Revised CGHS package rates for Cancer surgery at CGHS Empanelled hospitals

Revised CGHS package rates for Cancer surgery at CGHS Empanelled hospitals – Directorate General of CGHS provides revised procedure cancer treatment

F. No. S-11045/36/2012 – CGHS (HEC)

Government of India

Ministry of Health & Family Welfare

Directorate General of CGHS

Maulana Azad Road, Nirman Bhawan

New Delhi 110 108

Dated: 7th September, 2015

OFFICE ORDER

Subject: CGHS Rates for Cancer Surgery for hospitals empanelled under CGHS – Revised w. e. f. date of issue of this order.

The undersigned is directed to draw attention to the Office Memorandum of even no. dated the 1st October, 2014 and to clarify that CGHS rates for Cancer surgery at Hospitals empanelled under CGHS shall be as per the details given below:

2.1 Rates of Tata Memorial Hospital, Mumbai (2012), as mentioned below for Cancer surgical procedures are treated as CGHS rates for NABH accredited hospitals. For Non-NABH accredited hospitals the rates would be reduced by 15%. These rates are for treatment for Semi private ward entitled class with 10% decrease for Gl – Ward and 15 % enhancement for Private ward entitled beneficiaries.

2.2 The duration of treatment for different categories of Surgery will be as follows:

Category I ………………… 1-2 days

Category II ………………… 3-5 days

(7-10 days in respect of operations involving Abdominal / thoracic cavity)

Category III,IV,V & VI …………… 12… 14 days

2.3. The surgical procedures are enlisted under Categories – I, II, III, IV,V & VI and the list is annexed to this office order (at Annexure – I).

2.4 Rates applicable for room rent (Accommodation Charges) for different categories of wards are given below:

General ward – Rs.1000/- per day

Semi – Private Ward – Rs.2000/- per day

Private ward – Rs.3000/- Per day

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

S.NoBasic Pay (without the inclusion of grade pay)Entitlement
1Upto Rs. 13,950General Ward
2Between Rs.13,951/- and Rs.19,530/-Semi-Private Ward
3Rs.19,540/- and abovePrivate Ward

For any day care procedure requiring short admission – a few hours to one day-accommodation charge for one day as per entitlement shall be applicable provided the rates prescribed are procedural charges only. Room rent, investigations and cost of medicines are reimbursable in addition to procedural charges.

2.5 Investigation rages and procedure cahrges for Chemotheraphy shall be as per CGHS prescribed rates of concerned city. In case of Chemotherapy the rates prescribed are procedural charges only. Room rent, investigations and cost of medicies are reimbursable in addition to precedural charges.

2.6 Consultation fee shall be as per CGHS rates applicable.

2.7 Investigations rates shall be as per CGHS prescribed rates of concerned city.

2.8 Cost of Implants/Stents/Grafts is reimbursable in addition to package rates as per CGHS ceiling rates for Implants/stents/grafts.

2.9 The rates applicable for Anesthesia, Operation Theatre and Surgery charges under Grades – I,II,III,IV,V & VI are given below:-

Sr.NoDESCRIPTIONRate in Rupees
ANAESTHESIOLOGY CHARGES
1Anesthesia Fees – Grade I2700
2Anesthesia Fees – Grade II5000
3Anesthesia Fees – Grade III8000
4Anesthesia Fees – Grade IV10000
5Anesthesia Fees – Grade V14000
6Anesthesia Fees – Grade VI18000
SURGICAL ONCOLOGY – Operation Theatre (Hospital Service Charges)
1Minor OT – Service Charges1000
2Minor OT – Surgery Charges870
3Minor OT – Drugs/Consumables (Without GA)500
4Minor OT – Drugs/Consumables (with GA)750
5Major OT – Service Charges – Less than 2 Hrs5000
6Major OT- Service Charges – 2 to 4 Hrs10000
7Major OT – service Charges – More than 4 Hrs20000
SURGERY CHARGES
1Grade I Surgery5000
2Grade II Surgery12500
3Grade III Surgery20000
4Grade IV Surgery25000
5Grade V Surgery35000
6Grade VI Surgery45000

2.10 The admissible amount for Cancer surgery shall be calculated as per the formula given below:

‘Room rent as applicable + Anesthesia charges (as per category) + OT charges ( as per category) + Surgery charges (as per category) + Investigations at CGHS rates + Cost of Medicines and Surgical Disposables.’

Anesthesia charges (as per category) + OT charges (as Per category)+ Surgery charges (as per category) prescribed above are applicable for semi-private ward. If the beneficiary is entitled for general ward there will be a decrease of 10% in these rates, for private ward entitlement there will be an increase of 15%.

Other conditions as prescribed in office Memorandum of even number dated 1st October, 2014 remain unchanged.

A copy of this Officer Order and rates Cancer Surgery are placed on the website http://msotransparent.nic.in/cghsnew/index.asp

(Dr.D.C.Joshi)

Director (CGHS)

Download Department of Health and Family Welfare, Directorate of CGHS Office Memorandum F. No. S-11045/36/2012 – CGHS (HEC) dated 07.09.2015 along with Annexure-I 

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