CGHS Package rates code Number where differential pricing is applicable in reference to OM dated 19th December 2023 Revision of CGHS rates for Cardiology procedures inclusion of two new procedure and revision of rates PET CT Scan
FTS No: 8108208 File No: S-11011/27/2021/CGHS(HEC
File Name: Clarification on CGHS package
Government of India
Ministry of Health & Family Welfare
Directorate of Central Government
Health Scheme (CGHS), Hospital
Empanelment Cell (HEC)
Room No. 211 CGHS Bhawan
New Delhi-110066
Dated 12th January 2024
Office Memorandum
Subject: CGHS Package rates code Number where differential pricing is applicable in reference to OM dated 19th December 2023 Revision of CGHS rates for Cardiology procedures inclusion of two new procedure and revision of rates PET CT Scan- regarding.
Reference: Email dated 08.01.2024 from NHA requesting for CGHS rates code No. where differential pricing is applicable
List of CGHS package rates code and treatment procedure name of the revised CGHS rates for Cardiology Procedures, Two new procedures and revision of rates of PET CT Scan vide OM dated 19th December 2023, where differential pricing is applicable as per the terms and condition point No 4 of OM dated 26.11.2014, on Clarification regarding Empanelment & CGHS Rates, wherein it is mentioned that CGHS approved rates list for various treatment procedure are 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%, however, for investigations the rates mentioned in the CGHS list would apply irrespective of the entitlement of the beneficiary.
| The rates prescribed below are for semi private ward. CGHS Package rates code where differential pricing of 10% decrease for General Ward entitled Beneficiaries and 15% increase for those entitled Private ward is applicable are listed hereunder. | ||||
| SrNo | CGHS rate Code Number | TREATMENT PROCEDURE CARDIOVASCULAR AND CARDIAC SURGERY & INVESTIGATIONS | Non- NABH/ Non-NABL Rates in Rupee | NABH / NABL Rates in Rupee |
| 1 | 544 | Balloon coronary angioplasty/ Percutaneous transluminal coronary angioplasty (PTCA)/ Percutaneous coronary intervention (PCI) with Vascular closure device (VCD) | 78,200 | 92,000 |
| 2 | 545 | Balloon coronary angioplasty/ Percutaneous transluminal coronary angioplasty (PTCA)/Â Percutaneous coronary intervention (PCI) without Vascular closure device (VCD) | 71,150 | 83,725 |
| 3 | 546 | Rotablation | 47,775 | 56,206 |
| 4 | 547 | Balloon Mitral Valvotomy / Percutaneous transvenous mitral commissurotomy (PTMC) | 77,000 | 90,700 |
| 5 | 548 | Cardiac Catheterization (CATH) | 11,510 | 13,545 |
| 6 | 556 | Coarctation dilatation / Balloon dilatation of Aortic coarctation -including cost of Balloon | 60,860 | 71,600 |
| 7 | 558 | Temporary Pacemaker Implantation (TPI) (Temporary Cardiac Pacing) Single Chamber | 16,320 | 19,200 |
| 8 | 560 | Permanent pacemaker implantation (PPI)-Single Chamber | 27,200 | 32,000 |
| 9 | 561 | Permanent pacemaker implantation- Dual Chamber | 36,550 | 43,000 |
| 10 | 562 | Permanent pacemaker implantation (PPI)-Biventricular | 42,180 | 49,625 |
| 11 | 563 | Automatic implantable cardioverter defibrillator (AICD) -Single Chamber | 42,500 | 50,000 |
| 12 | 564 | Automatic implantable cardioverter defibrillator (AICD) -Dual Chamber | 44,500 | 52,350 |
| 13 | 565 | Combo device implantation | 50,150 | 59,000 |
| 17 | 569 | Radiofrequency (RF) ablation conventional | 81,600 | 96,000 |
| 18 | 570 | Radiofrequency (RE) ablation Atrial Tachycardia/ with 3-D mapping-All inclusive | 1,53,850 | 1,81,000 |
| 19 | 571 | Endomyocardial biopsy | Deleted | Deleted |
| 20 | 572 | Intra-aortic balloon pump (IABP)- Including Cost of Balloon | 42,500 | 50,000 |
| 21 | 573 | Intra vascular coiling | 63,750 | 75,000 |
| 22 | 574 | Septostomy- Balloon | 25,500 | 30,000 |
| 23 | 576 | Aortic valve balloon dilatation (AVBD) / pulmonary valve balloon dilatation (PVBD) | 47,940 | 56,400 |
| 25 | 578 | Digital subtraction angiography- venogram | 12,400 | 14,610 |
| 26 | 581 | Peripheral Angioplasty including Vascular Closure Device (VCD) | 46,750 | 55,500 |
| 27 | 583 | Renal Angioplasty | 46,750 | 55,000 |
| 30 | 588 | Inferior Vena Cava (IVC) filter implantation (Cost of Filter extra) | 25,500 | 30,000 |
| 31 | 589 | ASD/VSD/PDA device closure | Delete | Delete |
| 31 | 520 | Atrial Septal Defect (ASD) closure | 84,065 | 98,900 |
| 31 | 521 | Ventricular septal defect (VSD) closure | 93,415 | 1,0,9,900 |
| 31 | 541 | Patent ductus arteriosus (PDA), device closure | 46,750 | 55,000 |
| 35 | 601 | Coronary angiography | 11,240 | 13,225 |
| 36 | 608 | Pericardiocentesis | 8,500 | 10,000 |
| New CGHS Treatment Procedure under Cardiology included w.e.f. 19.12.2023 | ||||
| 1(2) | 1855 | Transcatheter Aortic Valve Implantation (TAVI) / Transcatheter Aortic Valve Replacement (TAVR) — Procedure Cost | 85,000 | 100,000 |
Dr Lanu Wapangg
Sr CMO HEC-Policy, CGHS
To
CEO National Health Authority, 9th Floor-I, Jeevan Bharati, Connaught Place, New Delhi – 110001
COMMENTS