SAC code 9993: health care services under GST The codes under heading 9993, the exemption that sits on top of them, and when a clinic writes one at all.

SAC 9993 is the Services Accounting Code heading for "Human health and social care services" in the Scheme of Classification of Services annexed to Notification 11/2017-Central Tax (Rate), 28 June 2017. A doctor's consultation falls under 999312, "Medical and dental services", and health care services by a clinical establishment or an authorised medical practitioner are exempt from GST under Sl. No. 74 of Notification 12/2017-Central Tax (Rate). The code classifies the service; the exemption decides the tax. Both matter.

What are the codes under heading 9993?

An OPD consultation, a dressing, a minor procedure in the clinic: 999312. A clinic's own lab test: 999316. An Ayurveda or homoeopathy consultation: 999319. Notification 11/2017 lists heading 9993 at Sl. No. 31 with a CGST rate of 9%, which is what would apply if the exemption did not.

Why is a consultation exempt if the heading has a rate?

Because the exemption notification overrides the rate for the services it names. Sl. No. 74 of Notification 12/2017-CT (Rate), against heading 9993, exempts "(a) health care services by a clinical establishment, an authorised medical practitioner or para-medics" and "(b) services provided by way of transportation of a patient in an ambulance". 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", but "does not include hair transplant or cosmetic or plastic surgery" unless done to restore anatomy after congenital defects, injury or trauma. Paragraph 2(s) defines a clinical establishment as "a hospital, nursing home, clinic, sanatorium or any other institution" offering diagnosis, treatment or care, and 2(k) an authorised medical practitioner as one "registered with any of the councils of the recognised system of medicines". Notification 04/2022-CT (Rate) added a proviso from 18 July 2022: the exemption does not cover a clinical establishment's room, other than ICU, CCU, ICCU or NICU, "having room charges exceeding Rs. 5000 per day". The worked cases are in GST on doctor consultation fees.

When does a clinic write a SAC code?

Only when it is registered under GST and issues GST documents. A doctor whose entire turnover is exempt health care has nothing to classify on a bill; the consultation fee goes on a plain receipt. A clinic that is registered because it also makes taxable supplies, for example a dispensing counter or cosmetic work, classifies each line: 999312 for the exempt consultation on a bill of supply, and the goods or taxable service codes on a tax invoice. How many digits of the code must appear depends on turnover rules that change; ask your CA. The medicines side is covered in GST on medicines dispensed by doctors.

What does this look like at a small OPD?

A single-doctor clinic with consultation income only is not GST-registered, charges no GST and prints receipts without a SAC. The same doctor who opens a skin clinic offering cosmetic procedures crosses into taxable territory for those procedures, registers, and from then on the consultation and the cosmetic procedure are classified and billed separately.