GST answers
GST on allied health assistant services
An allied health assistant's time can be GST free, but only inside a recognised professional's own listed health service. The ATO sets four conditions: billed in the professional's name with full responsibility for the service, part of the service they provide, the professional involved in part of it, and direct supervision. Assistant work sold on its own sits outside those conditions and is taxable unless another provision applies.
Key facts
- When an assistant's time is GST free
- Where it is part of a listed health service the recognised professional provides, and all four of the ATO's conditions hold1
- Who the invoice names
- The recognised health professional, who accepts full responsibility for the health service1
- What direct supervision takes
- Attending to the patient at the start of each treatment, staying readily available for the whole time the assistant works with the patient, being available to act in an emergency, planning all the treatment the assistant provides, and being able to show evidence of monitoring1
- An assistant working on their own
- Not a listed health service performed by a recognised professional, so it is taxable unless another provision reaches it1
- The host service still has to be listed
- Physiotherapy, occupational therapy, psychology, speech pathology, dietary, podiatry and social work are on the ATO's list; exercise physiology and massage therapy on its own are not1
- What the canonical templates hold
- No row for assistant time, so an assistant line resolves through the funding source row for the session it belongs to4
- Where an unclassified line lands
- The practice default row, account 400 clinical services for private patients, at the GST Free Income tax rate in Xero4
- NDIS therapy assistant supports
- Left open here: the ATO's NDIS requirements are stated on this page and the treatment is in the open questions below3
When an assistant's time is GST free
Assistant time has no GST treatment of its own. It takes the treatment of the service it is part of, and only where it is genuinely part of that service. A health service that is not a medical service is GST free where it is a listed health service, performed by a recognised health professional in that listed service or in certain circumstances their assistant, and generally accepted in that profession as necessary for the appropriate treatment of the recipient. The assistant sits inside the second limb of that test rather than beside it.
If part of the health service is performed by an assistant to the recognised health professional, it is included as part of the recognised health professional's service if all the following apply:1
- It is billed in the name of the recognised health professional, and they accept full responsibility for the health service.
- It is part of the health service that the recognised health professional provides.
- The recognised health professional has been involved in at least part of that health service.
- The recognised health professional supervises the assistant directly, in the five specific ways set out below.
All four have to hold. The two in the middle are the ones a program handed wholesale to an assistant fails: if the professional designed nothing and saw nobody, there is no service of theirs for the assistant's hour to be part of, whatever the invoice says.
What direct supervision takes
The fourth condition is not a general standard of oversight. The ATO spells out five things the recognised professional does, and a practice relying on the GST free treatment for assistant time is relying on all of them.
- Attending to the patient at the start of each treatment.
- Being readily available for the whole time the assistant works with the patient.
- Being available to take appropriate action if there is an emergency.
- Planning all the treatment the assistant provides.
- Being able to provide evidence that they monitor the assistant's services.
The last one is the one that shows up in a review, because it asks for evidence beyond what the invoice already shows. A practice that meets the first four in practice and holds nothing in writing has the harder conversation.
The host service has to be a listed one
The assistant conditions only reach a service that was GST free to begin with. The ATO's list is closed: physiotherapy, occupational therapy, psychology, speech pathology and speech therapy, social work, dietary, podiatry, chiropractic, osteopathy, nursing, optometry, audiology or audiometry, acupuncture, naturopathy, herbal medicine, dental, pharmacy, paramedical, chiropody and Aboriginal or Torres Strait Islander health services. The ATO adds that a service has to be one of those and cannot just be similar to one of them.
So an assistant supporting an exercise physiology program has no GST free host service to be part of, and neither does an assistant delivering massage therapy on its own. In a multi disciplinary practice the same job title can sit on both sides of the line depending on which clinician's caseload the hour belongs to.
Billed in the professional's name
The first condition is about the invoice, not the calendar. An appointment can be booked to the assistant, delivered by the assistant and reported by the assistant, and still be billed in the recognised professional's name with that professional carrying responsibility for it. What the condition rules out is an invoice that presents the assistant as the supplier.
| The arrangement | The conditions | What the line is under this test |
|---|---|---|
| A physiotherapist assesses the patient, plans the program, greets them at the start of each session, stays contactable while an assistant runs it and records the monitoring | Met, on the ATO's four conditions | Part of the physiotherapist's GST free service, billed in their name |
| The same program, run while the professional is offsite and unreachable | Direct supervision is not met | Not part of the professional's service, so a taxable supply |
| An assistant runs a mobility class of their own design and the practice bills it in the assistant's name | The first three conditions are not met | A taxable supply |
| An assistant supports a clinician whose discipline is not on the ATO's list | No listed host service to be part of | A taxable supply |
What the canonical templates post
None of the three canonical templates carries a row for assistant time. There is no assistant funding source and no assistant service category, because assistant time is not a payer and it is not a product: it is part of a session that a funder is already paying for. So a line for assistant delivered work resolves through the funding source row for that session, and the treatment follows the session rather than the person who delivered it.
Which leaves the case this page is really about. A taxable assistant program that nobody mapped does not announce itself. It falls through to the practice default row, the safety net every template holds, and that row is GST free. The template's own reason for the row says what to do with a line that reaches it: send it to the questions queue for review rather than post it silently.
A practice that sells an assistant delivered program as a taxable supply needs somewhere for it to land that is not the safety net: its own service category, its own revenue account, and the taxable rate on the row, approved by the practice with its BAS agent before anything syncs. That is a mapping decision about one practice's arrangement, which is why the canonical templates leave it out rather than guessing at it.
The NDIS therapy assistant question
For an NDIS participant there is a second GST free path, and it does not run through the listed service test. A supply to a participant is GST free where four things hold: the participant has an NDIS plan in effect, the supply is of reasonable and necessary supports specified in the statement of supports in that plan, there is a written agreement between the provider and the participant or another person, and the supply is covered by one of the tables in the disability services determination made in 2021.
The determination has two tables. An item in Table 1 satisfies the requirement on its own. An item that falls under Table 2 satisfies it only where the supply is also covered by one of three other determinations, which is a narrower reading than it first looks: the ATO's own worked example on that point is exercise physiology delivered in a clinic, which does not get there. Therapy assistant supports sit in the same territory.
The NDIS supports that are not listed health services page covers what the templates do with the non listed side of an NDIS plan, and NDIS listed supports covers the side that gets there through s38-10 anyway.
What each direction costs
Getting this wrong is quiet in both directions, and it compounds monthly. A taxable assistant program coded GST free understates GST on sales at 1A. The practice either did not charge the GST it owed, in which case whether it can go back to the payer depends on what was agreed, or it charged it and did not report it. Either way the shortfall stays owing until the practice corrects it.
The other direction costs money the practice already earned. Assistant time that does meet the conditions, coded taxable, remits one eleventh of revenue nobody charged GST on, and getting it back takes a revised activity statement. Both errors have the same shape as one of the most common errors a bookkeeper finds in allied health files.
Coding everything GST-free because 'health is GST-free' is one of the most common errors we find in practice files.5
Keeping the two kinds of assistant time apart
The practical problem is that both kinds of assistant hour look identical in a practice management system: same staff member, same appointment type, same fee. What separates them is the clinical arrangement around them, which lives outside the booking.
- Decide which assistant delivered work sits inside a recognised professional's service and which is sold on its own, per program rather than per staff member.
- Give the work that is sold on its own a service category of its own, so it stops sharing a row with clinical sessions.
- Keep the invoice for the qualifying work in the recognised professional's name, with that professional carrying responsibility for the service.
- Hold something in writing for the supervision condition: who planned the treatment, who attended the start of each session, and how the professional monitors the assistant's work.
- Have the practice's BAS agent read the arrangement once, and record what they concluded against the row it affects.
What Ledger Map does with it
Ledger Map holds one standing map for the practice, approved before anything syncs. An assistant delivered line resolves through that map to the account and the tax rate the practice's own template carries for the session, the funder's payment is posted as one balanced document set per deposit, and one exact match is left in the bank feed. A line the map cannot resolve becomes a question with the options laid out, which is the treatment the practice default row asks for.
Nothing on this page is a treatment Ledger Map chose. The account and the rate come from the canonical template the practice starts from, the conditions come from the ATO, and the practice approves the map before a single invoice syncs. How it works walks through the approval, and the GST answers hub carries the same reading for the other categories a practice bills.
Questions
Is work done by an allied health assistant GST free?
Only where it is part of a recognised health professional's own listed health service. The ATO sets four conditions: billed in the professional's name with them accepting full responsibility, part of the service that professional provides, the professional involved in at least part of it, and direct supervision. An assistant's service sold on its own is taxable unless another provision, such as the NDIS one, reaches it.
Do I need to pay GST as a support worker?
Support work is not one of the ATO's listed health services, so it does not reach the GST free treatment the way physiotherapy or psychology does. For an NDIS participant the GST free path is the NDIS one instead: a plan in effect, reasonable and necessary supports specified in that plan, a written agreement, and a supply covered by the disability services determination. Whether you charge GST at all also depends on whether you are registered, which turns on turnover rather than on the treatment.
Does the supervising professional have to be in the room?
The ATO's test is more specific than presence. The professional attends to the patient at the start of each treatment, stays readily available for the whole time the assistant works with the patient, is available to act in an emergency, plans all the treatment the assistant provides, and can show evidence that they monitor the assistant's services.
Is therapy assistant time GST free under the NDIS?
The research behind this page leaves that open, and this page leaves it open too. An NDIS supply is GST free where the participant has a plan in effect, the supports are specified in it, a written agreement exists, and the supply is covered by the determination, but therapy assistant supports fall in the part of that determination where an item is only covered if another determination also covers it. It is a question for the practice's BAS agent on the facts.
What health services are GST free in Australia?
Medical services, and the closed list of other health services the GST Act names: physiotherapy, occupational therapy, psychology, speech pathology and speech therapy, social work, dietary, podiatry, chiropractic, osteopathy, nursing, optometry, audiology, acupuncture, naturopathy, herbal medicine, dental, pharmacy, paramedical, chiropody and Aboriginal or Torres Strait Islander health services. A service has to be one of those, not merely similar to one, and it also has to be appropriate treatment by a recognised professional.
Sources
Open questions
- Therapy assistant supports under the disability services determination's Table 2 are recorded as a grey area in the project's own research, and the ATO's NDIS page does not settle them. This page states the requirements and the two tables and leaves the treatment to the practice's BAS agent.
- Every ato.gov.au page refuses an automated fetch. The three ATO pages cited here were read on 3 Sep 2026 through a signed in browser and carry their own last updated dates of June 2024. AustLII refused s38-10 with HTTP 403 on the same day, and the Federal Register of Legislation returns the table of contents rather than the section text, so the section is cited through the ATO's summary of it and is listed as unverified, with no key fact resting on it.
- Whether the four conditions hold is a question about one practice's arrangement rather than a treatment this page can settle. The condition that is hardest to evidence is the last one, being able to show that the professional monitors the assistant's services.
- The Transport Accident Commission publishes allied health assistant item codes with a note about GST on its maximum payment rates. That fee schedule refused a fetch on 3 Sep 2026, so no rate or claim from it appears on this page.
- Other health services, GST and health
Australian Taxation Office. Retrieved 3 Sep 2026. Source updated 12 Jun 2024.
primary
- Appropriate treatment, GST and health
Australian Taxation Office. Retrieved 3 Sep 2026. Source updated 12 Jun 2024.
primary
- National Disability Insurance Scheme, GST and health
Australian Taxation Office. Retrieved 3 Sep 2026. Source updated 13 Jun 2024.
primary
- Allied health, psychology and NDIS plan managed canonical templates
Ledger Map. Retrieved 3 Sep 2026.
primary
- Bookkeeping for speech pathology and allied health group practices
True Tally. Retrieved 3 Sep 2026. Source updated Jul 2026.
secondary
- Is my psychology or allied health service GST free?
Allied Health Accounting. Retrieved 3 Sep 2026. Source updated 18 Sep 2024.
secondary
Review
Last reviewed 3 Sep 2026 by Shane
General information for Australian allied health practices, not tax advice. Confirm a treatment with your BAS agent or accountant before you post it.
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