Visiting consultant agreement for a clinic: fee, TDS, records What the agreement must settle, and the regulation 6.4 line between a consultancy fee and fee-splitting.

A visiting consultant agreement for a clinic has to settle six things: whether the consultant is paid a fixed fee or a share of the fees patients pay for her consultations; that no part of any payment is for sending patients; the TDS the clinic will deduct; whose name, degrees and registration number go on the prescription; who keeps the records and who answers a patient's request for them; and how the arrangement ends. Each has a rule behind it, and a two-page agreement that states them in plain words protects both doctors more than a 70:30 message ever will.

Fee share or fixed fee: which is lawful?

Both can be, and both can fail, depending on what the money is for. Regulation 6.4.1 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, which still govern registered medical practitioners, reads: "A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. A physician shall not directly or indirectly, participate in or be a party to act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment." Regulation 6.4.2 extends this to referrals of specimens for diagnostics, and then draws the line that makes visiting arrangements possible: "Nothing in this section, however, shall prohibit payment of salaries by a qualified physician to other duly qualified person rendering medical care under his supervision."

The test is the sentence in the agreement that says what the payment is for. "Rs X per session for consultations rendered" or "the clinic retains Y% of the consultation fee as its charge for premises, staff and collection" describe care and facilities. "Z% on every patient referred" describes a commission. A clinic that cannot write the first sentence honestly has a commission arrangement whatever the heading says. Where the regulation touches clinical practice, read it yourself and ask your state medical council; our post on the NMC professional conduct regulations covers the regulations' current status.

TDS on the consultant's fee

A visiting consultant paid a fee is a professional, not an employee, and the clinic deducts tax on "fees for professional services". The Income-tax Act, 2025, in force from 1 April 2026, carries the rule in section 393 and its Table: serial 6(iii) covers sums by way of fees for professional services paid by a specified person, at 10% of the sum in cases other than technical services and film royalties, with a threshold of ₹50,000 for the year. Below the threshold no deduction is made; once the year's payments cross it, the clinic deducts on each payment, deposits it and issues the certificate. Which clinics count as a "specified person" and the exact deposit and return dates are in our post on TDS when a clinic pays a visiting consultant; the agreement should say that fees are paid net of TDS and that the clinic will issue the certificate.

If instead the consultant is on a monthly salary with fixed hours and the clinic's control, she is an employee, tax is deducted under the salary head, and she counts towards the clinic's head count for ESI, gratuity and provident fund; see PF and ESI for small clinics. Decide which it is before the first payment, and write the agreement to match.

Whose letterhead and registration number go on the prescription?

The treating doctor's. Regulation 1.4.1 says: "Every physician shall display the registration number accorded to him by the State Medical Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money receipts given to his patients." Regulation 1.4.2 allows as suffix to the name "only recognized medical degrees or such certificates/diplomas and memberships/honours which confer professional knowledge". So a prescription written by the visiting cardiologist carries her name, her degrees and her registration number, whichever letterhead it is printed on. The agreement should say the consultant signs her own prescriptions and certificates, and that the clinic's letterhead, if used, shows her name and registration number for her consultations. Our post on what a prescription must contain in India lists the rest.

Who owns the records and answers the patient?

Regulation 1.3.1 puts the duty to maintain records on "every physician", and regulation 1.3.2 requires records to be issued within 72 hours of a request by the patient or an authorised attendant. Under the Digital Personal Data Protection Act, 2023 the clinic that registers the patient and runs the system is the Data Fiduciary for the record. The agreement should therefore say: the consultation record is kept in the clinic's system; the consultant has access to her own patients' records during and after the engagement for continuity of care and medico-legal need; a patient's request for records is answered by the clinic within the 72 hours; and on termination the consultant receives a copy of her consultation records while the clinic retains the originals. Our post on patient requests for medical records within 72 hours covers the request itself.

The clauses, in order

1. Parties and registration: the consultant's name, qualifications and state medical council registration number; the clinic's name, owner and clinical establishment registration.
2. Sessions: days, hours, number of patients per session if any, and notice for a missed session.
3. Fee: a fixed fee per session or month, or the consultant's consultation fee with the clinic's stated charge for premises, staff and collection; the sentence that says the payment is for consultations rendered.
4. No referral payment: an express statement that no payment is made or received for referring, recommending or procuring patients or specimens, in the words of regulation 6.4.
5. Payment and tax: pay date, bank transfer, TDS at the rate the Income-tax Act prescribes, certificate issued by the clinic.
6. Prescriptions and certificates: signed by the consultant under her own name, degrees and registration number.
7. Records: kept in the clinic's system; access, requests and copies as above.
8. Confidentiality: patient data and the clinic's business information, surviving termination; see staff confidentiality undertaking for clinics.
9. Indemnity insurance: each doctor holds her own professional indemnity cover; see professional indemnity insurance for doctors.
10. Publicity: the consultant's name, qualification and timings may be displayed; no testimonials, superlatives or paid promotion, in line with the NMC's advertising guidelines; see NMC advertising guidelines 2026 for clinics.
11. Term and termination: notice on either side, settlement of fees due, hand-over of patients under treatment.