Hospital bill format with GST

What a hospital bill must show

India has no single, hospital-specific "bill format" prescribed by statute. What a bill needs to show comes from two places: ordinary commercial-invoice practice (so the patient and their insurer or employer can understand and act on it), and GST law, for the portion of a hospital's charges that are taxable. In practice, a usable hospital bill covers:

• Hospital details — legal/trade name, address, and GSTIN if the hospital is GST-registered (most hospitals are, if only for their pharmacy or a taxable service line).
• Patient identifiers — patient name, MR number (the permanent medical-record number) and, for an admission, the IP (in-patient) number for that stay.
• Bill number and date, written DD/MM/YYYY as is standard in India.
• Line items — each service or item, its SAC (Services Accounting Code, for services like room rent or a procedure) or HSN (Harmonized System of Nomenclature, for goods like medicines), quantity, rate, taxable value, the GST rate applied (or "Exempt"), and CGST/SGST where GST applies.
• Totals — subtotal, GST, any advance already paid and adjusted, and the final amount payable — in both figures and words, which is standard invoicing practice and guards against a figure being altered after the fact.

Because most hospital charges are exempt from GST, a bill that is entirely for exempt services is, strictly, a bill of supply rather than a tax invoice — GST law reserves "tax invoice" for taxable supplies. Most real hospital bills mix exempt and taxable lines in the same stay (a consultation is exempt; a private room over ₹5,000 a day is not), and CGST Rule 46A lets a registered person issue one combined invoice-cum-bill of supply for a patient who isn't GST-registered — which is effectively every patient. That single combined document is what the template below produces.

How GST applies to hospital bills

Health care services are exempt

Services by way of diagnosis, treatment or care for illness, injury, deformity, abnormality or pregnancy, supplied by a clinical establishment, an authorised medical practitioner or para-medics, are exempt from GST under Sl. No. 74 of Notification No. 12/2017-Central Tax (Rate), dated 28 June 2017. That covers consultations, nursing, procedures, surgery and diagnostics billed by the hospital. CBIC Circular No. 32/06/2018-GST (12 February 2018) confirms this extends to the fees a hospital retains when it pays a visiting consultant less than what it charges the patient — the whole amount is still exempt health-care service, not a separate taxable commission.

Room rent above ₹5,000 a day is the exception

Since 18 July 2022, room rent charged by a clinical establishment for a room other than an ICU, CCU, ICCU or NICU, where the room charge exceeds ₹5,000 per day, is taxable at 5% GST (2.5% CGST + 2.5% SGST), with no input tax credit available to the hospital on inputs used for that room. This came from two notifications issued the same day: Notification No. 03/2022-Central Tax (Rate) added a new taxable entry (Sl. No. 31A) for that exact service, and Notification No. 04/2022-Central Tax (Rate) added a matching proviso excluding it from the Sl. No. 74 exemption. ICU-category rooms stay fully exempt regardless of the daily charge.

Pharmacy and consumables — it depends who's billed

Medicines, consumables, implants and stents used while treating a patient who is admitted are treated as part of one composite supply of health care — the hospital pharmacy dispensing them to an in-patient isn't a separate retail sale, so no GST is charged on that line, whatever it costs. This follows the same reasoning CBIC applied to in-patient food in Circular 32/06/2018-GST, and was applied directly to medicines and consumables by the Kerala Authority for Advance Ruling in the matter of KIMS Health Care Management Ltd (2018). The moment the same pharmacy counter sells to someone not admitted — an outpatient, a discharged patient's take-home prescription billed separately, a bystander or a walk-in — that is an ordinary, taxable sale of goods at whatever GST rate applies to that medicine's HSN code.

Field-by-field notes

• SAC / HSN. Services use a 6-digit SAC (9993-series codes cover human health services); goods like medicines use an HSN code from the drug's tariff heading. Leaving this column blank makes a bill harder to reconcile against your GSTR filings later.
• Taxable value. The value of the line before GST — used as the base for CGST/SGST even on an exempt line, where it's simply the full charge.
• CGST / SGST. For an intra-state supply (patient and hospital in the same state, the normal case), GST splits evenly into Central and State GST rather than one combined rate.
• Advance adjusted. Any deposit collected at admission and applied against this final bill, shown as a deduction after the GST-inclusive total — not netted against individual lines.
• Amount payable / in words. The balance the patient (or their insurer/TPA) still owes after GST and advance, spelt out in words as a safeguard against alteration. This document is the final bill for the stay, distinct from the provisional estimate a hospital may share earlier.