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Clarification on billing queries in respect of CGHS Rate List

April 26, 2017

CGHS Rate List 2014 – Clarification

Clarification on billing queries in respect of CGHS Rate List – 2014 – Reg.

HEADQUARTERS’ OFFICE
EMPLOYEES’ STATE INSURANCE CORPORATION
PANCHDEEP BHAVAN: C.I.G ROAD: NEW DELHI – 110002
(ISO 9001-2000 Certified)

U-16/30/580/2016-Pro.Cell(SST)/WUL-290

Dated: 05/04/2017

To,
Director (Med.) Delhi, Director (Med.) Noida
MS’s- All ESIC Hospitals
SSMC’s/SMC’s- All States

Sub: Clarification on billing queries in respect of CGHS Rate List – 2014- reg

Sir/Madam,
As per policy, ESI Corporation follows listed rates of CGHS for clearing bills of Empanelled Hospitals. In this context, ESIC Headquarters is receiving numerous representations from field units as well as tie-up hospitals regarding issues pertaining to defined CGHS package rates. As per clarifications received from CGHS Hqrs, New Delhi, the decisions are as under:

S.No. / Queries Raised / Decisions

1.Whether 10% deduction on rates admissible for General Ward is done for Radiotherapy, Physiotherapy Echocardiography, Dobutamine Stress Echocardiography.

No deduction or enhancement for Radiotherapy, Physiotherapy Echocardiography, Dobutamine Stress Echocardiography.

2.Whether immunosuppressant therapy for Kidney Transplantation (Related) is included within the package rates.

Yes, the rate is inclusive of immunotherapy.

3.Whether any charges for the consumable (balloon) are to be paid additionally over the package rate for Balloon Mitral Valvotomy/PTMC- (CGHS 547)

No additional Charges need to be paid.

4.Whether charges for the dye/medicine are to be paid additionally over the Package rates for Radio-Isotope Therapy- (CGHS 1364-1370)

Rates are inclusive of the dyes. No additional charges need to be paid.

These instructions will be valid from 01.04.2017.

This issues with the approval of Director General.

Your faithfully
sd/-
(Dr.Sangeeta Mathur)
Dy. Medical Commissioner (SST)

Authority: http://esic.nic.in/

Related posts:

  1. New List of CGHS Hospitals comes into effect from October 2014
  2. Latest list of CGHS Hospitals & Revised Package Rates effective from 1.10.2014
  3. Fresh empanelment of private Health Care Organizations (HCOs) and revision of package rates applicable under CGHS Delhi & NCR
  4. CGHS Rates Easy Search – Package Rates for Treatments Procedures and Investigations
  5. EMPANELLED HOSPITAL CLAIMS-OPHTHALMIC PROCEDURES – ECHS
  6. Deduction of CGHS Contribution on change of Grade Pay by virtue of promotion/grant of NFSG from retrospective date – CGHS Clarification
  7. Delegation of powers for settlement of reimbursement claims/Permissions ex-post-facto approval in respect of Pensioner CGHS beneficiaries
  8. Clarification for Pensioners Superannuating on 31.1.2017 – CGHS Subscription as per 7th CPC
  9. CGHS : Enhancement of ceiling rate from Rs. 2 Lakhs to Rs. 5 Lakhs
  10. Clarification on CGHS Health Care Facilities Under ‘Pardhan Manri Jan Arogya Yojana‘

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