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

Clarification on billing queries in respect of CGHS Rate List-2014 * Headquarters Office, Employees State Insurance Corporation, Panchdeep Bhavan : C.I.G.Road : New Delhi – 110 002. * U-16/30/580/2016-Pro.Cell(SST)/WUL-290 Dated 05-04-2017 * To The Director (Med.) Delhi, Director (Med.) Noida, MS’s-All ESIC Hospitals, SSMC’s/SMC’s – All States * Sir/Madam, As per policy, ESI corporation follows listed rates of CGHS for dearing
bills of empanelled Hospitals, In this context, ESIC Headquarters is
receiving numerous representations from filed 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

Clarification on billing queries in respect of CGHS Rate List-2014 
 

TeleFax:011-23230146

VOIP:1001019

E-mail: dmc-sst.hq @wsic.in
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
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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 dearing
bills of empanelled Hospitals, In this context, ESIC Headquarters is
receiving numerous representations from filed 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.

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This issues with the approval of Director General.

Yours faithfully
(Dr.Sangeeta Mathur)

Dy.Medical commissioner (SST) 

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