What’s inside:
This article shares important updates about changes in medical procedure rates under the Central Government Health Scheme (CGHS) that will start from October 13.
The Central Government has announced a change in the rates for around 2000 medical procedures under the Central Government Health Scheme (CGHS). This update will take effect from October 13. It will apply to medical reimbursement claims from health institutions, serving employees, pensioners, and other beneficiaries.
The new rates will vary based on the quality and location of the hospitals. Accredited hospitals that meet NABH or NABL standards will receive full rates. Non-recognized hospitals will have a 15% reduction in rates, while super-specialty hospitals will get 15% more due to higher treatment costs. Hospitals in smaller cities will have lower rates compared to those in metro cities.
This update is expected to benefit private hospitals, as it allows them to charge more for treating CGHS patients. For example, in Tier-2 cities, rates will be 10% less, while in Tier-3 cities, they will be 20% less than in major cities. Also, the OPD consultation fee has recently increased from Rs 150 to Rs 350.
Key points to note include: all CGHS accredited hospitals must sign a new Memorandum of Agreement (MoA) with the Directorate of CGHS within 90 days, as the current MoA will end on October 13. The last update to the rates was in 2023, and health stocks saw a rise of up to 6% recently.
Moving forward, hospitals need to adjust to the new rates and ensure that they comply with the new MoA requirements. Beneficiaries should be aware of these changes, especially regarding the costs of their treatment.
Summary:
- CGHS rates for 2000 medical procedures are changing from October 13.
- Accredited hospitals will receive full rates; others will have reductions.
- Private hospitals will benefit from increased treatment costs.
- New MoA must be signed within 90 days by accredited hospitals.
- Beneficiaries should note the changes in treatment costs and fees.
