Cghs Rate List
Cghs Rate List
FAX: 040-27900115
GOVERNMENT OF INDIA
The undersigned is directed to say that the issue of fresh recognition of private hospitals
and diagnostic centers for treatment of CGHS beneficiaries under CGHS, Hyderabad and fixation
of package/ceiling rates has been under consideration of the Government for quite some time. It
has now been decided to recognize the hospitals/diagnostic centers for different specialities as per
list attached at Annex.A&B.
2. (a) Package rate is defined as lump sum cost of in-patient treatment or diagnostic
procedure for which a patient has been referred by competent authority or CGHS to Hospital or
Diagnostic Center. This includes all charges pertaining to a particular
treat ment/procedure including admission charges, accommodation charges, ICU/ICCU
charges, monitoring charges, operation charges, anesthesia charges, operation theatre
charges, pro cedural charges/surgeon's fee, cost of disposable, surgical charges and cost of
medicine used during hospitalization, related routine investigations, physiotherapy charges
etc.
(b) The package rate does not include diet, telephone charges, T.V.charges and
cost of cosmetics, toiletry, tonics and medicines advertised in mass media. Cost of
these, if offered on request of patient will be realized from the individual patient and are
not to be included in package charges.
(c) The recognized hospital/diagnostic center will not charge more than the package
rate from the beneficiary.
4. However if the beneficiary has to stay in the hospital for his/her recovery for more
than the period covered in the package rate, the additional reimbursement shall be
limited to room rent as per entitlement, cost of the prescribed medicines and
investigations, doctors visits (not more than 2 times a day) for additional stay.
(b) Package rate offered to CGHS for treatment in Semi-Pvt. Ward is mentioned and
indicated in the rate list at Annex.-C.
(c) It has further been decided that the CGHS beneficiaries taking treatment in the
above mentioned hospitals with the prior permission of the CGHS will be entitled
for reimburse - ment as per the package rates given in the Annex.-C. The rates for
indoor treatment mentioned in attached Annexures are for Semi Private
Category. For Private Ward there will be an increase of 15% and for General
Ward there will be a decrease of 10%.
(d) The implant shall be reimbursed as per actuals except for the items where ceiling
is defined.
7. (a) For investigations and treatment procedures for which admission is not required
rates will be same for all categories.
Day Care (6-8 hours admission) Rs.500/- per day (same for all categories)
8. The beneficiary will have the option of availing specialized treatment/diagnostic tests at
CGHS recognized Hospitals/Diagnostic Centers of his/her choice after the Specialist of
CGHS/ Govt.Hospital/CMO I/c of CGHS Dispensary recommends the procedure/test.
9. For non-emergency cases, beneficiaries of Central Govt. Health Scheme are entitled to
medical reimbursement for treatment in hospitals/diagnostic centers recognized under the
scheme subject to written permission from the competent authority.
10. On production of valid permission, the recognized hospitals/diagnostic centers shall
provide credit facilities to:
Freedom Fighters, or
CGHS Employees
11. In case of an emergency, the recognized private hospital shall not refuse admission or
demand advance from the beneficiary and shall provide credit facilities to the concerned
patient on the production of valid CGHS card. The recognized CGHS
Hospital/Diagnostic Center shall submit the bill for reimbursement subject to the ceiling
of approved rate to the respective Department/Joint Director, CGHS where the payment
is made by CGHS Directorate.
13. The recognized hospitals/ diagnostic centers will provide necessary medicines & all
disposable sundries of standard quality and will not get them purchased through
CGHS beneficiaries.
14. If one or more treatment procedures form part of a major treatment procedure,
package charges would be made against the major procedures and only one half of
approved charges quoted for the other procedures would be added to the package charges
of the first major procedure.
15. Treatment taken in branches of the recognized hospitals will not be admissible for
reimbursement.
16. Any legal liability coming out of such services shall be dealt by the hospital/ diagnostic
center and it shall be responsible alone.
17. This issues with the concurrence of Finance Division Vide JS(FA) Dy. No.
5618/JS(FA)/2002 dated 6.9.2002.
18. All the Hospitals/Diagnostic Centers mentioned in Annx. A & B have signed the
Memo randum of Agreement (MOA) with Director, CGHS about recognition and rates.
19. An abstract of every indoor treatment/test shall be sent by the recognized private
hospitals/diagnostic centers to every Joint/Additional Director of concerned CGHS city
on monthly basis by the 10th of the following month, indicating Name of the patient,
CGHS Card Number, Name of Office/Organization, Name of referring Specialist,
Permission No. and Date, Description of procedure/tests performed and the amount
charged, in the proforma at Annex.'D'
(B.B.BHATTACHARJEE)
DY.SECRETARY TO THE
GOVERNMENT OF INDIA
1
Annexure-I
Rates of Hospital/Diagnostic Center Recognized under CGHS Delhi
1. OUT PATIENT
3.16 EAR
3.16.1 Ear lobule stitching 1350/-
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3.17 NOSE
3.17.1 Septoplasty 8500/-
3.17.2 Submucous Resection 6600/-
3.17.3 Septo-rhinoplasty 15400/-
3.17.4 Rhinoplasty 15100/-
3.17.5 Fracture Reduction 7500/-
3.17.6 Intra Nasal Diathermy 2800/-
3.17.7 Turbinectomy 5480/-
3.17.8 Endoscopic DCR 12000/-
3.17.9 Endoscopic Surgery 12600/-
3.17.10 Septal Perf. Repair 12600/-
3.17.11 Antrum Puncture 1500/-
3.17.12 Lateral Rhinotomy 1100/-
3.17.13 Cranio-facial resection 28000/-
3.17.14 Maxillectomy 21200/-
3.17.15 Ethamoidectomy 14100/-
3.17.16 Caldwell Luc Surgery 9600/-
3.17.17 Angiofibroma Excision 18900/-
3.17.18 Endoscopic Hypophysectomy 25680/-
3.17.19 Endoscopic Optic Nerve 25000/-
3.17.20 Decompression 22000/-
3.18 THROAT
3.18.1 Ranula Excision 10300/-
3.18.2 Cyst Excision 7000/-
3.18.3 Tongue Tie excision 3000/-
3.18.4 Sub Mand Duct Lithotomy 6200/-
3.18.5 Adendidectomy 5864/-
3.18.6 Palatopharyngoplasty 17000/-
3.18.7 Cleft Palate repair 15750/-
3.18.8 Pharyngoplasty 15900/-
3.18.9 Styloidectomy 12000/-
4
4. EYE
4.1 Cauterisation of ulcer/subconjuctival injection
4.1.1 One eye 162/-
4.1.2 Both eyes 242/-
4.2 Retrobular Injection
4.2.1 One Eye 162/-
4.2.2 Both Eyes 242/-
4.2 Syringing of Lacrimal Sac
4.3.1 For oen eye 162/-
4.3.2 For both eyes 242/-
4.4 Paracentesis 808/-
4.5 Foreign body removal 323/-
4.6 Refraction/Fundoscopy 81/-
4.7 Ortho-optic check up 81/-
4.8 Ortho-optic exercises 81/-
4.9 Plepoptic Exercises 81/-
4.10 Perimetry/field test 323/-
4.11 Chalazion operation
4.11.1 One Eye 707/-
4.11.2 Both Eyes 808/-
4.11.3 Dressing 81/-
4.12 Clinical Photography 600/-
4.13 Pterygium 1440/-
4.14 Orbitotomy 21510/-
4.15 Ptosis 12000/-
4.16 Ectropion 4640/-
4.17 Xenon Arc Laser 1850/-
4.18 DCR 9700/-
4.19 ECCE/ICCE 8200/-
4.20 Epicantuhus 4800/-
4.21 DCY 6300/-
4.22 Squint Correction 11500/-
4.23 Keratoplasty 18600/-
4.24 Trabeculectony 8300/-
4.25 Trabeculectomy 9700/-
4.26 Iridectomy 3200/-
4.27 Goniotomy 9700/-
4.28 Scalaral Bukling 16500/-
(Retinal Detachment Surgery)
4.29 Electrooculogram ----
4.30 ERG 700/-
4.31 Flouresein Angioraphy 1300/-
4.32 A-Scan 300/-
4.33 Tono Graphy 500/-
4.34 VER 1000/-
4.35 Goldmen Perimetry 500/-
4.36 Specular microsopy ----
5
6. PHYSIOTHERAPY
6.1 Electro therapy
6.1.1 Ultrasonic therapy 71/-
6.1.2 S.W. Diathermy 71/-
6.1.3 Electrical stimulation (therapeutic) 71/-
6.1.4 Muscle testing and diagnostic 71/-
6.1.5 Infra red 71/-
6.1.6 U.V. Therapeutic does 71/-
6.1.7 Electric vibrator 71/-
6.1.8 Vibrator belt massage 71/-
6.2 Electric/Mechanical Traction
6.2.1 Intra Lumbar Traction 71/-
6.2.2 Intermittent Cervical traction 71/-
6.2.3 Combined Lumbar & Cervical 71/-
6.3 Hydrotherapy
6.3.1 Wax bath 71/-
6.3.2 Hot pack 71/-
6.3.3 Whirl pool bath 71/-
6.4 Miscellaneous
6.4.1 Obesity Exercises 71/-
6.4.2 Breathing Exercises & Postural Drainage 71/-
6.4.3 Cerebral Palsy – Massage 71/-
6.4.4 Post – polio exercise 71/-
7. DENTAL
7.1 Extraction of tooth including LA 101/-
7.2 Complicated Ext. per Tooth including LA 202/-
7.3 Flap Operation per Tooth 404/-
7.4 Gingivectomy per tooth 242/-
7.5 Cyst under LA (small) 242/-
7.5.1 Cyst under LA (large) 404/-
7
15. HISTOPATHOLOGY
15.1 Pap Smear 162/-
15.2 Smear for Malignant cells 162/-
15.3 Hostopath 303/-
15.4 Frozen section & Paraffin section 242/-
15.5 Blood gas analysis 283/-
15.6 Blood gas analysis with electrotypes 364/-
15.7 Vaginal Cytology for Hormonal evaluation 323/-
BIOPSIES
21.23 Cervical Lymph Node 1616/-
21.24 Auxillary Lymph Node 2020/-
21.25 Inguinal Lymph Node 2020/-
21.26 Excision/Biopsy of Large Lumph Nodes 2020/-
21.27 Excision Biopsy of Ulcers 3030/-
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23 BREAST
23.1 Drainage of Abscess 6060/-
23.2 Excision of Lumps 9090/-
23.3 Local Mastectomy (Simple) 12275/-
23.4 Radical Mastectomy (Formal or Modified) 30000/-
23.5 Excision of Mammary Fistula 15150/-
23.6 Segment Resection of Breast 16160/-
25. ABDOMEN
25.1 Gastroscopy 1616/-
25.2 Gastric & Duodenal Biopsy (Endoscopic) 2424/-
25.3 Pyleromyotomy 6868/-
25.4 Gastrostomy 10100/-
25.5 Simple Closure of Perforated peptic Ulcer 10100/-
25.6 Vagotomy Pyleroplasty/ Gastro Jejunostomy 21466/-
25.7 Duodenojejunostomy 18988/-
25.8 Partial/Subtotal Gastrectomy for Carcinoma 21816/-
25.9 Partial/Subtotal Gastrectomy for Ulcer 21816/-
25.10 Operation for Bleeding Peptic Ulcer 18988/-
25.10.1 Gastrojejunostomy & Vagotomy 18988/-
25.11 Operation for Gastrojejunal Ulcer 18988/-
25.12 Total Gastrectomy for Cancer 27876/-
25.13 Highly Selective Vagotomy 18988/-
25.14 Selective Vagotomy & Drainage 18988/-
25.15 Congenital Diaphragma tic Hernia 21210/-
25.16 Hiatus Hernia Repair
25.16.1 Abdominal 21210/-
25.16.2 Transthoracic 21210/-
25.17 Exploratory Laparotomy 11110/-
25.18 Epigastric Hernia 10504/-
25.19 Umbilical Hernia 10504/-
25.20 Ventral and Scar Hernia 12928/-
25.21 Inguinal Hernia ----
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SPECIALISED PROCEDURES/INVESTIGATIONS
Rates of Hospital/Diagnostic Centers Recognized under CGHS Delhi.
I am to inform you that 55 private hospitals and diagnostic centers were recognized vide
Ministry OM No.Rec-24/ 2001/ JD(M)/ CGHS/ Delhi/ CGHS(P) dated 7th September, 2001.
The beneficiary can take treatment in the following hospitals and reimbursement will be
restricted to the package rates approved in the Ministry OM No.S11011/16/94/-CGHS
Desk-II/CMO(D)/CGHS(P) dated 18th September, 1996.
All Additional Directors are advised to inform CMO I/c of the dispensaries under their
administrative control to issue permission to the beneficiaries if they desired to avail
treatment in above mentioned private hospitals. CMO I/c may also be instructed to issue
medicines to the beneficiary on their prescription as per rules.
DIRECTOR(CGHS)