Revised CGHS Rate List 2023 PDF Free Download

Revised CGHS Rate List 2023 PDF Download Info

Revised CGHS Rate List 2023 PDF Free Download, Cghs Rates And A List Of Hospitals And Diagnostic Centers That Are Enrolled. Diagnostic Center/hospitals With Panels. 2200. Look Up Hospital/city. Look Up.

Revised CGHS Rate List 2023 PDF

Remember That The Icu Fees Are Rs 862 For Hospitals Affiliated With Nabh And Rs 750 For Non-nabh Facilities. It Covers Room Rental, Nursing Care, Monitoring, And Rmo Fees. The Room Rent Will Be Determined By The Cghs Beneficiary’s Entitlement In The General, Semi-private, Or Private Ward.

Cardholders Of Cghs Need To Be Aware Of The Most Recent Room Rate. The Room Fee For The General Ward Has Been Increased To Rs 1,500. The Cost Of A Room In A Semi-private Ward Would Be Rs 3,000. The Room Fee For The Private Ward Is Fixed At Rs 4,500.

Additionally, The Cghs Wellness Center Referral Procedure Has Been Made Simpler By The Union Ministry Of Health And Family Welfare (Mohfw). In The Past, The Cghs Recipient Was Required To Personally Visit The Cghs Wellness Center And Get A Hospital Referral. However, The Ministry Noted In A Statement Earlier This Year That If The Cghs Recipient Is Unable To Travel, He May Send Someone On His Behalf To The Wellness Center With His Paperwork.

“After Reviewing The Documentation, The Medical Officer May Recommend That The Recipient Visit The Hospital. In Addition, Beneficiaries Of Cghs May Accept Referrals Via Video Call,” It Said.

For Whom Is The Central Government Health Scheme (Cghs) Applicable?

The Central Government Health Scheme Website States That The Following Groups Qualify For Benefits Under The Program.

1. All Central Government employees paid from the Central Civil Estimates (except Railways and Delhi Administration), including their families.
2. Pensioners of Central Government (except pensioners belonging to Railways and the Armed Forces) and their families.
3. Central Government Pensioners retiring with Contributory Provident Fund benefits and their families.
4. Widows of Central Government pensioners, in receipt of family pension.
5. Delhi Police personnel and their families, in Delhi only.
6. Railway Board employees.
7. Civilian employees of Defence are paid from Defence Service Estimates (except in Mumbai where the scheme is in operation).
8. Child drawing pension on death of a Central Government employee including minor brothers and sisters of such child.
9. Ex-Governors and Lt. Governors and their families.
10. Ex-Vice Presidents and their families.
11. Central Government servants who are deputed to semi-government and autonomous bodies receiving substantial grants from, or financed by the Central Government.
12. Central Govt. employees on deputation to statutory/autonomous during the period of deputation.
13. Military Officers while on deputation to civil departments and getting their emoluments from Central Civil Estimates.
14. Families of Government servants transferred to a non-CGHS area, for a maximum period of six months on deposit of CGHS contribution (for 6 months) in advance.
15. Families of IAS Officers in the North-Eastern Cadre, who continue to stay back in Delhi even after repatriation of the IAS Officer to the North-Eastern Cadre, provided that they continue to occupy Government accommodation in Delhi/New Delhi, on deposit of CGHS contribution in advance (one to three years). The same also applies to families of IAS Officers of J&K Cadre.
16. Parliamentary Secretaries of the Central Government and their families.
17. Members of Parliament and their families.
18. Ex-Members of Parliament.
19. Sitting Judges of the Supreme Court and High Court of Delhi and former Judges of Supreme Court and High Courts.
20. Work Charged and Industrial Staff working in establishments run by various Ministries/Departments of Central Government, immediately from the date of their joining the service.
21. Employees of Kendriya Vidyalaya Sangathan stationed at Delhi & NCR, Kolkata, Chennai, Hyderabad, Mumbai and Bengaluru.
22. Employees of Ordnance Factory Board Headquarters, Kolkata and Ordnance Equipment Factories Headquarters, Kanpur.
23. All India Service pensioners who retire while serving under the State at their option.
24. Freedom Fighters and members of their families receive a Central Pension under the Swatantrata Sainik Samman Pension Scheme.
25. Family members of the Deceased Ex-Members of Parliament.
26. Pensioners of Ordnance factories.
27. Members of Staff Side of the National Council of the Joint Consultative Machinery, even though not serving as Central Government employees.
28. Persons employed in semi-government and autonomous bodies are permitted to join the CGHS Scheme.
29. An Accredited Journalist who produces a certificate from the Press Council of India stating that he is a member of the Press Association, New Delhi (for OPD and at RML Hospital).
30. Retired Divisional Accountants of the Indian Audit and Accounts Department and those whose pay and pension are entirely borne by the State governments.
31. PSU absorbees who had commuted 100% of their pension and have been restored 1/3rd portion of their pension after 15 years.
32. Employees of Statutory Bodies/Autonomous Bodies of Central Govt. (including those who proceeded on deputation initially or were on deemed deputation and then absorbed), who are in receipt of Central Civil Pension.

Complete list of 2023 CGHS Revised Rates: The CGHS package prices for each and every beneficiary have been updated by the Union Ministry of Health and Family Welfare (MoHFW). For the benefit of its workers, the Union Government has improved rates in addition to streamlining the CGHS referral procedure.

The Union Health Ministry has suggested to first amend the CGHS package prices of consultation fees, ICU charges, and room rent, the Ministry of Health and Welfare said in a statement. This is after carefully examining the requests made by stakeholders and accounting for the rise in the cost of different health care components.

The fee has been raised to Rs 5,400 (rounded to Rs 5,400) which includes lodging for all ward entitlements (Rs 862 + Rs 4,500 for Private ward = 5,362).

For non-NABH hospitals, the ICU costs are Rs 750; for NABH hospitals, they are Rs 862. These fees include monitoring, RMO charges, nursing care, and room rent according to the beneficiary’s ward entitlement, which may include a general ward, semi-private ward, or private ward. The previous fee for NABH was Rs 862 + room rent based on ward eligibility.

The ministry said that there has been a simplification of the CGHS referral procedure.

In the past, the CGHS recipient was required to personally visit the CGHS Wellness Center and get a hospital referral. However, the recipient of CGHS may now send someone on his behalf to the wellness center with his documentation if he is unable to attend, according to the statement.

“After reviewing the documentation, the medical officer may recommend that the recipient visit the hospital. In addition, beneficiaries of CGHS may accept referrals via video call,” it said.

The fee has been raised to Rs 5,400 (rounded to Rs 5,400) which includes lodging for all ward entitlements (Rs 862 + Rs 4,500 for Private ward = 5,362).

For non-NABH hospitals, the ICU costs are Rs 750; for NABH hospitals, they are Rs 862. These fees include monitoring, RMO charges, nursing care, and room rent according to the beneficiary’s ward entitlement, which may include a general ward, semi-private ward, or private ward. The previous fee for NABH was Rs 862 + room rent based on ward eligibility.

Room Rent

• The General Ward room rent has been increased from Rs 1000 to Rs 1500.
• The Semi-Private ward room rent has been increased from Rs 2000 to Rs 3000.
• The Private Ward room rent has been increased from Rs 3000 to Rs 4500.

The ministry further said that the referral process under CGHS has also been simplified.

“Earlier the CGHS beneficiary had to visit the CGHS Wellness Center himself and take referral to the hospital. But now, if the CGHS beneficiary is unable to go, he can send someone on his behalf with his documents to the wellness centerm,” the statement said.

“The medical officer can refer the beneficiary to go to the hospital after checking the documents. Apart from this, CGHS beneficiary can also take referral through video call,” it added.

Introduction to CGHS:

The Central Government Health Scheme (CGHS) is a comprehensive health care program for Central Government employees and pensioners, as well as for Members of Parliament, Supreme Court Judges, and other specific groups. CGHS provides health services through a network of empanelled hospitals, diagnostic centers, and pharmacies.

CGHS Empanelment Process:

Empanelment refers to the process through which healthcare providers, including hospitals, diagnostic centers, and pharmacies, get recognized and approved by CGHS to provide services to beneficiaries. CGHS empanels a range of healthcare facilities to ensure that beneficiaries have access to quality healthcare services.

Types of CGHS Panels:

1. Hospital Empanelment:
   • CGHS empanels hospitals that meet specific criteria for infrastructure, medical facilities, and quality of services. These hospitals are categorized into different panels based on the facilities they offer.
2. Diagnostic Center Empanelment:
   • Diagnostic centers are empanelled to provide various medical tests and diagnostic services. These centers are expected to maintain high standards of accuracy and efficiency.
3. Pharmacy Empanelment:
   • CGHS empanels pharmacies to provide medicines to beneficiaries at specified rates. Empanelled pharmacies are expected to maintain a sufficient stock of medicines and adhere to CGHS guidelines.
4. Imaging Center Empanelment:
   • Some CGHS panels may include empanelment of imaging centers, which provide services such as X-rays, MRIs, CT scans, etc.

Benefits of CGHS Empanelment:

1. Wider Access to Healthcare:
   • CGHS empanelment ensures that beneficiaries have access to a wide network of healthcare providers, reducing the burden on specific hospitals or centers.
2. Quality Assurance:
   • Empanelment involves a thorough assessment of the facilities and services provided by healthcare providers. This helps maintain a certain standard of quality across the network.
3. Cost-Effective Healthcare:
   • CGHS negotiates rates with empanelled hospitals, diagnostic centers, and pharmacies. This helps beneficiaries receive services and medicines at pre-defined, cost-effective rates.
4. Transparency:
   • The empanelment process and the list of empanelled facilities are made transparent and accessible to CGHS beneficiaries. This transparency ensures that beneficiaries are aware of the facilities available to them.

Empanelment Criteria:

CGHS has specific criteria that healthcare providers must meet to be eligible for empanelment. These criteria include:

1. Infrastructure and Facilities:
   • Hospitals and diagnostic centers must have adequate infrastructure and facilities to provide quality healthcare services.
2. Quality of Services:
   • Empanelled facilities are expected to maintain a high standard of medical care and services.
3. Rates and Packages:
   • CGHS negotiates rates with empanelled facilities for various medical procedures, tests, and treatments.
4. Accessibility:
   • Empanelled facilities should be easily accessible to CGHS beneficiaries.

Empanelment Process:

The empanelment process typically involves the following steps:

1. Application Submission:
   • Healthcare providers interested in empanelment submit applications to CGHS, providing details about their facilities, services, and infrastructure.
2. Document Verification:
   • CGHS authorities verify the submitted documents to ensure that the healthcare provider meets the required criteria.
3. Inspection:
   • A team from CGHS may conduct an on-site inspection of the healthcare provider’s facilities to assess the quality of services.
4. Negotiation of Rates:
   • CGHS negotiates rates with the healthcare provider for various services and procedures.
5. Empanelment Approval:
   • Once the verification and negotiation processes are completed successfully, the healthcare provider is officially empanelled by CGHS.

Renewal and De-empanelment:

Empanelment is not a one-time process. Facilities must undergo periodic renewals to ensure that they continue to meet the required standards. CGHS also has provisions for de-empanelment in cases where a facility fails to maintain the necessary standards or violates the terms of the empanelment agreement.

Challenges and Concerns:

While CGHS empanelment brings several benefits, there have been challenges and concerns, including:

1. Limited Choices:
   • CGHS empanels a limited number of facilities, and beneficiaries may face challenges in finding empanelled providers in certain areas.
2. Infrastructure and Equipment:
   • Some facilities may struggle to meet the infrastructure and equipment criteria, limiting their eligibility for empanelment.
3. Quality Assurance:
   • Ensuring consistent quality across all empanelled facilities can be challenging, and occasional lapses in quality have been reported.
4. Timely Payments:
   • Healthcare providers sometimes face delays in receiving payments from CGHS, affecting their willingness to participate in the empanelment process.

Conclusion:

The CGHS empanelment process is a crucial component of the healthcare system for Central Government employees and pensioners. It aims to provide beneficiaries with access to quality and cost-effective healthcare services. While challenges exist, ongoing efforts are made to streamline the empanelment process, address concerns, and ensure that beneficiaries receive the best possible care through the CGHS network.

For the latest and most accurate information regarding CGHS panels, empanelment criteria, rates, and other related details, it is recommended to refer to the official CGHS website or contact CGHS authorities directly.