CGHS Rates for Cancer Surgery in empanelled hospitals revised

CGHS Rates for Cancer Surgery for hospitals empanelled under CGHS – Revised with effect from September 2015

CGHS issued an Office Order on Rates for Cancer Surgery in hospitals empanelled under CGHS.

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.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

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 patient has been admitted in a room as per his/her entitlement.

2.5 Investigation rates and procedure charges for Chemotherapy 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 medicines are reimbursable in addition to procedural 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.No	DESCRIPTION	Rate in Rupees
ANAESTHESIOLOGY CHARGES
1	Anesthesia Fees – Grade I	2700
2	Anesthesia Fees – Grade II	5000
3	Anesthesia Fees – Grade III	8000
4	Anesthesia Fees – Grade IV	10000
5	Anesthesia Fees – Grade V	14000
6	Anesthesia Fees – Grade VI	18000
SURGICAL ONCOLOGY – Operation Theatre (Hospital Service Charges)
1	Minor OT – Service Charges	1000
2	Minor OT – Surgery Charges	870
3	Minor OT – Drugs/Consumables (Without GA)	500
4	Minor OT – Drugs/Consumables (with GA)	750
5	Major OT – Service Charges – Less than 2 Hrs	5000
6	Major OT- Service Charges – 2 to 4 Hrs	10000
7	Major OT – service Charges – More than 4 Hrs	20000
SURGERY CHARGES
1	Grade I Surgery	5000
2	Grade II Surgery	12500
3	Grade III Surgery	20000
4	Grade IV Surgery	25000
5	Grade V Surgery	35000
6	Grade VI Surgery	45000

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

(Dr.D.C.Joshi)

Director (CGHS)

Tel: 011 – 2306 2800

Download CGHS Office Order F. No. S-11045/36/2012 – CGHS (HEC) dated 07.09.2015