How should medical tourism providers in India receive payments from foreign patients?

India receives patients from around the world for cardiac surgery, orthopaedics, fertility treatment, oncology, dental work, eye care and Ayurveda and wellness programmes. The providers include multi-speciality hospitals in Chennai and Gurugram, single-speciality clinics in Hyderabad, independent surgeons and dentists, Kerala wellness centres, and medical travel facilitators that connect patients with hospitals. Payment flows are unusual: large advance deposits before arrival, card payments at the billing desk, insurer settlements and follow-up teleconsultations after the patient returns home.

This page explains how payment routes, platforms, GST, RBI reporting and income tax apply to those flows. It describes the law as written; for your own facts, especially facilitation fees, check with a chartered accountant (CA).

How do international clients pay medical tourism providers in India?

International patients usually pay medical tourism providers in India by an advance wire before travel, by international card at the billing desk or through a payment link, or through an insurer, employer or government sponsor that settles the bill directly. A cross-border payment aggregator can collect card payments online, but RBI caps each such transaction at ₹25 lakh, so large surgical packages may need a SWIFT wire.⁸

• Advance deposits: Wired before the patient travels, against an estimate.
• Billing desk: International cards on arrival or at discharge. See export payment by card.
• Sponsors: Insurers, employers or governments settling the bill directly.
• Follow-up care: Teleconsultation fees after the patient returns home.

For example, a patient from Nairobi may wire a deposit before a knee replacement in Chennai and pay the balance by card at discharge. See advance payment against exports and refund of an advance export payment for deposits returned when treatment is cancelled.

Where does the money go between a foreign client and the Indian bank account of medical tourism providers in India?

The money from a foreign client reaches medical tourism providers in India through their Indian bank, the authorised dealer (AD) bank, either directly as a wire or through a payment provider that collects it first. The AD bank may credit the export proceeds only after satisfying itself that the transaction is genuine, and it updates the export entry in the Export Data Processing and Monitoring System (EDPMS) at the same time.¹¹

• Direct wire: The client's bank sends the payment to the AD bank, which credits rupees and reports the transaction, with its purpose code, in RBI's Foreign Exchange Transaction Electronic Reporting System (FETERS).¹¹
• Payment provider: A cross-border payment aggregator (PA-CB) collects the payment and pays it to the AD bank, and must give the AD bank the documents or information the exporter needs.⁸
• Proof of receipt: Banks send electronic inward remittance messages (IRMs) to DGFT, and the exporter self-certifies an e-BRC against them.¹²

Whichever route the client uses, the AD bank is where the export is recorded, so the invoice, purpose code and EDF all meet there.

What are the ways for medical tourism providers in India to receive international payments?

Medical tourism providers in India can receive international payments by SWIFT wire to an Indian bank, through local account details from a payment provider, and through PayPal, card or payment links. Each route differs in who sets the cost and what proof of receipt you get.

How does a SWIFT wire to an Indian bank work for medical tourism providers in India?

A SWIFT wire sends the client's payment from its bank to the Indian AD bank of medical tourism providers in India, which credits rupees once it is satisfied the transaction is genuine.¹¹

• How it works: You give the client your bank's SWIFT details; the client's bank sends the payment, and your bank converts it and reports it with a purpose code.¹¹
• Pros: No third-party account to open; the bank's IRM lets you self-certify an e-BRC on DGFT.¹²
• Cons: Charges and the exchange rate vary from bank to bank, so compare your bank's published charges.¹¹
• Cost: As set in the bank's published policy, which must list charges for each process and keep them reasonable and proportional.¹¹
• Settlement: Depends on the banks involved and is not fixed in advance.
• FIRA: Ask your bank how it issues a FIRA or e-FIRC; the e-BRC comes from its IRM data.¹²
• Ideal for: Advance deposits for surgical packages and insurer or sponsor settlements.

How do local account details from a payment provider work for medical tourism providers in India?

Local account details let a foreign client pay medical tourism providers in India by a domestic transfer in its own country, after which the provider converts the money and pays rupees into the Indian bank account.

• How it works: A cross-border payment aggregator (PA-CB) or similar provider collects the payment and passes the documents your AD bank needs.⁸
• Pros: The client pays as it pays a local supplier.
• Cons: Each PA-CB transaction is capped at ₹25 lakh, and providers differ in who can sign up.⁸
• Cost: The provider's published fee and FX markup; the calculator at the top of this page compares them.
• Settlement: The provider's published settlement time.
• FIRA: Check whether the provider issues a FIRA or e-FIRC for every payment.
• Ideal for: Teleconsultation fees from patients abroad who pay by bank transfer.

How do PayPal, card payments and payment links work for medical tourism providers in India?

PayPal, card payments and payment links let a client pay medical tourism providers in India by card or wallet, and the provider settles rupees to the Indian bank account.

• How it works: You send a payment link or invoice; the client pays by card or PayPal balance.
• Pros: Familiar to small clients and individuals.
• Cons: Providers price card and PayPal routes separately from bank transfers, so the same invoice can cost more.
• Cost: The provider's published card or PayPal fee; see the calculator.
• Settlement: The provider's published settlement time.
• FIRA: Check what the provider issues for each payment.
• Ideal for: Billing-desk and online payments from patients and attendants.

Which platforms are best for medical tourism providers in India?

The platforms that suit medical tourism providers in India depend on how their clients pay: by bank transfer, card, PayPal balance or a marketplace payout. The table lists the providers in this site's USD cost model, ordered by estimated cost on published fees, cheapest first, with providers that do not publish enough pricing to estimate listed after, A to Z.

The platform cost comparison and how to choose a payment platform apply the same criteria to every provider.

How much INR do medical tourism providers in India receive on $2,000, $5,000 and $10,000?

The INR that medical tourism providers in India receive on these three invoice sizes depends on each provider's published fees and conversion markup, and the table below works it out at today's exchange rate.

Note: A single payment through a PA-CB cannot exceed ₹25 lakh, for inward and outward transactions alike.⁸ Check how a provider handles an invoice above that limit before you send it.

What should medical tourism providers look for beyond cost?

Beyond cost, medical tourism providers should check card and currency coverage, transaction limits, refund handling, proof of receipt and authorisation status, because patient payments are large, often by card, and sometimes refunded.

• Cards and currencies: Whether it accepts the card networks and currencies your patients use, and its published card fee and foreign exchange (FX) markup.
• Limits: Per-transaction limits against your typical package size.⁸
• Refunds: How refunds and chargebacks are handled.
• FIRA: Whether you get a FIRA (Foreign Inward Remittance Advice) or equivalent advice for each receipt.
• Purpose code: Whether you can set the purpose code per receipt, for example P1108 for treatment and teleconsultations.³
• Authorisation: Its status, for example on RBI's list of cross-border payment aggregators (how to check).

The compare hub applies the same criteria to each provider.

What compliance documents do medical tourism providers need?

Medical tourism providers need the right purpose code and proof of each foreign receipt, must apply the GST health care exemption correctly, and should ask their bank how it wants foreign patient receipts declared under the 2026 RBI rules.²³⁶

Is treatment of a foreign patient an export of services under GST?

Treatment of a foreign patient in India is not an export of services under GST, because one of the five conditions in section 2(6) of the IGST Act, that the place of supply is outside India, fails.¹ Section 13(3)(b) puts the place of supply at the location where the services are actually performed for services supplied to an individual that require the physical presence of the recipient (or a person acting on their behalf) with the supplier.¹ Surgery, consultations and in-patient care in India therefore have their place of supply in India, even if the patient pays in dollars or dirhams.

Is GST charged on medical treatment for foreign patients?

Notification No. 9/2017-Integrated Tax (Rate) exempts "health care services by a clinical establishment, an authorised medical practitioner or para-medics".² The notification defines health care services as diagnosis, treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India, including transport of the patient to and from a clinical establishment.² It excludes hair transplant and cosmetic or plastic surgery, except when done to restore or reconstruct anatomy or body functions affected by congenital defects, developmental abnormalities, injury or trauma.² This page quotes the notification as issued; check its current amended text before relying on it.

Which services around medical treatment follow different place of supply rules?

Services around the treatment each have their own place of supply rule in section 13 of the IGST Act:¹

These rules come from sections 2(13), 13(2), 13(3)(b), 13(4) and 13(5) of the IGST Act.¹ Facilitators paid commission by an Indian hospital are supplying to that hospital, a domestic supply. Facilitators paid by the patient or a foreign insurer should read intermediary services under GST and place of supply for export of services.

Which RBI purpose code fits medical tourism receipts?

Two RBI purpose codes fit medical tourism receipts, and the bank decides which it reports.³⁵ The descriptions, from the list introduced by A.P. (DIR Series) Circular No. 84 of 29 February 2012, are:³⁵

The Directorate General of Foreign Trade (DGFT) maps medical and dental services (SAC 999312) and in-patient services to P1108.⁴ P1108 is the only one of these that also covers remote services, so it suits teleconsultations.³ The Best for column is our reading of the descriptions. Agree the code with your bank for each type of receipt; see wrong purpose code consequences.

Do medical tourism providers file an EDF under the 2026 RBI rules?

From 1 October 2026, the Foreign Exchange Management (Export and Import of Goods and Services) Regulations, 2026 require every exporter of services to file an Export Declaration Form (EDF) with the authorised dealer bank, within 30 days from the end of the month of invoicing, or for non-software services on or before the date payment is received.⁶ Export value must be realised within nine months of the invoice date (twelve months for rupee invoices).⁶⁷

The Regulations' text does not say whether treatment given in India to a visiting patient is an export for this purpose, or how card receipts at a hospital desk are handled.⁶ Remote teleconsultations billed to patients abroad are closer to a conventional service export. Ask your bank how it wants each type of foreign receipt documented. See EDF for service exporters.

What tax applies to international income for medical tourism providers?

International income of medical tourism providers is taxed in India, and individual doctors can use the 50% presumptive scheme because "medical" is one of the specified professions in section 62(4) of the Income-tax Act, 2025.¹⁰ Under Table row 3 of section 58(2), a resident individual or partnership firm (not an LLP) in a specified profession may declare 50% of gross receipts (or higher actual profit) as income, if gross receipts do not exceed ₹50 lakh, or ₹75 lakh where cash receipts are within 5%.⁹

• Hospitals and clinics: Those run as companies or LLPs cannot use this scheme and are taxed on actual profits.⁹
• Facilitators: Not in a specified profession, and the business scheme in Table row 1 excludes anyone earning commission or brokerage or carrying on an agency business.⁹

Agree your approach with a CA; the section 44ADA calculator shows the 50% arithmetic.⁹