- The law: you can't receive ₹2 lakh or more in cash from one person in a day, against one transaction, or for one event — s.186 of the Income-tax Act, 2025 (old s.269ST).
- The penalty is the whole cash amount, not the part above ₹2 lakh — s.451 (old s.271DA).
- A package or one bill is one transaction, so cash paid in instalments over several days still adds up.
- Separate bills for one admission are a grey zone: a 2026 tribunal ruling (KNS Memorial, ITAT Lucknow) said they are not automatically one event, but the department can still argue it. ⚑ Check with your CA.
- We treat the patient's whole family as one payer for the one-day test, which is the safe way to run a desk. ⚑ Check with your CA.
- A penalty can be dropped if you prove a reasonable cause (s.470), but don't plan around it. ⚑ Check with your CA.
- Government hospitals are exempt. Private, trust and charitable hospitals are not.
- Allowed ways to take the rest: UPI, debit or credit card, net banking, NEFT, RTGS, IMPS, account-payee cheque or draft.
This check applies the Income-tax Act, 2025 as read on 13 Oct 2026. It is a guide for your front desk, not a legal opinion. Grey-zone results need your CA's view before you rely on them.
Rules checked 13 Oct 2026.