Applicability of GST on ambulance services provided to Government by private service providers under the National Health Mission (NHM) — Reg.
51/25/2018 Dated:- 31-7-2018 CGST – Circulars / Ordes
GST
Circular No. 51/25/2018-GST
F. No. 354/220/2018-TRU
Government of India
Ministry of Finance
Department of Revenue
Tax research Unit
Room No. 146, North Block,
New Delhi, 31st July, 2018
To,
The Principal Chief Commissioners/ Chief Commissioners/ Principal Commissioners/ Commissioner of Central Tax (All) /
The Principal Director Generals/ Director Generals (All)
Madam/Sir,
Subject: Applicability of GST on ambulance services provided to Government by private service providers under the National Health Mission (NHM) – Reg.
I am directed to invite your attention to the Circular No. 210/2/2018- Service Tax, dated 30th May, 2018. The said Circular has been issued in the context of service tax exemption contained in notification No. 25/2012- Service Tax dated 20.06.2012 at
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nd GST notification read as under.
Service Tax
GST
Sl. No. 2:
(i) Health care services by a clinical establishment, an authorized medical practitioner or para-medics;
(ii) Services provided by way of transportation of a patient in an ambulance, other than those specified in (i) above.
Sl. No. 74:
Services by way of-
(a) health care services by a clinical establishment, an authorized medical practitioner or para-medics;
(b) services provided by way of transportation of a patient in an ambulance, other than those specified in (a) above.
Sl. No.25(a):
Services provided to Government, a local authority or a governmental authority by way of water supply, public health, sanitation conservancy, solid waste management or slum improvement and upgradation
Sl. No. 3:
Pure services (excluding works contract service or other composite supplies involving supply of any goods) provided to the Central Government, State Government or Union territory or local authority or a Governmental auth
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rticle 243 W of the Constitution read with Twelfth schedule to the Constitution. Thus ambulance services are an activity in relation to the functions entrusted to Panchayats and Municipalities under Articles 243G and 243 W of the Constitution.
4. In view of the above, it is clarified that the clarification contained in the Circular No. 210/2/2018- Service Tax dated 30th May, 2018 with regard to the services provided by Government and PSPs by way of transportation of patients in an ambulance is applicable for the purpose of GST also, as the said services are specifically exempt under notification No. 12/2017- Central Tax (Rate) dated 28.06.2017 vide Sl. No. 74.
5. As regards the service provided by PSPs to the State Governments by way of transportation of patients on behalf of the State Governments against consideration in the form of fee or otherwise charged from the State Government, it is clarified that the same would be exempt under-
a. Sl. No. 3 of notification No. 12/2017- Cent
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l Directors General/ Directors General / Chief Commissioner AR CESTAT
All Principal Commissioners/Commissioners of Central Excise & GST/AR CESTAT
All Principal Additional Directors General/ Additional Directors General
Madam/Sir,
Subject: Applicability of service tax on ambulance services provided to government by private service providers under the National Health Mission (NHM)
I am directed to draw your attention to a reference of the Ministry of Health & Family Welfare, Government of India on the above subject and analyse the manner in which the taxability has to be determined in such cases.
2. It has been stated that under the National Health Mission (NHM), a flagship programme of the Government of India, the Central Government provides technical and financial support to states to strengthen healthcare systems including for free ambulance services (Dial 102/108 services). Dial 108 is the emergency response system primarily designed to attend to patients of critical care, tr
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who avail of these ambulance services. The PSP however charges a fee from the State government for carrying out the third activity.
3.2 Any activity carried out by one person for another without any consideration will not be covered by the definition of 'service' in section 65(44) B of the Finance Act, 1994. Even if a consideration was charged, by virtue of entry 2(ii) of notification no 25/2012- Service Tax dated 20th June, 2012, services provided by way of transportation of a patient in an ambulance, other than health care services by a clinical establishment, an authorized medical practitioner or paramedics, are exempted from the whole of the service tax leviable thereon. Thus the activities provided by the State government and the PSP to patients are not leviable to service tax.
3.3 As regards the activity undertaken by the PSP for the State government for which consideration is charged, attention is invited to sl.no 25(a) of the notification no 25/2012 – Service Tax date
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rm and will cover a number of activities which ensure the health of the public. In the Ministry of Health & Family Welfare's reference, it has been stated that this activity of providing free ambulance services by the states is funded under the National Health Mission (NHM). One of the core values of the NHM enlisted by the Framework for implementation of National Health Mission (2012-2017) is to strengthen public health systems as a basis for universal access and social protection against the rising costs of health care. As a part of its goals, outcomes and strategies the framework has categorically stated that NHM will essentially focus on strengthening primary health care across the country. The Framework further states that assured free transport in the form of Emergency Response System (ERS) and Patient Transport Systems (PTS) is an essential requirement of the public hospital and one which would reduce the cost barriers to institutional care.
3.6 Thus the provision of ambula
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