How Can Medical Tourism Providers in India Receive International Payments in 2026?

• Ticket size: Bills range from a teleconsultation or diagnostic package to a major surgery with a hospital stay. Many providers ask for an advance deposit against a cost estimate, followed by a final bill at discharge that adjusts for the actual treatment given.
• Currencies: Patients and insurers usually pay in USD, EUR, GBP, AED or other major currencies. The FEMA (Manner of Receipt and Payment) Regulations, 2023 allow payers outside the Asian Clearing Union to pay in INR or any foreign currency through an authorised bank or authorised person.
• Geography: Patients come from many regions, including neighbouring countries, the Gulf, Africa and Central Asia. Patients from Nepal and Bhutan, and payers in Asian Clearing Union member countries, follow separate rules in the same RBI regulations, so check the route with your AD bank.
• Payment methods: Patients often pay an advance by bank wire before travel and settle the balance by card at the hospital. Overseas insurers, employers and government health schemes usually pay by bank transfer against a guarantee of payment or a final bill.

1. 1Patient's or insurer's bankDeduction: A sending fee, if the payer's bank charges one. International transfers often carry a sender fee, and on a SWIFT wire the payer chooses who bears the charges.
2. 2Intermediary bankDeduction: A possible flat handling deduction. Correspondent banks that route a SWIFT wire can take their charge before the money reaches India, so less than the estimate may arrive.
3. 3Collecting provider or AD bankDeduction: A currency conversion margin and any transfer fee. The foreign currency is converted to INR at a rate set by the bank or provider, which sits away from the mid-market rate.
4. 4GST on feesDeduction: GST on the fee charged by an Indian provider or bank. Fees that an India-based bank or provider charges you are a domestic supply.
5. 5Your Indian bank accountDeduction: None in most cases, though some banks levy an inward charge. The INR credit arrives with an inward remittance record that you match to the patient file and bill.

The table ranks platforms with full published pricing for USD by the INR received on USD 8,000, then lists other business platforms that accept USD, unranked. Fees were checked on 30 Sept 2026 or later.

Each row applies the platform's published fee, FX markup and 18% GST on the fee to the mid-market rate of ₹94.84 per USD for 3 Nov 2026.

• Purpose code: The RBI purpose code list has P0304, "Travel for medical treatment including TCs purchased by hospitals", in the travel group. A facilitator paid a commission may fit a different code, such as P1019 "Commission agent services". Confirm the code with your AD bank before the credit. See RBI purpose codes list.
• Patients in India: Under Regulation 3(3) of the FEMA (Manner of Receipt and Payment) Regulations, 2023, a current account payment made in India by a non-resident on a visit, other than a trade transaction, may be made only in INR or through a bank account kept under FEMA rules. Patients can change foreign currency with an authorised person first.
• Large bills: A cross-border payment aggregator can process up to ₹25 lakh per inward transaction under paragraph 11(d) of the RBI Master Direction on Payment Aggregators. A larger surgery deposit can be paid by SWIFT wire directly to the hospital's bank.
• Refunds: Advance deposits often exceed the final bill. Keep the original remittance record, because your AD bank usually needs it to send an unused balance back to the payer abroad. Ask the bank for its refund documents before you take the deposit.
• Name matching: Payments often come from a relative, employer or insurer rather than the patient. Ask the payer to quote the patient's name and hospital registration number in the payment reference, so your team can match the credit to the right file.

Medical tourism providers in India need an inward remittance record and the correct purpose code for each foreign payment. Ask your AD bank whether it treats a receipt as an export of services that needs an EDF and an EDPMS entry under the FEMA (Export and Import of Goods and Services) Regulations, 2026, in force from 1 October 2026.

• FIRA or FIRC: FIRA is not a term defined in RBI regulations. Banks issue a FIRC or inward remittance advice, and the DGFT eBRC FAQs explain self-generated eBRCs from bank data. See FIRC vs FIRA vs eBRC.
• Purpose code: Banks report receipts in FETERS using the RBI purpose code list. P0304 is "Travel for medical treatment including TCs purchased by hospitals". P1019 is "Commission agent services" and P1099 is "Other services not included elsewhere". Confirm the code with your AD bank.
• EDF: Where your AD bank treats the receipt as an export of services, Regulation 3(2) requires an EDF within 30 days from the end of the invoice month. Exporters of services other than software may submit it on or before the date payment is received. See EDF form for exports.
• EDPMS: Your AD bank closes an export entry in EDPMS when payment is realised. Under Regulation 4(2), an invoice up to ₹10 lakh can be closed on your declaration, filed per invoice or quarterly in bulk. See EDPMS for service exporters.
• Realisation: Export proceeds must be realised within nine months from the invoice date, or twelve months if invoiced or settled in INR, under Regulation 5. An advance and later realisation must go through the same AD bank under Regulation 10(1), unless both banks are told of a change.
• Fund safety: A cross-border payment aggregator must be authorised by RBI and is subject to the RBI Master Direction on Payment Aggregators. Before using a provider for patient deposits, check that it holds the required RBI authorisation. See RBI PA-CB guidelines.

Treatment given in India to a foreign patient is usually not an export of services for GST, because the patient is physically present in India. Under IGST Act section 13(3)(b), the place of supply is where the service is performed. Fees remain taxable income in India under the Income-tax Act, 2025 from tax year 2026-27.

• Treatment: Health care services by a clinical establishment, an authorised medical practitioner or para-medics appear as exempt in the 2017 GST Council services rate schedule. Confirm with a GST adviser that the current exemption covers each service you bill, since cosmetic or wellness items may be treated differently.
• Teleconsultation: Online advice to a patient abroad does not need the patient's physical presence, so the general rule in IGST Act section 13(2) applies and the place of supply is the recipient's location. Check whether the service is exempt health care or a zero-rated export under section 16.
• Facilitators: A facilitator billing a foreign party can be an exporter of services if the supply meets the five conditions in IGST Act section 2(6). The CBIC text shows clause 13(8)(b) on intermediary services omitted by the Finance Act, 2026. File an LUT under CGST Rule 96A before invoicing without IGST.
• Section 58: Under section 58 of the Income-tax Act, 2025, a resident individual or firm, other than an LLP, in a specified profession can be taxed on 50% of gross receipts, or higher actual profit. Section 62(4) names the medical profession. Receipts must not exceed ₹50 lakh, or ₹75 lakh with cash receipts within 5%.
• Old 44ADA: The Income Tax Department FAQ says old section 44ADA is consolidated into section 58 from 1 April 2026, and the 1961 Act still governs tax years before that. Hospitals run as companies or trusts follow their own regular tax rules. See section 44ADA for freelancers.

Rules and rails are linked to official sources below with the dates they were checked. Platform figures come from each platform's own pages, checked on 30 Sept 2026 or later, and RBI authorisation was checked against RBI's published list. Rates are XE live mid-market rates, dated 3 Nov 2026. The method is on the methodology page.

1. Foreign Exchange Management (Export and Import of Goods and Services) Regulations, 2026, Notification No. FEMA 23(R)/2026-RB, In force 1 October 2026; Reg 3(2) EDF within 30 days from end of invoice month, (b) services other than software may submit on or before receipt; Reg 4(2) EDPMS closure on declaration up to ₹10 lakh, quarterly bulk option; Reg 5(1) nine months from invoice date, twelve if invoiced/settled in INR; Reg 10(1) advance and realisation through the same AD (checked 8 Oct 2026)
2. RBI A.P. (DIR Series) Circular No. 20 (16 January 2026), Supersedes the Master Directions on Export and Import from 1 October 2026 (checked 8 Oct 2026)
3. Foreign Exchange Management (Export and Import of Goods and Services) (Amendment) Regulations, 2026 (22 September 2026), Regulation 5(1): realisation periods of nine and twelve months (checked 8 Oct 2026)
4. Foreign Exchange Management (Manner of Receipt and Payment) Regulations, 2023, Reg 3(2)(I)(a): Nepal and Bhutan in INR; ACU mechanism; other countries in INR or any foreign currency. Reg 3(3): payment and receipt in India for a current account transaction, other than a trade transaction, with a person resident outside India on a visit to India may be made only in Indian Rupees, or by debit/credit to a bank account maintained under FEMA (checked 8 Oct 2026)
5. RBI A.P. (DIR Series) Circular No. 84, Annex: Purpose codes for reporting under FETERS (receipts), P0304 'Travel for medical treatment including TCs purchased by hospitals'; P1019 'Commission agent services'; P1099 'Other services not included elsewhere' (checked 8 Oct 2026)
6. RBI A.P. (DIR Series) Circular No. 84 (29 February 2012), Circular notifying the revised purpose code list for FETERS reporting (checked 8 Oct 2026)
7. RBI Master Direction on Regulation of Payment Aggregator (PA) (15 September 2025), Para 11(d): maximum ₹25 lakh per inward or outward transaction for a PA-CB (checked 8 Oct 2026)
8. RBI circular: Guidelines to facilitate faster cross-border inward payments (9 April 2026), Para 3: banks shall endeavour to credit inward payments received during forex market hours within the same business day; para 4: effective six months from the circular date (9 April 2026) (checked 8 Oct 2026)
9. Integrated Goods and Services Tax Act, 2017, section 13 (CBIC), 13(2) place of supply is the location of the recipient; 13(3)(b) services to an individual requiring physical presence of the recipient: location where services are actually performed; 13(8)(b) omitted by section 157 of the Finance Act, 2026 dated 30.03.2026 (checked 8 Oct 2026)
10. Integrated Goods and Services Tax Act, 2017, section 2 (CBIC), Section 2(6): definition of export of services (checked 8 Oct 2026)
11. Integrated Goods and Services Tax Act, 2017, section 16 (CBIC), Section 16(1): export of services is a zero-rated supply (checked 8 Oct 2026)
12. Central Goods and Services Tax Rules, 2017, Rule 96A (CBIC), Export without payment of integrated tax under bond or Letter of Undertaking in Form GST RFD-11 (checked 8 Oct 2026)
13. Schedule of GST rates for services as approved by GST Council (CBIC), Item 82: '(i) Health care services by a clinical establishment, an authorised medical practitioner or para-medics' in the list of exemptions continued in GST (checked 8 Oct 2026)
14. DGFT FAQs on Self-Generation of eBRC, Self-generated eBRC from bank inward remittance data (checked 8 Oct 2026)
15. Income Tax Department: Objective and scope of the new Act (Income-tax Act, 2025), 1961 Act repealed on 01.04.2026; old Act governs tax years beginning before 1 April 2026; sections 44AD, 44ADA and 44AE consolidated into section 58 (checked 8 Oct 2026)
16. Income-tax Act, 2025 (as amended by Finance Act, 2026), Income Tax Department, Section 58(2) Table Sl. 3: specified profession under section 62(4), gross receipts up to ₹50 lakh or ₹75 lakh where cash receipts do not exceed 5%, 50% of gross receipts or higher actual profit; 58(11)(b) resident individual or firm other than an LLP; 62(4)(a) includes medical profession (checked 8 Oct 2026)
17. Skydo homepage (pricing and fee calculator), Know what you pay; calculator showing GST 18% of transaction fee (checked 6 Oct 2026)
18. Razorpay MoneySaver Export Account (International Bank Transfers) pricing, Standard Plan: 0% FX markup, 1% fee, FlashLinks 2%, GST applicable, flat fee of INR 1,000 on transactions below INR 1,00,000, setup and AMC INR 0 (checked 6 Oct 2026)
19. Kotak Everyday Savings Account fees and charges, Foreign Inward Remittance certificate (Branch Request) INR 100/Request; GST on Foreign Currency Conversion; fees exclusive of GST (checked 6 Oct 2026)
20. Wise India: Fees for receiving money (Business), Conversion fee depends on the currency; eFIRC for every transfer; GST 18% of (conversion fee + eFIRC fee); calculator (checked 6 Oct 2026)
21. HDFC Bank: Remittance Services Fees & Charges, Inward Remittance Charge: No Charge; FIRC Charge for Inward Remittance & FCY Cheque Collection INR 200 per FIRC; GST slabs on amount of currency exchanged (checked 6 Oct 2026)
22. Stripe India pricing, International cards with USD/other currency presentment 4.3% + 2% if currency conversion is required; Mastercard and Visa cards issued outside India 3% + 2%; American Express outside India 3.5% + 2%; dispute received INR 1,000.00 (checked 7 Oct 2026)
23. PayPal India Merchant Fees, Receiving international transactions; Currency Conversions (3.0% converting balance and payments received; 4.00% all other cases); Withdrawals Out of PayPal; Dispute Fees; Other Fees (Last Updated 28 March 2024) (checked 6 Oct 2026)
24. Airwallex Help: Eligible Countries and Territories, INDIA IN - AWX Legal Entity SINGAPORE (checked 7 Oct 2026)