CGHS Package Rates for 15 Investigations under CGHS 2020

CGHS Package Rates for 15 Investigations under CGHS 2020

CGHS

S-1101110912019/ Addg.HQ/ CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 14th January,2020

OFFICE MEMORANDUM

Subject: Notification of CGHS Rates for 15 Investigations under CGHS

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office memorandum No S.11045/ 36/2012-CGHS (HEC) dated 01.10.2014 vide which CGHS package rates for various treatment procedures and investigations were notified by the Government for Health Care Organizations (HCOs) empanelled under CGHS and to state that representations from various stake holders regarding non-availability of CGHS rates for some of the investigations have been received in this Ministry. The matter was reviewed and it is now decided to notify CGHS package rates for the following investigations and their inclusion in CGHS rate list as under:

S. No.	Name of Unlisted Investigations/ Unlisted Implant	Recommended Rates (in Rupees)
1.	Kappa Lambda Light Chains, Free, Serum	3500/-
2	Serum IGE level	300/-
3	NT-Pro BNP	1800/-
4	CECT Chest	2500/-including CD
5	MRI-Prostate (Multi-parametric)	6000/-including CD
6	HCV RNA Quantitative	1500/-
7	Tarcolimus	2300/-
8	Protein Creatinine Ratio, Urine	120/-
9	Fibroscan Liver	1000/-
10	HLA B27 (PCR)	500/-
11	Montoux Test	175/-
12	Procalcitonin	1800/-
13	TORCH Test	1120/
14	Lntracoronary OCT (AIIMS Rates)	65000/-+GST
15	FFR Wire cost (AIIMS Rates)	Wire as per AIIMS rates of Rs. 23500 + GST And procedure charges as per existing CGHS rates of Rs. 15000 for NABH and Rs. 12750 for Non NABH hospitals

The rates for investigations from S.No.1 to S.No.13 are for Non-NABL/ Non-NABH accredited HCOs. The rates for NABL/ NABH accredited HCOs shall be 15% more. The rates from S.No.14 &15 shall be common for both NABH-accredited /Non-NABH accredited HCOs.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

These rates shall come in to force from the date of issue of the letter.

This issues with concurrence of Integrated Finance Division of Ministry of Health & Family Welfare vide CD No 3495 dated:13.01.2020.

Sd/-(Dr. Manoj Jain)
Addl. DDG (HQ), CGHS

Read this: CGHS - Medical benefits to dependent parents of Central Government Employees

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Action to strengthen ECHS

Action to strengthen ECHS

Ministry of Defence

Measures to Improve ECHS

18 NOV 2019

An additional allotment of Rs.3,500/- crores have been sought to overcome the problem.

Following steps have been taken to check and curb the misuse of funds in ECHS and inflated bill being raised by empanelled hospitals:

Also check: VERIFICATION OF ONLINE APPLICATION FOR ECHS CARDS BY RECORD OFFICE

•     Strict monitoring of bills is done and they are restricted to CGHS rates. Disciplinary action is taken against defaulting hospitals which includes suspension of referrals/financial penalties/disempanelment.
•     A detailed SOP for taking action against empanelled hospitals has been issued on 10.10.2019 by Department of Ex Servicemen Welfare, Ministry of Defence.

This information was given by Raksha Rajya Mantri Shri Shripad Naik in a written reply to ShriRajeev Chandrasekharin Rajya Sabha today.

PIB

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ECHS: PRIOR SANCTION FOR TREATMENT IN NON EMP HOSPITAL

ECHS: PRIOR SANCTION FOR TREATMENT IN NON EMP HOSPITAL

Tele: 25682870
Mil: 36833

Central Organisation, ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry of Defence (Army)
Maude Lines
Delhi Cantt-110010

B/49770/AG/ECHS

05 Oct 18

All Regional Centres

PRIOR SANCTION FOR TREATMENT IN NON EMP HOSP

1 Ref Para 18(a) of SOP on treatment Management in ECHS.

2. All prior sanctions for treatment in Non Empanelled Hospitals will be accorded by Dir RC except in the following cases:-

(a) Major cardiac surgery/ interventional cardiology.
(b) Oncology
(c) Organ transplant cases.
(d) Joint Replacement cases.
(e) Major Neurosurgical / Neurology cases.
(f) Bariatric surgery cases.
3. Format of prior sanction by Dir RC ECHS will be same as is being followed by CO ECHS.

4 Bills will be reimbursed at CGHS Rates only. No representation will be accepted for full reimbursement in such cases.

5. No TA is admissible in such cases.

6. Cases already received and dispatched by 10 Oct 18 will be processed by Central Org ECHS Org ECHS.

sd/-
(Ravi Pal Kapoor)
Lt Col
Jt Dir (Med)
for MD ECHS

Source: https://echs.gov.in

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CGHS Rates for Dental Treatment Procedure: Corrigendum dated 21-7-2015

CGHS Rates for Dental Treatment Procedure: Corrigendum dated 21-7-2015

F. No. S-11011/34/2015-CGHS (HEC)

Ministry of Health 85 Family Welfare

Directorate General of Health Scheme

(Hospital Empanelment Cell)

Nirman Bhawan, New Delhi.

Dated .21st July, 2015

CORRIGENDUM

Subject: - Change in approved treatment procedure mentioned at Sr. No. 216 in CGHS approved rate list.

With reference to the above mentioned subject the undersigned is directed to draw attention to OM No. 8-1 1045/36/2012-CGHS (HEC) dated 01.10.2014 whereby CGHS treatment procedures were notified along with their rates for Delhi/ NCR, by Government for empanelled hospitals under CGHS.

In this regard it has been decided with approval of competent authority to revise the treatment procedure mentioned at Sr. No. 216 as follows:-

Sr. No. of CGHS List	Presently mentioned as	To be read as
216	Removable partial denture-Acrylic based-more than 3 teeth	Removable partial denture- Acrylic based-more than 3 teeth /per tooth

Rate of Rs.264/- for Non-NABH and Rs.304/- for NABH HCOs at Sr. No. 216 would remain the same.

D. C. J oshi

Director (CGHS)

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File1107.pdf

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Revision of rates for various treatment procedures under ECHS

Revision of rates for various treatment procedures under ECHS

Central Organisation, ECHS
Adjutant General’s Branch
integrated Headquarters
Ministry of Qefence (Army)
Maude Line’s
Delhi Cantt-110010

B/49773/AG/ECHS/Rates/Policy

10 Feb 2015

REVISION OF RATES FOR VARIOUS TREATMENT

PROCEDURES UNDER ECHS

1. Ref this office letter No B/49773/AG/ECHS/Rates/Policy dt 07 Oct 2014 and B/49773/AG/ECHS/Rates/Policy dt 19 Nov 2014

2. CGHS has revised the rates for various treatment procedures vide their OM No S-11011/48/2014-CGHS (HEC) dt 18 Feb 2015. The rates of under mentioned treatment procedures alongwith their CGHS code are as under:-

Sr. No.	CGHS Code	Treatment Procedure	Current Rate		Revised Rates
			Non-NABH	NABH	Non-NABH	NABH
Gynae & Obst
1	648	RVF Repair	140000	16100	18975	21821
2	1590	USG for Obstetrics –Anomalies scan	323	380	770	887
Nephrology & Urology
1	793	Epididymectomy	8000	9200	15938	18750
2	888	Lithotripsy Extra corporeal shock wave	19000	21850	19550	22483
3	746	Ureteric Catheterization	690	794	8278	10950
4	807	Kidney transplant (Related)	3500	4025	200000	230000
5	808	Kidney transplant (Unrelated including immunosuppressant therapy)	143000	164450	300000	345000
General Surgery
1	372	Secondary suture of wounds	290	334	3400	4000
2	390	Haemorrhoidectomy	2500	2875	20720	24375
3	391	Stappler Haemorrhoidectomy	4025	4629	38000	43700
4	393	Varicose vein surgery; Trendelenburg operation with suturing or ligation.	8625	9919	10000	11500
5	18	Catheterization	83	95	425	500
6	477	Fissure in Ano-Fissurectomy	5750	6613	13800	15870
7	506	Laparoscopic Paraumblical Hernia Repair	12580	14800	17500	20125
Ophthalmology
1	32	Pterygium Surgery	86	99	5500	6325
2	34	Conjunctival wound repair or exploration following blunt trauma	115	132	3300	3795
Imaging Investigations
1	150	CT-orbit and brain	173	199	1600	1840
2	991	Foramen magnum decompression for Chari Malformation	1100	1265	93750	107813
Cardiology
1	534	DVR	53000	60950	155422	178735

2. Reimbursement to beneficiaries/ empanelled hospitals shall be limited to ceiling rate or as per actuals, whichever is lower. The other terms and conditions as regards to CGHS package rates remain unchanged.

3. The revised rates shall come into force for ECHS from the date of issue and shall be in force till further orders and are applicable in all cities.

(Vijay Anand)
Col
Dir (Med)
for MD ECHS

Source: http://echs.gov.in/images/pdf/med/med128.pdf

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CGHS Delhi and NCR: Revision of rates for various treatment procedures

Revision of rates for various treatment procedures under CGHS.

F. No.S-11011/48/2014 – CGHS (HEC)

Ministry of Health & Family Welfare

Directorate General Central Govt. Health Scheme

(Hospital Empanelment Cell)

Nirman Bhavan, New Delhi,

Dated the February 18, 2015

 

OFFICE MEMORANDUM

Subject:- Revision of rates for various treatment procedures under CGHS.

With reference to the above mentioned subject the undersigned is directed to draw attention to O.M. No. S.11045/36/2012-CGHS (HEC) dated 1.10.2014 whereby CGHS package rates for various treatment procedures were notified by the Government empanelled hospitals under CGHS Delhi and NCR. This Directorate has been receiving representations from different stake holders regarding discrepancies in these notified rates. The matter was examined in this Directorate and now it has been decided with the approval of competent authority to revise the rates of following treatment procedures under CGHS.

 

Sr. No.	TREATMENT PROCEDURE	Revised Rates Non-NABH	Revised Rates NABH
Gynae & Obst
1	RVF Repair	18975	21821
2	USG for Obstetrics –Anomalies scan	770	887
Nephrology & Urology
1	Epididymectomy	15938	18750
2	Lithotripsy Extra corporeal shock wave	19550	22483
3	Ureteric Catheterization	8278	10950
4	Kidney transplant (Related)	200000	230000
5	Kidney transplant (Unrelated including immunosuppressant therapy)	300000	345000
General Surgery
1	Secondary suture of wounds	3400	4000
2	Haemorrhoidectomy	20720	24375
3	Stappler Haemorrhoidectomy	38000	43700
4	Varicose vein surgery; Trendelenburg operation with suturing or ligation.	10000	11500
5	Catheterization	425	500
6	Fissure in Ano-Fissurectomy	13800	15870
7	Laparoscopic Paraumbilical Hernia Repair	17500	20125
Ophthalmology
1	Pterygium Surgery	5500	6325
2	Conjunctival wound repair or exploration following blunt trauma	3300	3795
Imaging Investigations
1	CT-orbit and brain	1600	1840
2	Foramen magnum decompression for Chari Malformation	93750	107813
Cardiology
1	DVR	155422	178735

Reimbursement to beneficiaries/empanelled hospitals shall be limited to ceiling rate or as per actual, whichever is lower. The other terms and conditions as regards to CGHS package rates remain unchanged.

 

2. The revised rates shall come into force from the date of issue and shall be in force till further orders and are applicable in all CGHS cities.

 

3. This issues with concurrence of Integrated Finance Division of Ministry of Health and Family Welfare vide diary no.C-2289 dated 13/02/2015.

(Dr. (Mrs. Sharda Verma)

Director CGHS

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File924.pdf

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Medical Treatment Rates by CGHS empanelled hospitals queried in Lok Sabha

Medical Treatment Rates by CGHS empanelled hospitals queried in Lok Sabha

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA
UNSTARRED QUESTION NO 2402
ANSWERED ON 25.07.2014

ARBITRARY RATES FOR MEDICAL TREATMENT

2402 . Dr. VIRENDRA KUMAR

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:-

(a) whether certain Government hospitals/private CGHS empanelled hospitals across the country including the Institute of Liver and Biliary Sciences in Delhi are reportedly charging arbitrary ratesfor
treatment/diagnostic tests from Central Government Employees instead of rates approved by CGHS;
(b) if so, the details thereof and thereasons therefor including action taken against the offenders;

(c) whether the Government has issuedany direction to these hospitals to charge the rates for treatment of diagnostic testsas per CGHS approved rates from CGHS beneficiaries and if so, the details thereof;

(d) the mechanism put in place tomonitor the effective implementation of the directions of the Government in the matter;and

(e) the corrective measures taken/proposed to be taken by the Government in this regard including reimbursement offull expenses incurred on medical treatmentof the CGHS beneficiaries?

ANSWER

THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. HARSH VARDHAN)
(a) & (b): There are certain complaints of overcharging by the CGHS empanelled private hospitals. However it does not include the Institute of Liver and Biliary Sciences in Delhi, which is an autonomous body under State Government of Delhi.

The Complaints received against some Private CGHS empanelled hospitals are as under:

Delhi

1.Kukreja Hospital
2. Indraprastha Apollo Hospital
3. JeewanHopsital& Nursing Home
4. Dr B.L.Kapoor Hospital
5. Yashoda super speciality Hospital
6. Fortis Flt Lt. RajanDhall Hospital
7. Medanta the Mediciti
8. National Heart Institute
9.Saral Advanced Diagnostics Pvt. Ltd.
10.NoidaMedicare centre
11. Max Super speciality Hospital
12. Escort’s Hospital Faridabad
13.Kailash Hospital & Heart Institute
14. Mata Chanan Devi Hospital
15. Dr Lal Path Lab

Excess amount charged has been deducted and paid to the beneficiaries.

Bengaluru:

1. Fortis Hospital , Cunningham Road
2. Fortis Hospital Bennerghatta Road
3. Shankar Eye Hospital
4. Imperial Hospital

Warning letters were issued by Addl. Director, CGHS and the excess amount charged was recovered and paid to the beneficiaries.

Patna

Show Cause Notice was issued to Ruban Memorial Hospital

Jabalpur

1. Jabalpur Hospital & Res.Centre
2. Marble city Hospital & Res. Centre

Warning letters were issued by Addl. Director, CGHS and the excess amount charged was returned to the beneficiaries.

(c): The CGHS empanelled hospitals and diagnostic centres are to charge only the approved package rates and this clause is part of Memorandum of Agreement (MOA) signed between CGHS and CGHS empanelled hospitals and diagnostic centres at the time of empanelment.

(d)& (e): Monitoring is done by the officers of CGHS, including Addl. Director of the concerned city, Joint Director(Grievances), Hospital Cell and Hospital Empanelment Cell.

As and when any instance of excess charging comes to the knowledge of CGHS, the matter is taken up with the concerned hospital / diagnostic centre and Show Cause Notice is issued seeking explanation. In case of unsatisfactory reply or no reply suitable action is taken as per terms and conditions of Memorandum of Agreement signed by the hospitals like forfeiture of performance bank guarantee , recovery of excess amount and in extreme cases removal from CGHS panel.

Source: Lok Sabha

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Clarification of CGHS rates on 2014 which have been placed on CGHS website for information and acceptance only

Clarification of CGHS rates on 2014 which have been placed on CGHS website for information and acceptance only

F. No. S. 11011/20/2014-CGHS (HEC)
Directorate General of Central Govt. Health Scheme
Ministry of Health & Family Welfare

Nirman Bhavan, New Delhi
Dated, 16th July, 2014

CLARIFICATION

It has been brought to the notice of the undersigned that some of the CGHS empanelled Health Care Organizations have started charging new CGHS rates 2014 which have been placed on CGHS website for information and acceptance only. Since these rates have not yet been notified by Ministry of Health and Family Welfare, the empanelled HCOs cannot charge these new rates and CGHS 2010 rates would prevail. Charging these new rates 2014 from CGHS beneficiaries by empanelled health care organizations would amount to overcharging and suitable action including recovery of overcharged amount and forfeiture of performance bank guarantee would be initiated against those HCOs by CGHS.

Dr. (Mrs.) Sharda Verma
Director (CGHS)

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File712.pdf

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Fresh empanelment of private hospitals and diagnostic centres and revision of package rates applicable under CGHS BANGALORE AND HYDERABAD

Fresh empanelment of private hospitals and diagnostic centres and revision of package rates applicable under CGHS BANGALORE AND HYDERABAD

No: S.11011/23/2009-CGHS D.II/Hospital Cell / Part IX
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 Dated the 17th January, 2012.

OFFICE MEMORANDUM

Subject: Fresh empanelment of private hospitals and diagnostic centres and revision of package rates applicable under CGHS BANGALORE AND HYDERABAD.

The undersigned is directed to invite reference to this Ministry’s Office Memoranda of even number dated the 8th December 2010 and the 19th January 2011 vide which continuous empanelment scheme has been initiated under CGHS, BANGALORE AND HYDERABAD for treating CGHS beneficiaries. The CGHS rates applicable have already been notified and are available on CGHS website. Three rates were notified, one for super-speciality hospitals, the second for hospitals that were accredited with the NABH and the third for hospitals not accredited with the NABH.

2. The undersigned is directed to enclose further list of hospitals and diagnostic centres under the categories mentioned in the application for continuous empanelment and tender document that have conveyed their acceptance of the CGHS rates notified under different CGHS Cities and have signed the Memorandum of Agreement with CGHS and have also furnished the appropriate performance bank guarantee. These hospitals and diagnostic centres are now taken as included in the list of approved hospitals for empanelment under CGHS, BANGALORE AND HYDERABAD.

3. It has now been decided that in the list of hospitals and diagnostic centres enclosed, and have now been approved under the fresh empanelment procedure and have now signed the fresh Memorandum of Agreement and submitted the appropriate performance guarantee will be eligible to treat CGHS beneficiaries and charge at the revised rates with effect from the date of issue of this Office Memorandum. The empanelment shall be for a period of one year or till next empanelment, whichever is earlier.

4 Reference is invited to the list of hospitals in the annexure II of OM No: S.11011/23/2009-CGHS D.ll/Hospital Cell / Part IX dated 1st November 2011 and to state that the hospitals which did not sign MOA and which are not notified as CGHS empanelled hospitals in Hyderabad and Pune stand removed from the list of approved hospitals empanelled under CGHS in Hyderabad and Pune without any further notice.

5. This Office Memorandum and the rates applicable under CGHS for hospitals and diagnostic centres can be downloaded from the website of CGHS, http://msotransparent.nic.in/cghsnew/index.asp

sd/-
[Jai Prakash]
Under Secretary to Government of India

Source: http://msotransparent.nic.in/cghsnew/index.asp
[http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File444.pdf]

LIST OF HOSPITALS/DIAGNOSTIC CENTRES EMPANELLED CATEGORY WISE:
BANGALORE

S.No.	Name of the Hospital/Diagnostic Centre	Empanelled for	Whether NABH/NABL accredited	Whether already empanelled and services empanelled for

EYE CARE CENTRE
1.	Sankara Eye Hospital, Varthur Road, Kundalahalli Gate, Bangalore-560037	Eye Care Centre	No	No

2. LIST OF HOSPITAL/IDIAGNOSTIC CENTRES EMPANELLED CATEGORY WISE:
HYDERABAD
 

S.No.	Name of the Hospital/Diagnostic Centre	Empanelled for	Whether NABH/NABL accredited	Whether already empanelled and services empanelled for

GENERAL PURPOSE
1.	Global Hospital (A Unit of Ravindranath GE Medical Associates Pvt. Ltd.), 6-1-1070, Lakadi Ka pool, Hyderabad. Tel. No. 040-23244444	General Purpose Including Cardiology, Cardiovascular & Cardiothoracic and Joint Replacement	No	Yes for General and Specialised purpose (Cardiology and Cardio-thoracic Surgery, Renal Transplantation, Haemodialysis, Laparoscopic Surgery, Liver Transplantation, Joint Replacement) and Diagnostic Services (Laboratory CT, USG/Colour Doppler and X-Ray).

SPECIALITY (SELECTIVE)
1.	Pragna Childrens Hospitals, # 6-3-347/22/B/1, Dwarkapuri Near Sai Baba Temple, Punjaguta, Hyderabad - 500082. Tel. No. 040-66827999	Paediatrics and Paediatrics Surgery	No	Yes for Paediatrics and Paediatrics Surgery.

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