HEALTH

CGHS New Package Rates: OPD, Room Charges Revised; Know What Has Changed For Beneficiaries

The Union Health Ministry has decided to revise the Central Government Health Scheme (CGHS) package rates for all beneficiaries and has also simplified the referral process under it for the benefit of the employees.

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OPD rates have been increased to Rs 350 from Rs 150 earlier while IPD consultation fee saw a Rs 50 rise to Rs 350. ICU services have been fixed at Rs 5,400, including accommodation for all ward entitlements.

CGHS is the nodal healthcare provider to around 42 lakh Central government employees, pensioners and certain other categories of beneficiaries and their dependents enrolled under the scheme.

Hospital room rent also saw a revision. The rent of a general room has been fixed at Rs 1500 from Rs 1,000 earlier, a semi-private ward has been increased to Rs 3,000 from Rs 2,000 earlier while the rate of a private room has been increased from Rs 3,000 to Rs 4,500.

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The move will lead to the government incurring an additional expense ranging from Rs 240 crore to Rs 300 crore.

According to the statement, the ministry has proposed to initially revise the CGHS package rates of consultation fees, ICU charges and room rent following an examination of demands from stakeholders and taking into consideration the increase in costs of various components of healthcare.

The referral process under CGHS has also been simplified.

Earlier the CGHS beneficiary had to visit the CGHS Wellness Centre in person to be referred to a hospital. Now, a CGHS beneficiary can send a representative with the documents to the wellness centre to get referred to a hospital.

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A medical officer can refer the beneficiary to a hospital after checking the documents. A CGHS beneficiary can also get a referral through a video call.

What are the facilities available under CGHS?

  • OPD Treatment at WCs including issue of medicines.
  • Specialist Consultation at Polyclinic/Govt. Hospitals and at CGHS empanelled hospitals after referral by CGHS.
  • OPD/ Indoor treatment at Government and empanelled Hospitals.
  • Investigations at Government and empanelled Diagnostic centers.
  • Cashless facility available for treatment in empanelled hospitals and diagnostic centers for Pensioners and other identified beneficiaries.
  • Reimbursement of expenses for treatment availed in Govt. /Private Hospitals under emergency and specific treatment advised by Govt. Specialist or Specialist of Pvt.
  • HCOs duly endorsed by CMO/MO of WCs.
  • Reimbursement of expenses incurred for purchase of hearing aids, artificial limbs, appliances etc., after obtaining permission.
  • Family Welfare, Maternity and Child Health Services.
  • Medical consultation. Dispensing of medicines in Ayurveda, Homeopathy, Unani and Siddha system of medicines (AYUSH)
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