Indian telemedicine companies, hospitals offering second-opinion services, and individual specialist doctors serving NRI patients or international medical tourism clients increasingly receive cross-border payments. This guide covers the payment infrastructure for systematic international patient payment collection.
International Patient Payment Profile
NRI patients in US/UK/UAE/Canada/Australia:
Seeking Indian specialist consultations, second opinions, chronic disease management, psychiatric care, and follow-up care after treatment in India. Consultation fees: $50-$300 per session. Subscription care plans: $100-$500/month.
Medical tourism (pre-treatment and post-treatment):
International patients planning India-based surgery or treatment need pre-surgical consultation, diagnostic reviews, treatment planning, and post-treatment follow-up. Fees: $100-$1,000 per consultation episode depending on specialty.
Corporate wellness:
International companies hiring Indian wellness consultants for employee wellness programs. Monthly or annual contracts: $1,000-$10,000/month.
Cross-Border Payment Infrastructure for Indian Healthcare
Individual Consultation Booking (Card)
Playto Pay** payment link:**
- NRI patient pays by Visa/Mastercard/Amex at time of booking
- 4% flat, zero forex markup
- FIRA auto per consultation payment
- Daily INR direct to hospital/clinic account
- Card payment link can be embedded in telemedicine platform appointment booking flow
Subscription Care Plans (Recurring)
Playto Pay auto-billing:
- Patient enters card once at plan enrollment
- Charged automatically monthly (6-month or 12-month care plan)
- 4% flat per monthly charge
- FIRA auto per charge
- Reduces collection friction for recurring care plans
Large Medical Packages (Wire)
Playto Pay VBA or Skydo for packages above $1,000:
- Surgical package deposit: USD wire to VBA at 1% flat
- Pre-paid annual wellness package: wire or card
- FIRA auto
Patient Confidentiality in Cross-Border Payments
Payment reference: Use patient ID or booking reference (not patient name or medical condition) in payment references.
Example FIRA reference: Consultation Booking REF-2026-0042 rather than [Patient Name] Cardiac Second Opinion.
FIRA purpose code: P1002 (Health Services) or P0701 (Professional Services) depending on nature. Consult CA for correct classification.
GDPR and international data protection: Telemedicine companies serving EU/UK patients should ensure payment infrastructure compliance with relevant data protection regulations on the patient data side. Payment gateways (Playto Pay) handle payment data separately from medical records.
Regulatory Considerations
Telemedicine Guidelines 2020 (India): The MoHFW telemedicine guidelines govern Indian doctors providing teleconsultation. Cross-border telemedicine to NRI/international patients falls within these guidelines for Indian-registered practitioners.
FEMA compliance: International payment receipt for telemedicine services = export of services. Standard FEMA/PA-CB framework applies. FIRA per consultation for compliance.
GST on international healthcare services: Medical services are generally GST-exempt in India. For international patients: export of services in any case (zero-rated). Consult CA on whether healthcare services specifically maintain their exempt status even as international export.
FAQ
What is the best way for Indian telemedicine companies to accept international patient payments? Playto Pay: 4% flat card for individual consultations, auto-billing for care plans, VBA at 1% for large medical packages. FIRA auto per payment. Daily INR direct.
Can NRI patients in the US pay Indian doctors by credit card? Yes. Via Playto Pay payment link: NRI patient pays by US Visa/Mastercard. Indian doctor receives INR at 4% flat processing fee, zero forex markup.
Is GST applicable on telemedicine consultations to international patients? Medical services have GST exemption in India. As export of services, international patient consultations are zero-rated regardless. Consult CA for your specific service category.