Consultation fee: the rules that apply to a doctor's fee in India Who sets it, where it must be displayed, whether GST applies, and what the receipt has to say.

A consultation fee is the amount a doctor or clinic charges a patient for a consultation. In India no national rule fixes it for a private clinic, but four rules govern how it is handled: regulation 1.8 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 says a physician "should announce his fees before rendering service"; rule 9 of the Clinical Establishments (Central Government) Rules, 2012 requires rates to be displayed where that Act applies; Sl. No. 74 of Notification 12/2017-Central Tax (Rate) exempts it from GST; and the receipt rules decide what the patient takes home.

Who sets a consultation fee?

The clinic. Rule 9(ii) of the 2012 central rules does give the Central Government a power: registered establishments "shall charge the rates for each type of procedures and services within the range of rates determined and issued by the Central Government from time to time, in consultation with the State Governments". Whether any such range reaches your clinic depends on your state and on what has actually been issued; ask the district registering authority. The working method for arriving at a number from costs and patient load is in our guide on how to set consultation fees.

Must the fee be announced or displayed?

Announced, always: regulation 1.8 says the physician "should announce his fees before rendering service and not after the operation or treatment is under way", and that remuneration "should be in the form and amount specifically announced to the patient at the time the service is rendered". Displayed, where the Clinical Establishments Act applies: rule 9(i) says every clinical establishment "shall display the rates charged for each type of service provided and facilities available, for the benefit of the patients at a conspicuous place in the local as well as in English language". Which states have adopted the Act is in our state list; the board itself is covered in signboard and fee display rules, and the free clinic rate list maker prints one.

Is GST charged on a consultation fee?

No. Sl. No. 74 of Notification 12/2017-Central Tax (Rate) exempts "health care services by a clinical establishment, an authorised medical practitioner or para-medics". Paragraph 2(zg) defines health care services as "any service by way of diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India", excluding hair transplant and cosmetic or plastic surgery unless reconstructive. Paragraph 2(k) covers any practitioner "registered with any of the councils of the recognised system of medicines". So an MBBS, BDS, BAMS or BHMS consultation is exempt alike. Where the line falls for cosmetic work and medicines is in GST on doctor consultation fees.

What does this look like at a small OPD?

A single-doctor clinic prints its consultation fee and its follow-up policy on a board at the desk, in the local language and English. The receptionist states the fee when the patient registers, before the doctor is seen. The receipt shows the fee with no GST line. If the doctor changes the fee, the board and the receipt change the same day; a patient who paid the old fee last week is not asked for the difference.