sold
Dialysers, bloodlines, needles and fluids used in a session are part of the service. Some centres list them separately on the bill for transparency; that is fine as long as they are shown as part of the exempt treatment, not as taxable goods. If a centre sells peritoneal dialysis fluid to patients for home use, that is a sale of goods and taxable at its applicable rate. Make it clear on the bill that itemised consumables are shown only for information.
Equipment and instrument costs
Dialysis machines and other medical instruments under 9018 moved from 12% to 5% from 22 September 2025. Water treatment plants for dialysis may fall under other headings with other rates. Since output is exempt, credit is blocked, so the GST paid becomes cost. The rate cut reduces the cost of expanding capacity. Keep the original invoices for machines with the fixed asset register.
Public-private partnership centres
Many dialysis centres operate under contracts with state governments, where the government pays the operator per session. If the operator provides dialysis directly to patients, it is health care and exempt. If the operator merely supplies staff or equipment to a government hospital that itself provides the treatment, the service may be taxable. Read the contract carefully. Contracts should say expressly who is the provider of health care to the patient.
Reverse charge on certain services
A registered dialysis centre may pay reverse charge on services such as security from a non-body-corporate provider or rent paid to an unregistered landlord. Since output is exempt, this is a cost. Budget for it when choosing premises or contractors.
Monthly consolidated bills
Patients dialysing three times a week prefer monthly bills. A monthly bill listing each session date is acceptable as long as it is issued within the time limit and contains all required details. Use consistent numbering so each month's bill is easy to trace. For scheme patients, follow the scheme's billing format and attach the session log.