Private ruling: GST and health
Date of advice: 7 April 2026
Published: 29 June 2026

Ruling: Q1: Is the supply of medical consultations by XXX to its patientsa GST-free supply pursuant to subsection 38-7(1) of the A New Tax System (Goods and Services Tax) Act 1999 (GST Act)? | A1: Yes | Q2: Is the supply of compounded medication by XXX to its patients a GST-free supply pursuant to subsection 38-50(1) of the GST Act? | A2: Yes | Q3: Is the supply of injection therapy by XXX to its patients a GST-free supply pursuant to subsection 38-50(1) of the GST Act? | A3: Yes | Q4: Is the supply of repeat prescriptionsby XXX to its patients a GST-free supply pursuant to subsection 38-7(1) of the GST Act? | A4: Yes | Q5: Is the delivery of medicationby XXX to its patients a GST-free supply pursuant to section 38-50 of the GST Act? | A5: Yes | Q6: Is the supply of Customs clearance letters by XXX to its patients a GST-free supply pursuant to subsection 38-7(1) of the GST Act? | A6: No | Q7: Is the treatment plan a GST-free supply under subdivision 38-B of the GST Act? | A7: No | Q8: Is the method of apportionment to be applied to the treatment plan considered fair and reasonable for the purposes of section 9-80 of the GST Act? | A8: Yes This private ruling applies for the following period: • DD MMMM 2025 to DD MMMM 2029

Relevant facts and circumstances: You are a company are registered for GST. You operate a clinic that provides custom treatments for certain medical conditions. A treatment plan typically involves you supplying a patient with the following goods and services: (a) Telehealth medical consultations with your contracted general medical practitioner. (b) Compounded medication that is to be administered orally, prepared by contracted compounding pharmacies in accordance with the prescription issued by a general medical practitioner during a medical consultation. (c) Delivery of compounded medication to an address of the patient's choosing. (d) One fitness plan. (e) The assignment of a manager to each patient to oversee the patient's treatment plan. (f) Access to 24/7 customer service support via online chat or telephone. A treatment plan has a number of variations that include optional therapy sessions and programs that you state are to be treated as taxable supplies. Injection therapy may be prescribed in place of compounded oral medication, as appropriate. Patients may also request to have a Customs clearance letter issued to them for overseas travel. Under an agreement with you, the medications are dispensed and delivered by a compounding chemist. Some components of the medications are listed as prescription only medicines under Schedule 4 of the Poisons Standards. Patients are invoiced at a flat rate.

Relevant legislative provisions: A New Tax System (Goods and Services Tax) Act 1999 section 9-5 | A New Tax System (Goods and Services Tax) Act 1999 section 38-7 | A New Tax System (Goods and Services Tax) Act 1999 section 38-50 | A New Tax System (Goods and Services Tax) Act 1999 section 195(1)

Reasons for decision: Summary: Detailed reasoning Subsection 38-7(1) provides that a supply is GST-free if it is a medical service . The term medical service is defined in section 195-1 to include: (a) a service for which a Medicare benefit is payable; or (b) any other service supplied by, or on behalf of, a recognised professional that is generally accepted in the profession as necessary for the appropriate treatment of the patient . In your case, the requirements for the consultations to be Medicare benefit payable are met. The consultations are provided to the patient by the medical practitioner who is under contract to you to provide them. Goods and Services Tax Ruling GSTR 2006/9 Goods and services tax: supplies (GSTR 2006/9) examines the meaning of supply in the GST Act and discusses how to identify and characterise supplies in the context of the transactions in which they are made. You engage the medical practitioner, under written agreement, to provide medical consultations to your patients. Therefore, the supply of medical consultations is made by you to your patients and is a GST-free supply pursuant to subsection 38-7(1). Detailed reasoning A supply of a health service is GST-free when it satisfies all the requirements in subsection 38-10(1). Pharmacy is listed at item 15 in the table in subsection 38-10(1), meaning that paragraph 38-10(1)(a) is satisfied. A pharmacist who is registered with the Australian Health Practitioner Regulation Agency (AHPRA) will meet the requirements for being a recognised professional in pharmacy for the purposes of paragraph 38-10(1)(b). Paragraph 38-10(1)(c) requires that the supply of the health service be generally accepted in the relevant health profession as being necessary for the appropriate treatment of the recipient of the supply. However, under subsection 38-10(2), a supply of a pharmacy services is not GST-free under subsection (1) unless it is, relevantly, a supply relating to a supply that is GST-free because of section 38-50. A supply of a drug or medicinal preparation is GST-free under section 38-50(1) if the supply is on prescription and meets one of the following requirements: (a) It is a restricted medicinal preparation but may be supplied on prescription. (b) It qualifies as PBS pharmaceutical benefits. Subsection 38-50(2) further provides that a supply of a drug or medicinal preparation is GST-free where the supply of that medicinal preparation to an individual for private or domestic use is restricted but is made by, relevantly, a medical practitioner or pharmacist. A supply of a drug or medicinal preparation can only be GST-free under section 38-50, if, and only if, the drug or medicinal preparation is for human use or consumption and the supply is to an individual for private or domestic use or consumption (subsection 38-50(7)). The most common active ingredients to be included in the compounded medication are classified under Schedule 4 of the Poisons Standards as medicines that are restricted by law but may be supplied on prescription. In this case, the medicinal preparations are prescribed by the general medical practitioner, dispensed by a registered pharmacist, for human use or consumption and are made to individuals for private or domestic use or consumption. As a result, the requirements of section 38-50 are satisfied. Under the terms of the agreement with the pharmacy, you appoint the pharmacy to compound, package and dispense (your name) named patient prescription formulations for the relevant conditions on behalf of you under your brand. You provide the pharmacy with the product information and formulations to be compounded and dispensed. The pharmacy invoices you for the supply and delivery. You invoice the patient (under the terms of the Clinic-Patient Agreement). Under GSTR 2006/9: • the entity that creates or transfers the title in the medicines is the supplier (paragraphs 13 - 18). • the supplier's identity is based on the commercial substance of the arrangement, not who physically delivers or performs tasks (paragraphs 21 - 27). In your situation, you, not the pharmacy, are the supplier of medicines to the patient, because you acquire title and transfer title to the patient in fulfilling your contractual obligations. The pharmacy is a contracted service provider, dispensing and delivering on your behalf and therefore does not make a supply of medications to the patient. Accordingly, the supply of the compounded medication to the patient is made by you and is a GST-free supply pursuant to section 38-50 as the requirements of subsections 38-50(1), (2) and (7) are met. Detailed reasoning The medication prescribed to patients is a compounded injectable medication combining drugs which are listed under Schedule 4 of the Poisons Standard as prescription-only medicines. The injectable medication is provided to the patient under prescription and is self-administered. In your situation, you, not the pharmacy, are the supplier of medicines to the patient, because you acquire title and transfer title to the patient in fulfilling your contractual obligations. The pharmacy is a contracted service provider, dispensing and delivering on your behalf and therefore does not make a supply of medications to the patient. Consistent with the reasoning provided under Question 2, the supply of the compounded injectable medication is a GST-free supply pursuant to section 38-50 as the requirements of subsections 38-50(1), (2) and (7) are met. Detailed reasoning Under subsection 38-7(1), the supply of a medical service is GST-free. ATO Interpretative Decision ATO ID 2001/492 GST and the supply of a repeat prescription (ATO ID 2001/492) addresses the situation where a repeat prescription is provided to a patient but not provided during a medical consultation. The medical practitioner has previously assessed the patient and determined that the repeat prescription is necessary for the ongoing treatment of the patient. The final paragraph of ATO ID 2001/492 states - The medical service is not excluded under subsection 38-7(2) of the GST Act. Therefore, the entity is making a GST-free supply under subsection 38-7(1) of the GST Act when it supplies a repeat prescription to a patient and it is evidenced that the supply is generally accepted in the medical profession as being necessary for the appropriate treatment of that patient. Under the terms of your agreement with the medical practitioner, you engaged them to provide a medical consultation to your patients. Therefore, the repeat prescription is a medical service and a GST-free supply made by you to your patients pursuant to subsection 38-7(1). Detailed reasoning As outlined above, the supply of the medication is a GST-free supply made by you to your patients under a contractual arrangement with the pharmacy. For the same reasons, the delivery of that product is a supply by you because, under that contract, the pharmacy is required to arrange and provide a service of delivery of that GST-free supply. Paragraph 2 of Goods and Services Tax Determination GSTD 2002/3 Goods and services tax: how do I account for GST when I supply taxable goods, non-taxable goods and delivery services together? (GSTR 2002/3) observes We consider that delivery is a separately identifiable part of a mixed supply where it is significant and could realistically be made as a separate supply. A delivery service is significant where it is an aim in itself. That is, your customers have a genuine choice under the contract about whether you deliver their goods. Such a choice is indicated where: • your customers are not obliged to use your delivery service; and • you provide reasonable access, at no extra charge, to customers who choose to make their own arrangements to collect the goods. Under the terms of the contract, the cost of delivery is separately identifiable to that of the medicine however, under the terms of contract with the patient, you will deliver the medication directly to the patient. The patient does not have any choice about whether you deliver their medication. Moreover, you remain responsible for the medication until it is supplied to the patient. Paragraphs 4 and 7 of GSTD 2002/3 provides that where you supply delivered goods, the character of the goods determines the GST status of the supply. In the case of the goods being non-taxable, the GST payable on the separate fee for delivery is nil. Accordingly, the delivery of medication you to your patients is a GST-free supply. Detailed reasoning Subsection 38-7(1) provides that a supply is GST-free if it is a medical service . A Customs clearance letter is not covered by Medicare. Paragraphs 10 and 11 of Issue 2.a. in the Goods and Services Tax Industry Issues Health Industry Partnership sets out the Commissioner's view on the meaning of 'appropriate treatment' in relation to section 38-10: 10. It is considered that 'appropriate treatment' will be established where the recognised professional assesses the recipient's state of health and determines a process to pursue, in an attempt to preserve, restore or improve the physical or psychological wellbeing of that recipient insofar as that recognised professional's particular area of training allows and will include subsequent supplies for the determined process. 11. 'Appropriate treatment' includes the principles of preventative medicine. Such treatment must be generally accepted in the profession associated with supplying services of that kind , as being necessary. 'Appropriate treatment' will not include supplies undertaken for a third party, which does not encompass treatment. While the letter is provided by the clinic to the patient, although quoting a 'prescriber number', it is not provided during consultation and is not considered appropriate treatment of the patient. A Customs clearance letter is simplypart of the Customs clearance process, which is a taxable service . It is an administrative/documentation service, not a medical service necessary for the patient's treatment and not a supply of drugs or medicines under section 38-50. Detailed reasoning Treatment plans are purchased as an individual plan rather than in parts. This is supported by the fact that patients are invoiced for an entire treatment plan, and not for separate respective parts, regardless of whether or not they are accessed. In Federal Commissioner of Taxation v Luxottica Retail Australia 2011 ATC 20-243 (Luxottica), their Honours said at 15: 'While "Supply" is defined broadly, it nevertheless invites a commonsense, practical approach to characterisation. An automobile has many parts which are fitted together to make a single vehicle. Although, for instance, the motor, or indeed the tyres, might be purchased separately there can be little doubt that the sale of the completed vehicle is a single supply. Like a motor vehicle, spectacles are customarily bought as a completed article and in such circumstances are treated as such by the purchaser. The fact that either the frame or the lenses may be purchased separately is not to the point. Similarly, the fact that one component, the lenses, is GST-free or that one component is subject to a discount does not alter the characterisation.'. Accordingly, each treatment plan should be treated as a single supply for GST purposes rather than a number of separate supplies. A single supply can contain components that are taxable supplies and GST-free supplies. Goods and Services Tax ruling GSTR 2001/8 Goods and services tax: Apportioning the consideration for a supply that includes taxable and on-taxable parts (GSTR 2001/8) describes characteristics of a supply that contains taxable and non-taxable parts. It refers to such a supply as a 'mixed supply'. GSTR 2001/8 also describes the characteristics of a supply that appears to have more than one part but is essentially a supply of one thing. This type of supply is referred to as a 'composite supply'. The treatment plan comprises several different components that, where treated separately, are a mix of GST-free and taxable supplies. In some instances, the services provided under the treatment plan are optional, although included in the cost. The supplies of medical consultations, medications and the delivery of the medication are GST-free supplies. The supplies of Customs clearance letters are taxable supplies. You have identified the optional therapy sessions and programs as taxable supplies. These are components of the treatment plan and will be treated as such. The activities of the manager are not separately identifiable as they are supplementary to the supply of each component in the treatment plan. Even though the services provided under the treatment plan are bundled, each element is of sufficient significance to constitute separately identifiable parts and each has its own commercial substance GST-free medical treatment is the principal supply and GST-free medication is integral and necessary for the treatment, as is the delivery of the medication. They may form part of a composite GST-free health supply. The taxable supplies thus far mentioned would be of sufficient significance to constitute separately identified parts and are not integral or incidental to the main medical service. Thus, the whole arrangement cannot be a composite supply because it includes non-integral, optional, and independently acquirable supplies. Accordingly, the treatment plans should be treated as a mixed supply that contains GST-free parts and parts subject to GST. Detailed reasoning GSTR 2001/8 provides guidance on how to apportion consideration for a supply that includes taxable and non-taxable supplies. Paragraphs 92 - 95 advises that the method of apportionment will need to be on a reasonable basis. A reasonable basis will be one which is based on a consideration of all the circumstances and not because it gives you a particular result. You have provided an apportionment method which we accept as fair and reasonable.

• unless otherwise stated, all legislative references are to the A New Tax System (Goods and Services Tax) Act 1999 (GST Act) | Under section 9-5 a supply will be a taxable supply where all the following requirements are met: | (a) the supply is made for consideration | (b) the supply is made in the course or furtherance of an enterprise that the supplier carries on | (c) the supply is connected with the indirect tax zone and | (d) the supplier is registered or required to be registered. | (e) However, the supply is not a taxable supply to the extent that it is GST-free or input taxed. | The supplies made you will be taxable supplies unless there is another provision in the GST Act that makes those supplies GST-free or input taxed. There are no provisions in the GST Act that would make these supplies input taxed. The relevant GST provisions under which each supply is made are considered further in the detailed reasoning for each question.