Billing Guidelines: Admissible & Non-Admissible Items
Last updated: October 13, 2025
Purpose
This section provides clarification on items and charges that are includable or excludable in bills as per CGHS. The HCO must adhere to these when billing CGHS or CGHS beneficiaries.
Consumables and Materials
Common medical consumables (cotton, gauze, gloves, syringes, needles, catheters, IV sets, tubing, dressing materials, etc.)
Non-Admissible Items
The following categories of items shall not be reimbursed by CGHS and the amount may be collected from beneficiary:
Note: In summary, anything that is not directly related to treatment and is primarily for patient convenience or personal preference is non-admissible.
Inadmissible Additional Charges
The HCO shall not separately bill for the following components, as they are considered part of standard charges for related services. Hence these are neither to be billed to CGHS nor amount to be collected from Beneficiaries:
Note: Essentially, any item that is by-nature a part of performing a test or procedure or running a ward facility cannot be carved out to charge extra.
Complete List of Non-Admissible Items
The following table lists commonly non-admissible items and services that cannot be billed to CGHS:
Note: The aforementioned categories are illustrative in nature and shall be deemed to include all other analogous items.
Items Already Included in Packages
The following items are deemed to be integral components of the package rates and shall, under no circumstances, be billed separately to CGHS or recovered from the beneficiaries:
Note: The aforementioned categories are illustrative in nature and shall be deemed to include all other analogous items.