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CGHS and CSMA Rules -Revision of Ceiling Rates for Knee and Hip Implants under CGHS and CS(MA) Rules
CGHS and CSMA Rules – EHS Section OM dated 26.09.2017
Government Of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi 11011
Dated the 26th September,2017
Subject: Revision of Ceiling Rates for Knee and Hip Implants under CGHS and CS(MA) Rules
with reference to the above mentioned subject the undersigned is directed to draw attention to this Ministry’s OM No.S.11018/1/95-CGHS (P), dated the 7th March, 1995 vide which ceiling rates for Knee and Hip implants under CGHS and CS(MA) Rules have been prescribed and to state that it has now been decided by competent authority to revise the ceiling rates and guidelines for Knee and Hip implants under CGHS and CS(MA) rules as per the details given under the succeeding paragraphs.
2. (A) PRIMARY KNEE REPLACEMENT SYSTEM
(*Ceiling Price in Rs.)
Applicable to all variants FEMORAL COMPONENT BY WHATSOVER NAME/ SPECIFICATIONS TIBIAL COMPONENT BY WHATOVER NAME/ SPECIFICATIONS ARTICULAR SURFACE/ INSERT BY WHATSOVER NAME/ SPECIFICATIONS
PATELLA COMPONENT BY WHATSOVER NAME/ SPECIFICATIONS 1. Titanium alloy coated 38,740 24,280 9550 4090 2. Oxidized Zirconium (OxZr) alloy 38,740 24,280 3. Hi-flex 25,680 4. Cobalt Chromium (CoCr) alloy and other than at 1,2, and 3 above 24,090 16,960 COMPONENT HAVING TIBIAL TRAY AND INSERT COMBINED AS SINGLE UNIT BY WHATOSOVER NAME SPECIFICATION Polyethylene or cross-linked polyethylene or highly cross linked polyethylene or any other material 12960 Tibial: Metallic Insert: Polyethylene or cross linked polyethylene or highly cross linked polyethylene or any other material 26,546
* plus GST wherever Paid or payable
(B) REVISION KNEE IMPLANT SYSTEM
(*Ceiling Price in Rs.)
FEMORAL COMPONENT BY WHATSOVER NAME/ SPECIFICATIONS TIBIAL COMPONENT BY WHATSOVER NAME/ SPECIFICATIONS ATRICULAR SURFACE/INSERT BY WHATSOVER NAME/ SPECIFICATIONS
PATELLA COMPONENT BY WHATSOVER NAME/ SPECIFICATIONS
* plus GST wherever paid or payable
(C) HIP IMPLANT – Rs.40,000/- + GST, wherever paid or payable
3. The rates prescribed shall be valid till further orders and are applicable to Implants of any name/category/commented/non-cemented.
4. The ceiling rates are applicable for treatment taken in government hospitals/ private empanelled hospitals/ other private hospitals.
5. Institutions such as hospitals utilizing knee implants shall specifically and separately mention the cost of the knee implant component-wise along with its brand name, name of manufacturer/importer/batch no./specifications and other details, if any in their estimate/proforma invoice/final billing,etc.,
6. Prior permission of Competent Authority may be obtained before undergoing knee/hip Implant surgery.
7. This issues with the approval of competent authority and concurrence of Integrated Finance Division vide Dy.No.C.No.3119442, dated 30.08.2017.
(Sunil Kumar Gupta)
Under Secretary to the Government of India