F. No.S·11045/36/20l2-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
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 &VJ.. 12 74 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 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
|
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, IT, IT, 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]
| |||
l
|
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
| |||
l
|
Grade I Surgery
|
5000
| |
2
|
Grade II Surgery
|
12500
| |
3
|
Grade III Surgery
|
20000
| |
4
|
Grade IV Surgery
|
25000
| |
5
|
Grade V Surgery
|
35000
| |
7
|
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 lst October, 2014 remain unchanged.
A copy of this Officer Order and
rates for Cancer surgery are placed on the website http:
//msotransoarent.nic.in/ cghsnew /index.asp
[ Dr. D.C. Joshi]
Director (CGHS)
[Tel: 
011-2306 2800]
011-2306 2800]
