Fresh empanelment of private hospitals and revision of Room Rent applicable under CGHS


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


Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 16th November , 2010

O F F I C E M E M O R A N D U M


Subject:     Fresh empanelment of private hospitals and revision of Room Rent applicable under CGHS.

        The undersigned is directed to state that CGHS had initiated action for fresh empanelment of private hospitals under CGHS and also for the revision of package rates (which were fixed in 2006-07), to be paid to hospitals, by floating tender for the same. On the basis of the responses received package rates for various procedures / treatments have been arrived at and have been uploaded in the website of CGHS:www.mohfw.nic.in\cghsnew\index.asp and can be downl oaded.

2.        “Package Rate” shall mean and include lump sum cost of inpatient treatment / day care / diagnostic procedure for which a CGHS beneficiary has been permitted by the competent authority or for treatment under emergency from the time of admission to the time of discharge including (but not limited to) –
(i) Registration charges,
(ii) Admission charges,
(iii) Accommodation charges including patients diet,
(iv) Operation charges,
(v) Injection charges,
(vi) Dressing charges,
(vii) Doctor / consultant visit charges,
(viii) ICU / ICCU charges,
(ix) Monitoring charges,
(x) Transfusion charges,
(xi) Anesthesia charges,
(xii) Operation theatre charges,
(xiii) Procedural charges / surgeon’s fee,
(xiv) Cost of surgical disposables and all sundries used during hospitalization,
(xv) Cost of medicines,
(xvi) Related routine and essential investigations,
(xvii) Physiotherapy charges etc.
(xviii) Nursing care and charges for its services.

(b)         Cost of Implants / stents / grafts is reimbursable in addition to package rates as per CGHS ceiling rates for Implants / stents / grafts or as per actual, in case there is no CGHS prescribed ceiling rates.

(c)         Treatment charges for new born baby are separately reimbursable in addition to delivery chares for mother.

d)         The hospitals empanel led under CGHS shall not charge more than the package rates / rates.

2.2         Package rates envisage upto a maximum duration of indoor treatment as follows:

                12 days for Specialised (Super Specialties) treatment;
                7 days for other Major Surgeries;
                3 days for Lapar oscopic surgeries / normal deliveries; and
                1 day for day car e / Minor (OPD) surgeries.

2.3         However, there are certain procedures where there is no prescribed package rate under CGHS. Similarly, there are medical emergencies where the treatment is mainly conservative. The admissible amount in such cases is calculated item wise, room rent, procedures, investigation , etc., .

        Therefore , it has now been decided to revise the rates applicable for room rent (Accommodation Charges) for different categor ies of wards as given below:
                General ward -Rs.1000/- per day
                Semi-private ward -Rs. 2000/ - per day
                Private ward -Rs.3000/- per day

3.         CGHS beneficiaries are entitled to facilities of private, semi-private or general ward depending on their basic pay / pension. The entitlement is as follows:-

S. No. Basic Pay (without the inclusion of grade pay) Entitlement
1. Upto Rs. 13,950/- General Ward
2. Between Rs.13,951/ - and Rs.19,530/- Semi-Private Ward
3. Rs. 19,540/- and above Private Ward


4.2         This issues with the concurrence of Internal Finance Division in the Ministry of Health & Family Welfare, vide Dy. No: AS & FA / 3932 /2010 dated the 8th November , 2010.

        The revised rates will come into effect from the date of issue of this Office Memorandum.

        A copy of this Office Memorandum along with rate list and a copy of MOA are placed on the internet at http://mohfw.nic.in/cghsnew/index.asp.


[R Ravi ]
Director
[Tel: 2306 3483]


Comments

KV PANICKER said…
Dear Sir,
It is a good news that the rates for various procedures and accommodation for treatment have been revised. However the major anomaly which is to be rectified is the basis of entitlement is on the basic pay. Infact it should have been on the basis of Grade Pay as in the case of LTC/TA/DA etc.
What the surprise is that the subscription is decided on the basis of Grade Pay. Who will bell the cat.
December 15, 2010 at 3:41 PM
Unknown said…
Accommodation entitlement should be on the basis of grade pay instead of basic pay + Grade pay as all other allowances and recoveries are deducted on the basis of grade pay. it is very surprising that the entitlement of accommodation in hospital is decided to be paid on the basis of basic pay + grade pay.
December 23, 2010 at 8:46 PM
Anonymous said…
I do agree with both the above comments. It is surprising that subscription as well as benefits are decided on tbe basis of grade pay but the entitltement for accommodation in a private hospital is decided on the basis of basic pay. May kindly be considered by the authorities early.
October 21, 2011 at 12:27 PM
Anonymous said…
I would like to enquire whether it is true that the scale of SO/PS has been upgraded in the pre-revised scale from 6500-10500 to 7500 onwards from the date the anomaly arose when the scale of Assistants/PAs was upgraded to 6500-9500 in September 2006.
October 21, 2011 at 12:31 PM
Anonymous said…
I am working as Deputy Registrar ,IGNOU. My basic pay was Rs.2450 as on 31-12-95 in Section Officer. Pay was coming lower than Rs.8000/- as on 1.1.96. But my basic pay was not revised from 1.1.96 due to promotion to AR on 31-0-196 as per 5th Pay commission. I was promoted to Post of Assistant Registrar on 31-1-1996 in scale of Rs.8000-275-13500 and pay was Rs.8000/- fixed minimum at that time of my promotion as per FR 22(I)(a)(1). Now, IGNOU has decided to implement Non-functional pay scale of Rs.8000-13500 to Section Officer on completion of 04 years services in Section Officer grade as per FR 22(I)(a)(2) wef 1.1.96 as per Government order. My basic pay is being fixed Rs.8000/-minimum wef 1-1-96 in Non-functional pay scale of Rs.8000-13500 in Section Officer on completion of 04 years services in Section Officer as per FR 22(I)(a)(2). Scale of Section officer and Assistant Registrar are same due to adoption of Non-functional pay scale of Rs.8000-13500. The duties and responsibilities of Assistant Registrar are higher than Section officer. Kindly confirm one increment will be get from 31-01-96 or not & can my pay will be increased to Rs.8275/- from 31-01-96 - My email ID ysbhamblkar@rediffmail.com – Y.S. Bhambulkar,
March 16, 2012 at 11:01 AM
Anonymous said…
ANYONE MAY GIVE ME RIGHT DIRECTION REGARDING NER LTC REIMBERSMENT.

I WAS TAKEN NER LTC UPTO GANGTOK, BUT THERE IS NO STATE TRANSPORT FACILITY AVAILABLE FOR GOING BAGDOGRA TO GANGTOK.
IN THAT CASE THE PRIVATE TAXI FARE (TRAVEL AGENCY APPROVED BY STATE GOVT.) IS ADMISSIBLE FOR GOING GANGTOK & RETURN BACK.
May 28, 2012 at 9:01 PM
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