Edited version of private advice

Authorisation Number: 1052387339735

Date of advice: 10 June 2025

Ruling

Subject: GST - services for government funded participants

Question

Are xxxx services provided by you under government funded programs (listed below) and funded by private clients taxable supplies for the purposes of section 9-5 of the A New Tax System (Goods And Services Tax) Act 1999 (GST Act)?

•                     Medicare,

•                     Chronic Disease Management (CDM),

•                     Department of Veteran Affairs (DVA),

•                     Workcover,

•                     My Aged Care (Home Care Package(HCP)), and

•                     National Disability Insurance Scheme (NDIS).

Answer

Generally, yes, supplies of xxxx services are a taxable supply as defined by section 9-5 of the GST Act. This includes supplies of xxxx to privately funded clients and clients funded by DVA and Workcover. However, supplies of xxxx services are not taxable, where:

•                     A Medicare benefit is payable for the service. This includes xxxx services supplied under a CDM plan which are eligible for a Medicare benefit.

•                     You receive home care subsidy under Part 3.2 of the Aged Care Act 1997 in relation to the supply of an xxxx service to a HCP recipient.

•                     You supply exercise xxxx to a NDIS participant who:

-                    is an early childhood aged NDIS participant; or

-                    resides in a residential care facility.

AND

-                    the NDIS participant has a NDIS plan in effect;

-                    the supply of xxxx is a reasonable and necessary support specified in the statement of supports in the participant's NDIS plan; and

-                    there is a written agreement between you and the NDIS participant (or another person) that identifies the participant and states that the supply of xxxx services is of one or more of the reasonable and necessary supports specified in the statement in the participant's plan.

This ruling applies for the following period:

10 June 20YY to 10 June 20YY

Relevant facts and circumstances

You are XYZ Pty Ltd. You carry on a business of providing a diverse range of allied health professionals which includes xxxx.

For the purposes of this ruling you are concerned only with the services provided by xxxxx.

The xxxx services are offered in a range of circumstances which can be under (or to):

•                     Medicare,

•                     CDM,

•                     DVA,

•                     Workcover,

•                     Private clients,

•                     HCP, or

•                     NDIS.

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 38-10

A New Tax System (Goods and Services Tax) Act 1999 section 38-30

A New Tax System (Goods and Services Tax) Act 1999 section 38-38

A New Tax System (Goods and Services Tax) Act 1999 section 195-1

Reasons for decision

In considering whether a supply is a taxable supply, regard must be given to section 9-5 of A New Tax System (Goods and Services Tax) Act 1999 (GST Act) which states:

You make a taxable supply if:

(a)          you make the supply for consideration; and

(b)          the supply is made in the course or furtherance of an enterprise that you carry on; and

(c)          the supply is connected with Australia; and

(d)          you are registered, or required to be registered.

However, the supply is not a taxable supply to the extent that it is GST-free or input taxed.

In your case, your supply of xxxx services satisfies paragraphs 9-5(a) to 9-5(d) of the GST Act, therefore your supply will be a taxable supply unless it is GST-free or input taxed under other provisions of the GST Act.

The supply of xxxxx services is not input taxed under any provisions of the GST Act or any other Act. Therefore, what is left to be considered is whether the supply of the xxxx services is GST-free.

Subdivision 38-B of the GST Act provides that certain supplies relating to health are GST-free.

In your case, the relevant provisions to examine are sections 38-7, 38-10, 38-30 and 38-38 of the GST Act.

Medical services

Section 38-7 of the GST Act provides that a supply of a medical service is GST-free. The term medical service is defined in section 195-1 of the GST Act to mean:

(a)          a service for which Medicare benefit is payable under Part II of the Health Insurance Act 1973; or

(b)          any other service supplied by or on behalf of a medical practitioner or approved pathology practitioner that is generally accepted in the medical profession as being necessary for the appropriate treatment of the recipient of the supply.

Accordingly, if a Medicare benefit is payable for an xxxx service you supply, the supply will be GST-free under section 38-7 of the GST Act.

Medicare

Under the Medicare Benefit Schedule, a Medicare benefit it payable for xxxx services in certain circumstances. When a Medicare benefit is payable for the xxxx service, the supply will be GST-free under section 38-7 of the GST Act. We understand that there are several Medicare Benefit Schedule item numbers (such as 10953, 81110, 81115 and 81315) relating to the provision of xxxx services. Where you provide one of these xxxx services for which a Medicare Benefit is payable, the supply of the xxxx service is GST-free under section 38-7 of the GST Act.

CDM

Where a CDM plan provides for xxxx as detailed by a GP and a Medicare benefit is payable for the xxxx service, the service will be GST-free as it satisfies subsection 38-7(1) of the GST Act.

DVA

The supply of xxxx services to DVA clients is not GST-free under subsection 38-7(1) of the GST Act since no Medicare benefit is payable for the service.

Workcover

In the case of supplies of xxxx services to Workcover funded clients, since there is no Medicare benefit payable for the service, the supply is not GST-free under subsection 38-7(1) of the GST Act.

Private Clients

The supply of xxxx to private clients for which no Medicare benefit is payable is not GST-free as it does not satisfy subsection 38-7(1) of the GST Act. This is so even if the service is paid for by the client's health fund.

Other health services

Subsection 38-10(1) of the GST Act provides that a supply of health services is GST-free if:

(a)          it is a service of a kind specified in the table in this subsection or of a kind specified in the regulations; and

(b)          the supplier is a recognised professional in relation to the supply of services of that kind; and

(c)          the supply would generally be accepted, in the profession associated with supplying services of that kind, as being necessary for the appropriate treatment of the recipient of the supply.

All three requirements in subsection 38-10(1) of the GST Act must be satisfied for a supply of health services to be GST-free under that subsection.

Xxxx is not a listed health service in the table in this subsection. Therefore, supplies of xxxx are not GST-free under subsection 38-10(1) of the GST Act.

Home care etc.

Under subsection 38-30(1) of the GST Act a supply of home care is GST-free in certain circumstances, including if a home care subsidy is payable to the supplier for the care:

(1)          A supply of * home care is GST - free if:

(a)          home care subsidy is payable under Part 3.2 of the Aged Care Act 1997 or Part 3.2 of the Aged Care (Transitional Provisions) Act 1997 to the supplier for the care; or

(b)          the Commonwealth contribution amount worked out in respect of the supplier, using section 48 - 1A of the Aged Care Act 1997, for the recipient of the care in respect of the payment period (within the meaning of that Act) in which the supply is made, is greater than zero; or

(c)          both of the following apply:

(i)           the supplier is eligible for home care subsidy under section 46 - 1 of the Aged Care (Transitional Provisions) Act 1997 in the payment period (within the meaning of that Act) in which the supply is made;

(ii)           the supply is a supply of a kind specified in the regulations.

HCP

Accordingly, where you receive home care subsidy under Part 3.2 of the Aged Care Act 1997 in relation to the supply of an xxxx service to a HCP recipient, the supply will be GST-free under subsection 38-30(1) of the GST Act. However, if you are contracted by another entity that receives home care subsidy, to provide xxxx services to their clients, this is a supply by you to the other entity and is generally not GST-free.

Disability support provided to NDIS participants

Under section 38-38 of the GST Act, the supply of certain disability supports to NDIS participants are GST-free.

For the supply to be GST-free, all four of the following must be satisfied:

(a)          the NDIS participant has a NDIS plan in effect;

(b)          the supply is of reasonable and necessary supports that are specified in the statement of supports in the participant's NDIS plan;

(c)          there is a written agreement between you and the NDIS participant (or another person) that identifies the participant and states that the supply is of one or more of the reasonable and necessary supports specified in the statement in the participant's plan; and

(d)          it is a supply covered by one of the tables in the NDIS Determination.

The current NDIS Determination applies to supplies made on or after 1 July 2021. The NDIS Determination contains two tables:

•                     Table 1[1] - supplies of supports

•                     Table 2[2] - supplies of supports covered by other determinations

If the supply is covered by Table 1, the requirement to be covered by the NDIS Determination is satisfied. Provided the other three requirements under paragraphs 38-38(a) to (c) of the GST Act are met, the supply of the support is GST-free.

If Table 1 doesn't apply, the supply may be covered by Table 2. When an item in Table 2 is relevant to the supply, the requirement to be covered by the NDIS Determination is only satisfied if the item is also covered by one of three other determinations.

Table 1

The supplies covered by Table 1of the NDIS Determination are:

1.             Specialist Disability Accommodation (within the meaning of the National Disability Insurance Scheme rules) and accommodation/tenancy assistance

2.             Assistance in coordinating or managing life stages, transitions and supports, including daily tasks in a group or shared living arrangement

3.             Household tasks

4.             Assistance with and training in travel/transport arrangements, excluding taxi fares

5.             Interpreting and translation

6.             Assistance to access and maintain education and employment

7.             Assistive equipment for recreation

8.             Early intervention supports for early childhood

9.             Management of funding for supports in a participant's plan

In relation to xxxx, the only item listed in Table 1 which may be applicable is item 8, 'Early intervention supports for early childhood'.

The Explanatory Statement to the NDIS Determination provides examples of the types of supplies covered by each item in the NDIS Determination. The examples given for item 8 in Table 1 in the NDIS Determination include 'specialised individual therapy for early childhood'.

The NDIS publication, NDIS Pricing Arrangements and Price Limits 2024/25 (version 1.3, released 1 October 2024), which is available at ndis.gov.au includes a section headed 'Early childhood supports (EC) - younger than 7[3]' in the category of 'Capability Building - Improved Daily Living' (refer to pages 85-87). It states that these early childhood support items can only be delivered by certain types of professionals. The list of early childhood professionals includes xxxx.

This means that supplies of xxxx provided to early childhood aged NDIS participants (i.e., those under nine years of age) are covered by item 8 in Table 1. Where the other three requirements of section 38-38 of the GST Act (listed above) are met, the supply of the xxxx to early childhood aged NDIS participants is GST-free.

Supplies of xxxx provided to NDIS participants other than early childhood aged participants are not covered by Table 1 of the NDIS Determination. However, Table 2 of the NDIS Determination can be considered to determine if the supply is of a kind covered by the NDIS Determination.

Table 2

If Table 1 does not apply, a supply is only covered by the NDIS Determination if it is both:

•                     covered by Table 2, and

•                     covered by any one of three other determinations:

-                    Schedule 1 to the GST-free Supply (Care) Determination 2017 (Care Determination),

-                    Section 6 of the A New Tax System (Goods and Services Tax) (GST-free Supply - Residential Care - Government Funded Supplier) Determination 2015 (Residential Care (Government Funded) Determination), or

-                    Sections 6 or 7 of the GST-free Supply (Health Services) Determination 2017 (Health Services Determination).

Table 2 lists the following supports:

1.            Assistance with daily personal activities,

2.            Specialised assessment and development of daily living and life skills, including community participation

3.            Assistive equipment for general tasks and leisure, including assistive technology specialist assessment, set up and training,

4.            Behavioural support and therapeutic supports,

5.            Home modifications.

The items in Table 2 that xxxx may qualify under are items 2 and 4 provided it is also covered in one of the three other determinations specified above.

The following is a summary of items from the three other determinations that are relevant to items 2 and 4 of Table 2:

Table 1: Summary of relevant items

Xxxx does not fall within the items covered by the Care Determination summarised in the right hand column above for either item 2 or 4 of Table 2. However, xxxx is covered by items in the Residential Care (Government Funded) Determination, summarised in the right hand column above, provided that the xxxx is provided to NDIS participants in a residential facility.

The requirement for the xxxx services to be supplied to participants in a residential facility arises from the requirements of the Residential Care (Government Funded) Determination itself which specifies that, to be covered, the services must be supplied to residents in a residential facility.[4]

Therefore, xxxx services supplied to NDIS participants in a residential facility are GST-free provided the other three requirements in paragraphs 38-38 (a) to (c) of the GST Act are also met. However, the xxxx services that you supply to NDIS participants in their own private homes are not covered under Item 4 of Table 2 in the NDIS Determination.

Your supplies of xxxx services to NDIS participants in their own homes will only be GST-free where:

•                     a Medicare benefit is payable for the service; or

•                     the supply is to early childhood aged NDIS participant.

•                     you receive home care subsidy for the supply to a HCP recipient for the supply.

[1] See subsection 6(1) of the NDIS Determination.

[2] See subsection 6(2) of the NDIS Determination.

[3] Early childhood support has now changed from 7 to 9 - NDIS Children younger than 9 (May) https://improvements.ndis.gov.au/how-we-can-help/disability-supports/children-younger-9 accessed 29 May 2025.

[4] See subsections 6(1), (2) and (3) of the Residential Care (Government Funded) Determination.

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