The Central Government Health Scheme (CGHS) plays a vital role in providing healthcare benefits to Central Government employees, pensioners, and their dependents. Recently, there have been significant updates regarding CGHS package rates, particularly concerning general surgery procedures. This article aims to elucidate these changes and provide essential information for eligible individuals.
Overview of CGHS Package Rates Modifications
Effective from February 1, 2024, the CGHS Directorate of the Department of Health and Family Welfare has implemented revised rates for various medical treatments and procedures under the CGHS scheme. These modifications encompass a range of services, including wound dressing, aspiration pleural effusion, abdominal/peritoneal aspiration, stitches/stitch removal, and venesection.
Eligibility Criteria for CGHS Benefits
CGHS benefits are extended to Central Government employees (excluding Railways and Delhi Administration employees), as well as Central Government pensioners and their families (excluding Railways and Armed Forces pensioners). To avail of CGHS services, individuals must fulfill the residence criteria, residing in any notified city where CGHS facilities are available. Currently, CGHS services are accessible in 80 cities across India.
Procedure for Availing CGHS Services
Central Government employees are required to submit necessary forms, along with photographs of eligible family members, to the Ministry/Department/Office where they are employed. On the other hand, Central Government pensioners can obtain CGHS cards from the Additional Director office in their respective cities. Provisional cards can be acquired if the Pension Payment Order (PPO) is not yet available, based on the last pay certificate.
Revised CGHS Package Rates for General Surgery
The table below outlines the revised CGHS package rates for general surgery procedures, categorized based on the treatment/procedure/checklist and the corresponding rates for both NABH (National Accreditation Board for Hospitals & Healthcare Providers) credit and non-NABH accredited facilities:
| Sl. No. | Code | CGHS Treatment/Procedure/Checklist | Revised CGHS Rates (NABH Credit) | Revised CGHS Rates (Non-NABH Accredited) |
|---|---|---|---|---|
| 1 | 3 | Wound dressing | ₹300 | ₹255 |
| 2 | 5 | Aspiration pleural effusion – diagnostic | ₹700 | ₹595 |
| 3 | 6 | Aspiration pleural effusion – therapeutic | ₹700 | ₹595 |
| 4 | 7 | Abdominal/Peritoneal Aspiration – Diagnostic/Aseptic Tapping/Paracentesis – Diagnostic | ₹700 | ₹595 |
| 5 | 8 | Abdominal / Peritoneal Aspiration – Clinical / Ascitic Tapping / Paracentesis – Clinical | ₹750 | ₹640 |
| 6 | 12 | Stitches/Stitch Removal (7-12 stitches) | ₹200 | ₹170 |
| 7 | 13 | Venesection | ₹700 | ₹595 |
Conclusion
The recent revisions in CGHS package rates signify a commitment to enhancing healthcare accessibility and affordability for Central Government employees and pensioners. By staying informed about these changes, eligible individuals can make informed decisions regarding their healthcare needs and utilize the benefits provided under the CGHS scheme.
