BHARAT SANCHAR NIGAM LTD
(A Government of India Enterprise)
Office of the
Principal General Manager Telecom,
Admin Section, Telephone Bhavan, Kala Talav ,
Kalyan (W).
To,
--------------------------------------------------------------------------------------------NO. KYN/ADMIN/HE2013-2014
DATED AT KALYAN THE 05/10/2013
SUB: EXPRESSION OF INTEREST FOR EMPANELMENT OF HOSPITALS FOR
PROVIDING INDOOR TREATMENT TO BSNL SERVING/RETIRED EMPLOYEES &
THEIR DEPENDENTS
The Asstt. General Manager (Admin), Kalyan Telecom District invites Expression of interest on
behalf of BSNL, Kalyan for the Empanelment of Hospitals for giving indoor treatment to BSNL
Serving/Retired Employees/Voluntary retired & their dependent family members from the hospitals run
by Government/Private/semi private/Charity/Trust or any other hospitals.
The documents containing terms and conditions shall be obtained from the Sub Divisional
Engineer (Admin-II) O/o PGMT, BSNL Kala Talav, Kalyan for free of cost or can be downloaded from
maharashtra.bsnl.co.in/ssa/kalyan
Other details are as under
Period of issue of forms
On all working days from 14/10/2013 to 10/11/2013
between 10.30 hrs. To 16.30 hrs.
Time & Date of submission of EOI
documents
Up to 15.00 hrs of.15/11/2013
by hand, register post , Speed post or by courier
Date of opening
At 15.30 hrs. of 15/11/2013
The Principal General Manage, BSNL, Kalyan reserves the right to accept or reject any or all the
expression of interest(s) without assigning any reasons whatsoever.
Asstt. General Manager (Admin)
O/o PGMT, BSNL, Kalyan 421301.
BHARAT SANCHAR NIGAM LTD
(A Government of India Enterprise)
Office of the
Principal General Manager Telecom,
Admin section, Telephone Bhavan, Kala Talav ,
Kalyan (W).
Terms, Conditions & Specifications for empanelment of hospital
NO. KYN/ADMIN/HE/2013-14/6
DATED AT KALYAN THE 05/10/2013
This Document Contains:
Part-I
: Definitions, General Terms & Conditions for empanelment of
Hospitals
Part-II
: Scope of work and specifications
Part-III
Part-IV
: Quotation for rates
: Agreement
( ANNEXURE A to be submitted after approval)
Sd/-
Asstt. General Manager (Admin& MIS)
O/o PGMT Kalyan-421 301
NOTE: Please ensure before sending documents by register post / by speed post or by courier
that:
1. The required documents are kept in envelope super-scribed as “Expression of interest for
empanelment of hospitals” vide Offer NO. KYN/ADMIN/HE/13-14/ Dated at Kalyan the-------------”.
2. The signature with stamp of hospital in-charge should be available on all pages of
EXPRESSION OF INTEREST DOCUMENTS.
3. All the contents enclosed with this documents shall be attested.
BHARAT SANCHAR NIGAM LTD
(A Government of India Enterprise)
Office of the
Principal General Manager Telecom,
Admin Section, Telephone Bhavan, Kala Talav ,
Kalyan (W).
NO. KYN/ADMIN/HE/2013-14/6
DATED AT KALYAN THE 05/10/2013
EXPRESSION OF INTEREST FOR EMPANELMENT OF
HOSPITALS FOR PROVIDING INDOOR TREATMENT TO
BSNL SERVING/RETIRED EMPLOYEES & THEIR
DEPENDENTS
Particulars of Issue of Document.
Name and address of the
Hospital/Dr.
Sd/-
Asstt. Geberal Manager(Admin&MIS)
% PGMT,BSNL, Kalyan 421 301.
O/O Principal General Manager Telecom,
Admin Section, Telephone Bhavan ,
Kala Talav, Kalyan (W)– 421 301.
PART-I
DEFINITIONS AND GENERAL TERMS & CONDITIONS OF THIS DOCUMENTS.
A. DEFINITIONS
1.
The BSNL means the Bharat Sanchar Nigam Ltd. and its successors.
2.
The PGMT means the Principal General Manager Telecom, Kalyan and his successors.
3.
The AGM (Admin) means Assistant General Manager (Admin.), office of the Principal
General Manager Telecom., Bharat Sanchar Nigam Limited, Telephone Bhavan, Kalyan and
his successors.
4.
Nodal officer/Representative of PGMT means officers and staff for the time being in Kalyan
Telecom District deputed by the PGMT for verifying the genuineness of beneficiary in all
indoor treatment.
B. GENERALTERMS & CONDITIONS FOR EMPANELMENT OF HOSPITAL.
1. All BSNL serving/retired employees who have opted for BSNL MRS & their dependents
(including voluntarily retired) will be eligible for this scheme.
2.
Empanelled hospitals are entitled to get reimbursement of expenses incurred towards the
medical expenses of all BSNL serving/retired/voluntarily retired employees and their
dependents, at the CGHS approved rates prevailing at the time of admission of patient at
hospitals recognized from time to time by the management. Entitlement under this clause will
be separate and distinct from the ceiling amount prescribed for domiciliary out door
treatment.
3. Medical card having photo of eligible family members of an employee shall be given to all the
eligible employees by Asstt. General Manager (Admin & MIS).
4. Before admission employee has to apply for an Authorization letter for indoor treatment, to
the competent authority, O/o PGMT, BSNL, Kalyan, through proper channel, for getting
indoor treatment from empanelled hospital.
5. Competent authority of BSNL shall issue “Authorization letter “ in Annexure- F to the
employee.
6.
Employee has to produce the Authorization letter to the hospital concern where he wants to
take indoor treatment. Hospital shall entertain only all such patient who produces
Authorization letter issued by Competent authority of BSNL. No patient has to be treated
without such letter under BSNL MRS.
7. In case of emergency or on holidays hospital can admit the patient by verifying their Medical
Card issued by Competent authority of BSNL, Kalyan. In such cases hospital authority
should intimate to Competent authority of BSNL, Kalyan in writing the reason for admission
of the patient and should insist the employee to produce Authorization letter on next working
day. Extending stay of in-patient beyond ten days needs consent of BSNL by referring to the
authority who has issued the original authorization for admission of the patient.
TREATMENT IN EMERGENCY.
08. TREATMENT IN EMERGENCY
In emergency the hospital shall not refuse admission or demand an advance
payment from the beneficiary or his family member and shall provide credit
facilities to the patient whether the patient is a serving employee or a pensioner
availing CGHS facilities, on production of a valid CGHS card and the hospital
shall submit the bill for reimbursement to the concerned Deptt. / Ministry / CGHS.
The refusal to provide the treatment to bonafide CGHS beneficiaries in
emergency cases without valid ground, would attract disqualification for
continuation of empanelment.
• The following ailments may be treated as emergency which is illustrative
only and not exhaustive, depending on the condition of the patient :
Acute Coronary Syndromes (Coronary Artery Bye-pass Graft /
Percutaneous, Transluminal Coronary Angioplasty) including Myocardial
Infarction, Unstable Angina, Ventricular Arrhythmias, Paroxysmal Supra
Ventricular Tachycardia, Cardiac Temponade, Acute Left Ventricular
Failure / Severe Congestive Cardiac Failure, Accelerated Hypertension,
Complete Heart Block and Stoke Adam attack, Acute Aortic Dissection.
Acute Limb Ischemia, Rupture of Aneurysm, Medical and Surgical shock
and peripheral circulatory failure.
Cerebro-Vascular attack-Stokes, Sudden unconsciousness, Head injury,
Respiratory failure, decompensated lung disease, Cerebro-Meningeal
Infections, Convulsions, Acute Paralysis, Acute Visual loss.
Acute Abdomen pain.
Road Traffic Accidents / with injuries including fall. Severe
Hemorrhage due to any cause.
Acute poisoning.
Acute Renal Failure.
Acute abdomen pain in female including acute Obstetrical and
Gynecological emergencies.
Electric shock.
Any other life threatening condition.
9. No refund of medical expenses will be made to the hospitals without complying to the
conditions of 6 or 7 above and the treatment done will be at the risk and cost of the hospitals.
10. Authorization letter issuing authority of BSNL, Kalyan shall depute one Nodal Officer to verify
the genuineness of beneficiary in all indoor treatment.
11. Nodal Officer will issue “Verification certificate” as per Annexure-V
12. After discharge of the patient, hospital has to raise the bill as per conditions stipulated in the
agreement duly executed between the BSNL and the Hospital concerned.
13. Hospital shall attach “Certificate for hospitalization” in Annexure D-1 along with the bill.
B. GENERAL TERMS & CONDITIONS FOR EMPANELMENT OF HOSPITAL.
1. The BSNL desires to empanel hospitals for giving indoor treatment to their employees & their
dependent family members. The specifications and the scope of work are mentioned in part-II.
2. Schedule for procurement & submission of the EXPRESSION OF INTEREST form.
Issue of form document
From
Up to
Address for getting the form
AGM(Admin) O/o the PGMT, Kala Talav, Kalyan (W)
Submission of form
BY hand, register post, speed post or by courier so as to
reach on or Before 15.00 Hrs. Of 15/11/2013
Date of opening
15.30 hours of 15/11/2013
3.
10.30 Hrs.
16.30 Hrs.
Of
Of
14/10/2013
10/11/2013
Documents to be submitted along with the EXPRESSION OF INTEREST
a. Registration Certificate for hospital.
b. Opinion Certificate from Civil Surgeon/Health Officer of Municipal Authorities as
per Annexure-O
C .Letter for agreeing to CGHS rates Mumbai. ( format attached)
d. Hospital brochure along with existing rate list of hospitals
e. Annexure G
4.
Filling the form: The interested hospitals shall fill up Annexure –G, The hospital
should give their details of services provided by them for indoor treatment (i.e
Emergency & Trauma services, Specialized services, facilities of clinical investigation
available with them. The facilities available with them like No. of special/private/semi
private/general wards, No of beds, Amenities provided. The diagnostic facilities like
pathological, Radiological, availability of Medical shops, etc. List of Doctors available
& their bio data.
5.
Information Regarding Submission Of Documents: The documents super scribed
on the envelope as “Documents for Expression of Interest form vide NIT NO.
KYN/ADMIN/HE/
Dated at Kalyan the
” are to be addressed to
Asstt General Manager (Admn&MIS),
Office of the Principal General Manager Telecom,
Administration Section, Kala Talav,
Kalyan (W)– 421 301
so as to reach on or before 15.00 hrs. of 15/11/2013
by Hand/
Registered Post/ Speed Post or by courier,
6.
TERMINATION FOR DEFAULT :
The BSNL, Kalyan can terminate the contract of any hospital by issuing written
notice in whole or in part, for the following reasons, without prejudice to any other
remedy for breach of contract.
a.
If the hospital fails to give treatment to the patient whom authorization letter is issued
by the competent authority of BSNL.
b.
If the contract is abandoned by the hospital for any reason, it will be de-listed from
the panel of BSNL and can be black listed.
c.
If the hospital refuses to give treatment.
d.
For poor treatment or for the bad act of the hospital.
7.
Procedure to Open & Evaluating of the Expression of Interest.
a.
An “EOI” opening committee shall be constituted for opening of Expression of
Interest documents and shall submit them to evaluation committee along with their
report.
b.
An “Evaluation Committee” shall be constituted for evaluation of the Expression of
Interest.
c.
The evaluation committee will examine the documents submitted. If required original
copies of documents submitted along with the Expression of Interest will be verified
by committee.
d.
The evaluation of document will be done as per the offer submitted by the hospital.
However BSNL Kalyan reserves the rights not to accept the higher rates.
e.
The BSNL Kalyan reserves the right to refuse consideration of any Expression of
Interest deficient or incomplete in any of the requisite matters, particulars or
formalities or for any reason which shall not be disclosed to the hospitals.
f.
Incomplete G form shall be rejected out rightly & no correspondence shall be
entertained in this regard.
g.
The offer with extraneous conditions or conditional offer will not be accepted.
Hospitals with such conditions are liable for rejection.
h.
The decision of the PGMT, BSNL, Kalyan on the recommendation of the “Expression
of Interest Evaluation Committee” shall be final.
i.
The Hospital should abide by CGHS rates applicable on the date of admission of
treatment
8
Validity of the offer:
a)The empanelment under this contract will be valid, normally, for a period of two
year from the date of Agreement. No increase in the approved rates will be allowed
due to any reason except the change if any in the rates of CGHS Mumbai during the
period of agreement shall be accepted from the date of change in rates of CGHS,
Mumbai
b) The BSNL Kalyan reserves the right to extend the validity period for another one
year with the same terms and conditions.
9.
Payments: The bills shall be submitted in duplicate to the BSNL within one month
from the date of discharge of the patient. The hospital shall be responsible to submit
the bills, which are prepared accurately, and giving all details to facilitate, treatment,
medicines supplied by them to the patient..
10.
The decision of the PGMT, BSNL, Kalyan shall be final & binding on the hospitals.
11.
The offer of black listed hospitals will not be entertained and the same will be
excluded from consideration
12.
In case of default, the BSNL will have right to discontinue the hospital from panel.
13.
The PGMT, BSNL, Kalyan may terminate the contract at his option at any time giving
30 days (Thirty days) notice and that without assigning any reason in the case of any
unethical medical practices.
14.
Submission of documents by the hospital shall be taken to signify the acceptance of
the stipulated terms and conditions. Any failure on the part of the hospital to observe
the prescribed procedure or any attempt to canvass for the work will prejudice the
hospital and make it liable for exclusion from consideration.
15.
The PGMT, Kalyan reserves the rights to accept or reject any hospital or all hospitals
and reserves the right to recall the offer without assigning any reason whatsoever.
16.
The PGMT, BSNL, Kalyan reserves the right of recommending one or more hospitals
in the area as he may think fit for approval.
17.
Late submission of offer form: The offer received after due date & time, will not be
accepted.
18.
The offer form is available on web site
http://www.maharashtra.bsnl.co.in/ssa/kalyan
19.
The successful bidder has to undergo an agreement as per Annexure-A
20.
ARBITRATION
20.1 In the event of any question, dispute or difference arising under the agreement or in
connection with (except as to the matters, the decision to which specifically provided
under the agreement), the same shall be referred to the sole arbitration of the
CGM,MH Circle BSNL,MUMBAI or in case his designation is changed or his office is
abolished, then in such cases to the sole arbitration of the officer for the time being
entrusted (whether in addition to his own duties or otherwise) with the functions of
the CGM,MH Circle BSNL,MUMBAI or by whatever designation such an officer may
be called (hereinafter referred to as the said officer), and if the CGM or the said
officer is unable or unwilling to act as such, then to the sole arbitration of some other
person appointed by the CGM,MH Circle BSNL, MUMBAI or the said officer. The
agreement to appoint an arbitrator will be in accordance with the Arbitration and
conciliation Act 1996. There will be no objection to any such appointment on the
ground that the arbitrator is a Government Servant or that he has to deal with the
matter to which the agreement relates or that in the course of his duties as a
Government Servant he has expressed his views on all or any of the matters in
dispute. The award of the arbitrator shall be final and binding on both the parties to
the agreement. In the event of such an arbitrator to whom the matter is originally
referred, being transferred or vacating his office or being unable to act for any reason
whatsoever, the CGM, MH Circle BSNL, MUMBAI or the said officer shall appoint
another person to act as an arbitrator in accordance with terms of the agreement and
the person so appointed shall be entitled to proceed from the stage at which it was
left out by his predecessors.
20.2 The arbitrator may from time to time with the consent of both the parties enlarge the
time frame for making and publishing the award. Subject to the aforesaid, Arbitration
and Conciliation Act, 1996 and the rules made there under, any modification thereof
for the time being in force shall be deemed to apply to the arbitration proceeding
under this clause.
20.3 The venue of the arbitration proceeding shall be the office of the
CGM,MH Circle BSNL, Mumbai or such other place as the arbitrator may
decide.
END OF PART-I
PART II
Scope of Work & Specifications
A.
Scope of Work:
The BSNL Kalyan desires to empanel the hospitals for giving indoor treatment to BSNL
employees & their dependent family members.
The hospital should entertain the patient on production of Authorization letter issued by
Competent authority, O/o PGMT, BSNL, Kalyan and immediate medical treatment
should be given without insisting for any advance payment.
Admission sought by the patients after office hours or on Sundays, Holidays & in case
of Emergency may be permitted on the basis of valid BSNL MRS Card.The BSNL MRS
Card should contains name and photograph of patient being admitted and should be
valid on the date of treatment. Hospital shall insist to produce authorization letter on
next working day. In such cases the hospital may issue a certificate about the
emergency condition of the patient and send the same along with the monthly bill.
The Hospital shall agree at rates for treatment are at par with approved rates of CGHS
Mumbai. The change if any in the rates of CGHS Mumbai during the period of
agreement shall be accepted from the date of change in rates of CGHS, Mumbai.
The hospital should supply all medicines/clinical material and any other material
required for treatment of the patient.
“During indoor treatment of the BSNL persons covered under the BSNL MR scheme,
the hospital shall not ask the eligible person to purchase medicines from outside, but
will have to be arranged and provided by the Hospital itself as a package deal, at the
approved rate by the CGHS vide G.O.I. Ministry of Health & Family Welfare, New Delhi
in their letter No. F.No.S.11011/23/2009-CGHS-D.II/Hospital Cell /Part I dated
28/08/2011& as amended from time to time which includes the cost of drugs, surgical
instruments and other medicines etc.
“During in-patient treatment “Any liability on account of default or negligence on the part
of the Hospital in providing or performing the medical services, arises, the Hospital shall
be fully responsible for such deficiency of service and the BSNL will no way be
responsible for the same.
The agreement shall remain in force for a period of two years from the date of
execution by both parties or finalization of new panel which ever is earlier.
The agreement shall be extendable on its expiry by consent of both the parties.
B: PROCEDURE FOR INDOOR TREATMENT
1)
2)
3)
4)
5)
6)
All the serving, retired and voluntary retired employee registered under BSNLMRS and his/her
dependents are eligible for treatment in recognized hospitals/nursing homes at the approved
rates at all hospitals recognized from time to time by the management.
Medical card shall be issued to all the serving and retired and voluntary retired employee
registered under BSNLMRS.
The BSNL empanelled hospital shall entertain the patient provisionally on production of
Medical card/Authorization letter issued by BSNL
An employee should intimate regarding his/her serious illness needing hospitalization to the
section dealing with medical policy implementation. A letter of Authorization shall be issued to
the hospital concerned by the Competent authority.
Copy of the Authorization letter issued by competent authority shall be given to the nodal
officer appointed by BSNL for verification of genuineness
After completion of treatment and discharge of patient, hospital shall send the bill to concern
Account Officer(Claim) of BSNL for payment.
Following documents are necessary along with the bill submitted for payment.
a) Admission/ Discharge letter/Card in which date and time of admission and Discharge of
patient should be clearly mentioned.
b) Original Authorization letter issued by BSNL.
c) Bill showing complete details of treatment given, Pathological charges, details of
medicine and their prices.
d) Form D-I duly signed by concern doctor.
e) Verification certificate issued by nodal officer of BSNL.
f) Xerox copy of Medical Card issued by BSNL with encircle to the photo of patient availed
indoor treatment.
7)
8)
Admission sought by patient on Sundays, Holidays,after office hours or in case of emergency
may be permitted by the hospital on the basis of Identity Card/Medical Card issued by BSNL.
In such cases patient should produce Authorization Certificate on next working day.
Authorization Letter issued is valid by ten days. For prolonged treatment the Hospital should
letter to Authority to issue authorization letter for continuation of treatment
END OF PART-II
PART – III
SCHEDULE FOR QUOTING RATES
NO. KYN/ADMIN/HE/13-14/6
DATED AT KALYAN THE 05/10/2013
(Please Read Part-I and Part-II Carefully before Quoting the Rates in Part-III)
The opinion of hospital should be as follows.
Agreed as per CGHS schedule rates approved by Government of India, Ministry of Health and
Family Welfare, New Delhi in their letter No S.11011/23/2009-CGHS D.II/ Hospital cell /part I Dated
28/08/2011.issued from time to time for CGHS, Mumbai.
At present CGHS SCHEDULE OF RATES are available as given below.
Approved by G.O.I., Ministry of Health & Family Welfare, New Delhi in their letter No.
.S.11011/23/2009-CGHS D.II/Hospital cell/Part I dated. 28/08/2011 .issued from time to time for
CGHS, Mumbai
No.S.11011/232009-CGHS D.II/Hospital Cell /Part I dt
8/08/2011
CORRECTED CGHS MUMBAI RATES FOR
HOSPITALS
NAME OF INVESTIGATION / TREATMENT
PROCEDURE
Rate for NABH
Rate for Non
Rate for Super Spl
Hospit
NABH Hospit
Hospit.
293
104
173
230
460
575
575
633
633
920
920
230
115
230
1380
288
460
460
144
518
1035
575
255
90
150
200
400
500
500
550
550
800
800
200
100
200
1200
250
400
400
125
450
900
500
345
345
345
575
575
575
575
575
403
300
500
500
500
500
500
350
230
81
173
1150
1150
200
70
150
1000
1000
30
31
32
33
34
OPD Procedures
Consultation OPD
Consultation- for Inpatients
Dressings of wounds
Suturing of wounds with local anesthesia
Aspiration Plural Effusion - Diagnostic
Aspiration Plural Effusion - Therapeutic
Abdomil Aspiration - Diagnostic
Abdomil Aspiration - Therapeutic
Pericardial Aspiration
Joints Aspiration
Biopsy Skin
Removal of Stitches
Venesection
Phimosis Under LA
Sterl puncture
Injection for Haemorrhoids
Injection for Varicose Veins
Catheterisation
Dilatation of Urethra
Incision & Draige
Interal Draige
Peritoneal dialysis
Skin
Excision of Moles
Excision of Warts
Excision of Molluscumcontagiosum
Excision of Veneral Warts
Excision of Corns
I/D Injection Keloid of Acne
Chemical Cautery (s)
Opthalmology
Subconjunctival/subtenon’s injections in one eyes
Subconjunctival/subtenon’s injections in both eyes
Pterygium surgeries
Conjunctival peritomy
Conjunctival wound repair or exploration following blunt trauma
35
36
Removal of corneal foreign body
Cauterization of ulcer/subconjunctival injection in one eye
345
173
300
150
37
Cauterization of ulcer/subconjunctival injection in both eyes
86
75
38
39
40
Corneal grafting—Penetrating keratoplasty
Corneal grafting—Lamellar keratoplasty
Cyanoacrylate /fibrin glue application for corneal perforation
173
16100
5750
150
14000
5000
41
42
Bandage contact lenses for corneal perforation
Scleral grafting or conjunctival flap for corneal perforation
575
575
500
500
43
Keratoconus correction with therapeutic contact lenses
3450
3000
44
45
46
47
48
49
UV radiation for cross-linking for keratoconus
EDTA for band shaped keratopathy
Arcuate keratotomy for astigmatism
Re-suturing (Primary suturing) of corneal wound
Penetrating keratoplasty ---- with glaucoma surgery
Penetrating keratoplasty --- with vitrectomy
2875
2300
345
2300
3450
23000
2500
2000
300
2000
3000
20000
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
50
51
52
53
23000
16100
17250
23000
20000
14000
15000
20000
17250
3450
1150
2300
4600
15000
3000
1000
2000
4000
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Penetrating keratoplasty ---- with IOL implantation
DALK- Deep anterior lamellar keratoplasty
Keratoprosthesis stage I and II
DSAEK- Descemet’s stripping automated endothelial
keratoplasty
ALTK- Automated lamellar therapeutic keratoplasty
Probing and Syringing of lacrimal sac- in one eye
Probing and Syringing of lacrimal sac- in both eye
Dacryocystorhinostomy—Plain
Dacryocystorhinostomy—Plain with intubation, and/or with
lacrimal implants
Dacryocystorhinostomy—conjunctival with implant
Caliculoplasty
Dacryocystectomy
Punctal plugs for dry eyes
Refraction
Indirect ophthalmoscopy
Orthoptic check-up- with synoptophore
Lees’ charting or Hess’ charting
Orthoptic exercises
Pleoptic exercises
Perimetry/field test—Goldman
Perimetry/field test— automated
Fluorescein angiography for fundus or iris
Ultrasound A- Scan
Ultrasound B- Scan
Indocyanin green angiography
Corneal endothelial cell count with specular micropscopy
9200
6900
4025
4600
288
58
92
173
575
144
173
345
863
345
230
345
1725
8000
6000
3500
4000
250
50
80
150
500
125
150
300
750
300
200
300
1500
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
Corneal topography
Corneal pachymetry
Auto-refraction
Macular function tests
Potential acuity metry
Laser interferometry
OCT- Optical coherence tomography
HRT- Heidelberg’s retinal tomogram
GDX--- Nerve fibre layer alyzer
UBM- Ultrasound biomicroscopy
Non Contact tonometry
IOP measurement with schiotz
IOP measurement with applation tonometry
Three mirror examition for reti
90 D lens examition
Gonioscopy
Chalazion incision and curettage in one eye
Chalazion incision and curettage in both eyes
Ptosis surgery with fasanella servat procedure
Ptosis surgery with LPS resection
Ptosis surgery with Sling surgery
Ectropion surgery- one lid
Ectropion surgery- both lids
Epicanthus correction
Cantholysis and canthotomy
Entropion surgery- one lid
Entropion surgery- both lids
Taorraphy
Suturing of lid lacerations
Lid retraction repair
Concretions removal
Bucket handle procedure for lid tumo
403
345
230
44
173
345
345
1438
2300
2300
230
58
35
58
115
115
115
431
460
6670
6670
5750
5175
5750
2300
2300
4600
2300
2300
4600
575
58
350
300
200
38
150
300
300
1250
2000
2000
200
50
30
50
100
100
100
375
400
5800
5800
5000
4500
5000
2000
2000
4000
2000
2000
4000
500
50
54
55
56
57
58
108
Cheek rotation flap for lid tumo
9200
8000
109
110
111
Orbitotomy
Enucleation
Enucleation with orbital implants and artificial prosthesis
11500
9200
5175
10000
8000
4500
112
113
Evisceration
Evisceration with orbital implants and artificial prosthesis
6900
6900
6000
6000
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
Telecanthus correction
Orbital decompression
Exenteration
Exenteration with skin grafting
Fracture orbital repair
Retinal laser procedures
retinal detachment surgery
retinal detachment surgery with scleral buckling
Buckle removal
Silicone oil removal
Anterior retinal cryopexy
Squint correction for one eye
Squint correction for both eyes
Trabeculectomy
Trabeculotomy
Trabeculectomy with Trabeculotomy
Trephition
Goniotomy
Glaucoma surgery with Glaucoma valves
Cyclocryotherapy
YAG laser iridotomy
YAG laser capsulotomy
ALT-Argon laser trabeculoplasty
PDT-Photodymic therapy
TTT- Transpupillary thermal therapy
PTK- Phototherapeutic keratectomy
Argon/diode laser for reti
Intralase application for keratoconus
EOG- electro-oculogram
ERG- Electrio-retinogram
VEP- visually evoked potential
Vitrectomy- pa pla
Intravitreal injections- of antibiotics
Intravitreal injections- of avastin
Intravitreal injections- of lucentis
X- Ray orbit
CT-orbit and brain
MRI- Orbit and brain
Dacryocystography
Orbital angio-graphical studies
ECCE with IOL
SICS with IOL
Phaco with foldable IOL (silicone and acrylic)/PMMA IOL
9200
9200
17250
17250
23000
2300
1725
17250
9200
3450
3450
3450
7475
11500
9200
6900
16100
3450
5750
4600
2300
1725
1495
2300
17250
3450
2300
920
920
1079
827
2300
3450
2300
4600
5750
213
2760
3450
1725
5750
5750
10781
8000
8000
15000
15000
20000
2000
1500
15000
8000
3000
3000
3000
6500
10000
8000
6000
14000
3000
5000
4000
2000
1500
1300
2000
15000
3000
2000
800
800
938
719
2000
3000
2000
4000
5000
185
2400
3000
1500
5000
5000
9375
157
158
Pa pla lensectomy with/without IOL
Secondary IOL implantation- AC IOL, PC IOL or scleral
fixated IOL
Cataract extraction with IOL with capsular tension rings
(Cionni’s ring)
Optic nerve sheathotomy
Iridodialysis repair or papillary reconstruction
Iris cyst removal
Lid Abscess incision and draige
10350
8050
9000
7000
8050
7000
2875
9200
4600
920
2500
8000
4000
800
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
Orbital Abscess incision and draige
Biopsy
Paracentesis
Scleral graft for scleral melting or perforation
Amniotic membrane grafting
Cyclodiathermy
Intraocular foreign body removal
Electrolysis
Perforating injury repair
Botulinum injection for blepharospasm or squint
Dental Procedures
Flap Operation per quadrant
Gingivectomy per quadrant
Reduction & immobilasation of fracture- Maxilla Under
LA
Reduction & immobilasation of fracture-Mandible Under
LA
splints/Cirucum mandibular wiring under LA
splints/Cirucum mandibular wiring under GA
Interl wire fixation/plate fixation of Maxilla under LA
Interl wire fixation/plate fixation of Maxilla under GA
Interl wire fixation/plate fixation of Mandible under LA
Interl wire fixation/plate fixation of Mandible under GA
575
3450
1150
345
1840
5750
5750
345
1725
4025
500
3000
1000
300
1600
5000
5000
300
1500
3500
414
1397
840
360
1215
730
6900
6000
8050
23000
23000
28750
28750
28750
7000
20000
20000
25000
25000
25000
184
185
186
187
Extraction per tooth under LA
Complicated Ext. per Tooth under LA
Extraction of impacted tooth under LA
Extraction in mentally retarded/patients with systemic
diseases/patient with special needs under short term GA
173
173
575
1725
150
150
500
1500
188
Cyst & tumour of Maxilla /mandible by
4600
4000
2875
2500
3450
3000
5750
6900
430
5693
20700
17250
20700
17250
24725
23000
18400
14950
5000
6000
374
4950
18000
15000
18000
15000
21500
20000
16000
13000
1725
1500
1035
1495
920
1380
1035
345
900
1300
800
1200
900
300
174
175
176
177
178
179
180
181
182
183
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
enucleation/excision/maupalisation upto 4 cms under LA
Cyst & tumour of Maxilla/mandible by
enucleation/excision/maupalisation size more than 4 cms
under LA
Cyst & tumour of Maxilla/mandible by
enucleation/excision/maupalisation size more than 4 cms under
GA
TM joint ankylosis- under GA
Biopsy Intraoral-Soft tissue
Biopsy Intraoral-Bone
Hemi-mandibulectomy
Hemi-mandibulectomy without graft
Segmental-mandibulectomy
Segmental-mandibulectomy without graft
Maxillectomy- Total
Maxillectomy- Total
Maxillectomy- partial
Maxillectomy- partial
renalease of fibrous bands & grafting -in (OSMF)
treatment under GA
Pre-prosthetic surgery- Alveoloplasty
Pre-prosthetic surgery - ridge augmentation
Root cal Treatment(RCT) Anterior teeth
Root cal Treatment(RCT) Posterior teeth
Apicoectomy- Single root
Apicoectomy-Multiple roots
Metal Crown-per unit
Metal crown with Acrylic facing per unit
Complete single denture-metal based
212
213
214
Complete denture- acrylic based per arch
Removable partial denture-Metal based-upto 3 teeth
Removable partial denture-Metal based-more than 3 teeth
14950
6900
6900
13000
6000
6000
215
216
Removable partial denture-Acrylic based-upto 3 teeth
Removable partial denture-Acrylic based-more than 3 teeth
6900
6900
6000
6000
217
218
219
220
221
222
223
224
225
226
227
228
Amalgum restoration-per tooth
Composite Restoration-per tooth-anterior tooth
Glas Ionomer-per tooth
Scaling & polishing
Removable Orthodontics appliance- per Arch
Fixed Orhtodontics-per Arch
Space maintaine-Fixed
Habit breaking appliances-removable
Habit breaking appliances-Fixed
Expansion plate
Feeding appliance for cleft palate
Maxillo-facial prosthesis (sal/auricular/orbital/facial lost part)
690
288
518
288
518
1840
13800
1150
4025
7475
3450
4025
600
250
450
250
450
1600
12000
1000
3500
6500
3000
3500
229
230
231
Functiol orthodentic appliances
Obturator (Maxillo-facial)
Occlusal night guard(splint)
E.N.T.,Head and Neck
ENT
Pure Tone Audiogram
Impedence with stepedeal reflex
SISI, Tone Decay
Multiple hearing assessment test to Adults
Speech Discrimition Score
Speech Assessment
Speech therapy per session of 30-40 minutes
Cold Calorie Test for Vestibular function
Removal of foreign body From Nose
Removal of foreign body From Ear
Syringing (Ear)
Polyp removal under LA
Polyp removal under GA
Peritonsillar abscess draige under LA
Myringoplasty
Staepedectomy
Myringotomy with Grommet insertion
Tympanotomy
Tympanoplasty
Mastoidectomy
Otoplasty
Labyrinthectomy
Skull Base surgery
Facial Nerve Decompression
Septoplasty
Submucous Resection
Septo-rhinoplasty
Rhinoplasty- Non-cosmetic
Fracture Reduction
Intra sal Diathermy
Turbinectomy
Endoscopic DCR
Endoscopic Surgery
Septal Perf. Repair
Antrum Puncture
Lateral Rhinotomy
4025
3450
3500
3000
230
403
403
403
604
138
230
138
230
460
460
230
978
2070
1380
4025
11615
4600
11500
17250
19550
20125
17250
33350
25300
11500
8625
20125
19550
8050
2875
7475
15525
16100
16100
1150
200
350
350
350
525
120
200
120
200
400
400
200
850
1800
1200
3500
10100
4000
10000
15000
17000
17500
15000
29000
22000
10000
7500
17500
17000
7000
2500
6500
13500
14000
14000
1000
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
Cranio-facial resection
Caldwell Luc Surgery
Angiofibroma Excision
Endoscopic Hypophysectomy
Endoscopic Optic Nerve Decompression
Decompression of Orbit
Punch/Wedge biopsy
Tonsillectomy
Uvulo-palatoplasty
FESS for antrochoal polyp
FESS for ethmoidal polyp
Polyp removal ear
Polyp removal Nose(Septal polyp)
Mastoidectomy plus Ossciculoplasty including TORP or
PORP
Endolymphatic sac decompression
Diagnostic sal endoscopy under GA
Yonges operation for Atrophic rhinitis
Vidian neurectomy for vasomotor Rhinitis
sal Packing-anterior
sal Packing-posterior
Ranula Excision
Tongue Tie excision
Sub Mandibular Duct Lithotomy
Adenoidectomy
Palatopharyngoplasty
Cleft Palate repair
Pharyngoplasty
Styloidectomy
Direct laryngoscopy including Biopsy under GA
oesophagoscopy/foreign body removal from
Bronchoscopy with F.B.removal
Head and Neck
Ear Lobe Repair one side
Excision of Pin for Growth (Squamous/Basal/ Injuries) Skin
Only
Excision of Pin for Growth (Squamous/Basal/ Injuries) Skin and
Cartilage
Partial Amputation of Pin
Total Amputation of Pin
Total Amputation & Excision of Exterl Auditory Meatus
Excision of Cystic Hygroma
Excision of Cystic Hygroma Extensive
Excision of Branchial Cyst
Excision of Branchial Sinus
Excision of Pharyngeal Diverticulum
Excision of Carotid Body-Tumou
Operation for Cervical Rib
Block Dissection of Cervical Lymph Nodes
Pharyngectomy & Reconstruction
Operation for Carcinoma Lip - Wedge-Excision
Operation for Carcinoma Lip - Vermilionectomy
Operation for Carcinoma Lip - Wedge Excision and
Vermilonectomy
Estlander Operation
Abbe Operation
Cheek Advancement
Excision of the Maxilla
Excision of mandible-segmental
Mandibulectomy
1725
35650
12650
24725
40250
40250
32200
5750
13800
28750
25300
28750
13800
13800
1500
31000
11000
21500
35000
35000
28000
5000
12000
25000
22000
25000
12000
12000
46000
34500
13225
17250
23000
3450
5750
9775
3450
6900
8050
at S. No.
1028
20700
20700
15525
17250
23000
40000
30000
11500
15000
20000
3000
5000
8500
3000
6000
7000
566
690
492
600
4370
3800
5175
7130
9200
4500
6200
8000
12075
8625
14375
11615
10465
11615
23926
17653
23230
36007
9758
9292
10500
7500
12500
10100
9100
10100
20805
15350
20200
31310
8485
8080
10465
9200
10465
11615
22304
20125
9100
8000
9100
10100
19395
17500
18000
18000
13500
15000
20000
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
Partial Glossectomy
Hemiglossectomy
Total Glossectomy
Commondo Operation
Parotidectomy - Superficial
Parotidectomy - Total
Parotidectomy - Radical
Repair of Parotid Duct
Removal of Submandibular Salivary gland
Hemithyroidectomy
Partial Thyroidectomy (lobectomy)
Subtotal Thyroidectomy
Total Thyroidectomy
Resection Enucleation of thyroid Adenoma
Total Thyroidectomy and Block Dissection
Excision of Lingual Thyroid
Excision of Thyroglossal Cyst/Fistula
Excision of Parathyroid Adenoma/Carcinoma
Laryngectomy
Laryngo Pharyngectomy
Hyoid Suspension
Genioplasty
Direct Laryngoscopy including biopsy under GA
Phonosurgery
Fibroptic examition of Larynx under LA
Microlaryngeal Surgery
Laryngofissure
Tracheal Stenosis Excision
Head and neck cancer
Excisiol Biopsies
Benign Tumour Excisions
Temporal Bone subtotal resection
Modified Radical Neck Dissection
Carotid Body Excision
Total Laryngectomy
Flap Reconstructive Surgery
Parapharyngeal Tumour Excision
Breast
Draige of abscess
Excision of lumps
Local mastectomy-simple
Radical mastectomy-formal or modified.
Excision of mammary fistula
Segmental resection of breast
General surgery
Injury Of Superficial Soft Tissues
Suturing of small wounds
Secondary suture of wounds
Debridement of wounds
Removal Of Foreign Bodies
Biopsies
Excision Cervical Lymph Node
Excision Axillary Lymph Node
Excision of Inguil Lymph Node
Excision Biopsy of Ulce
Excision Biopsy of Superficial Lumps
Incision Biopsy of Growths/Ulce
Trucut Needle Biopsy
Percutaneous Kidney Biopsy
Marrow Biopsy (Open)
Muscle Biopsy
22425
6900
13938
26019
29900
23000
29900
29900
21850
10925
17250
16100
21850
27600
12777
36800
26019
11615
25553
32200
42976
13800
At S.No.296
7475
19550
11500
13800
24150
19500
6000
12120
22625
26000
20000
26000
26000
19000
9500
15000
14000
19000
24000
11110
32000
22625
10100
22220
28000
37370
12000
11270
4313
13800
28750
28750
46000
25300
23000
23000
20125
6969
10465
17825
29038
17423
9800
3750
12000
25000
25000
40000
22000
20000
20000
17500
6060
9100
15500
25250
15150
269
345
575
633
234
300
500
550
2277
2530
2933
2933
4370
4428
2530
2530
2703
2645
1980
2200
2550
2550
3800
3850
2200
2200
2350
2300
6500
17000
10000
12000
21000
380
381
382
383
384
385
386
387
388
2645
2875
2070
2875
3450
3450
13800
19550
5118
2300
2500
1800
2500
3000
3000
12000
17000
4450
25300
22000
390
Scalene Node Biopsy
Excision of Sebaceous Cysts
Excision of Superficial Lipoma
Excision of Superficial Neurofibroma
Excision of Dermoid Cysts
Haemorrhoidectomy
Stapler haemorrhoidectomy
keloid excision
Vericose vein surgery;Tendelenburg operation with suturing or
ligation.
Oesophagus
Atresia of Oesophagus and Tracheo Oesophageal
Fistula
Operations for Replacement of Oesophagus by Colon
29273
25455
391
392
393
394
395
396
397
398
Oesophagectomy for Carcinoma Easophagus
Oesophageal Intubation (Mausseau Barbin Tube)
Achalasia Cardia Transthoracic
Achalasia Cardia Abdomil
Oesophago Gastrectomy for mid 1/3 lesion
Heller’s Operation
Colon-Inter position or Replacement of Oesophagus
Oesophago Gastrectomy – Lower Corringe procedure
35075
35075
14870
17250
14640
34500
27600
12650
30500
30500
12930
15000
12730
30000
24000
11000
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
Abdomen
Gastroscopy
Gastric & Duodel Biopsy (Endoscopic)
Pyloromyotomy
Gastrostomy
Simple Closure of Perforated peptic Ulcer
Vagotomy Pyleroplasty / Gastro Jejunostomy
Duodenojejunostomy
Partial/Subtotal Gastrectomy for Carcinoma
Partial/Subtotal Gastrectomy for Ulcer
Operation for Bleeding Peptic Ulcer
Gastrojejunostomy & Vagotomy
Operation for Gastrojejul Ulcer
Total Gastrectomy for Cancer
Highly Selective Vagotomy
Selective Vagotomy & Draige
Congenital Diaphragmatic Hernia
Hiatus Hernia Repair- Abdomil
Hiatus Hernia Repair- Transthoracic
Exploratory Laparotomy
Epigastric Hernia Repair
Umbilical Hernia Repair
Ventral /incisiol Hernia Repair
Inguil Hernia Herniorraphy
Inguil Hernia - Hernioplasty
Femoral Hernia Repair
Rare Hernias Repair (Spigalion, Obturator, Lumbar, Sciatic)
2243
2530
3163
12075
12650
14950
17825
26450
29900
29900
26450
26450
26450
27600
26450
18400
21062
21062
21062
17250
16100
16100
18400
18975
23575
18975
1950
2200
2750
10500
11000
13000
15500
23000
26000
26000
23000
23000
23000
24000
23000
16000
18315
18315
18315
15000
14000
14000
16000
16500
20500
16500
22425
27600
27600
32200
37375
19500
24000
24000
28000
32500
33350
41400
41400
29000
36000
36000
389
425
426
427
428
429
430
431
432
Splenectomy - For Trauma
Splenectomy - For Hypeplenism
Splenorenal Astomosis
Portocaval Astomosis
Direct Operation on Oesophagus for Portal
Hypertension
Mesentericocaval Astomosis
Warren Shunt
Pancerato Duodenectomy
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
By Pass Procedure for Inoperable Carcinoma of
Pancreas
Cystojejunostomy or Cystogastrostomy
Cholecystectomy
Cholecystectomy & Exploration of CBD
Repair of CBD
Operation for Hydatid Cyst of Liver
Cholecystostomy
Hepatic Resections (Lobectomy /Hepatectomy)
Operation on Adrenal Glands - Bilateral
Operation on Adrenal Glands - Unilateral for Tumour
Appendicectomy
Appendicular Abscess – Draige
Mesenteric Cyst- Excision
Peritonioscopy/Laparoscopy
Jejunostomy
Ileostomy
Resection & Astomosis of Small Intestine
Duodel Diverticulum
Operation for Intestil Obstruction
Operation for Intestil perforation
Benign Tumou of Small Intestine
Excision of Small Intestine Fistual
Operations for Haemorrhage of Small Intestines
Operations of the Duplication of the Intestines
Operations for Recurrent Intestil Obstruction (Noble
Plication & Other Operations for Adhesions)
Ilieosigmoidostomy
Ilieotransvee Colostomy
Caeomy
Loop Colostomy Transvee Sigmoid
Termil Colostomy
Closure of Colostomy
Right Hemi-Colectomy
Left Hemi-Colectomy
Total Colectomy
Operations for Volvulus of Large Bowel
Operations for Sigmoid Diverticulitis
Fissure in Ano with interl sphinctrectomy with fissurectomy.
41400
36000
29900
27600
19550
25300
24150
25300
19550
27600
31625
21275
21275
14375
15813
6900
18400
27025
27025
27025
27600
27600
26163
25875
28750
32200
26000
24000
17000
22000
21000
22000
17000
24000
27500
18500
18500
12500
13750
6000
16000
23500
23500
23500
24000
24000
22750
22500
25000
28000
32200
27025
27025
5750
20125
25875
27025
27025
27025
27025
31625
27025
28000
23500
23500
5000
17500
22500
23500
23500
23500
23500
27500
23500
Fissure in Ano - Fissurectomy
Rectal Polyp-Excision
Operation of Haemorrhoids -Lords procedure
Fistula in Ano - High Fistulectomy
Fistula in Ano - Low Fistulectomy
Prolapse Rectum - Theirch Wiring
Prolapse Rectum - Rectopexy
Prolapse Rectum - Grahams Operation
Operations for Hichsprungs Disease
Excision of Pilonidal Sinus
Abdomino-Perineal Excision of Rectum
Anterior Resection of rectum
Pull Through Abdomil Resection
Operations for Neuroblastoma
ICU/CCU procedures (Special Care Cases)
Corory Care with Cardiac Monitoring including ECG & Diet
9200
18400
7475
9775
22425
13800
14375
10925
27600
20125
17250
29900
29900
27600
8000
16000
6500
8500
19500
12000
12500
9500
24000
17500
15000
26000
26000
24000
3715
3230
4370
Compressed air / piped oxygen
Ventilator charges
Paediatric care for New born per day
Incubator charges (Per day)
Neotal ICU charges (Per day)
Resuscitation
Exchange Transfusion
Pneupack ventilator in Nuery (Per day)
Cardiovascular and cardiac surgery & investigations
2875
115
1380
1380
575
978
288
345
2500
100
1200
1200
500
850
250
300
1300
265
1795
1200
1795
880
880
1200
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
ASD Closure
VSD
TOF/TAPVC/TCPC/REV/VSOV repair
V.D.Glenn/Left atrium myxoma
Senning/ASO
DSO
AV Cal repair
Fonten
Conduit repair
CABG
CABG + IABP
CABG +I valve.
Asending aorta replacement
DVR
MVR/AVR
MV repair + AV repair
Aorta femoral bypass
B.T Shunt/Coaractation
P.A.Banding septostomy
Pericardictomy
CMV/PDA
CABG without bypass.
Gunshot injury
Heart transplant
Balloon corory angioplasty/PTCA
Intra corory stenting
Direct stenting
Directiol atherectomy
Rotablation
balloon valvotomy/PTMC
CART
CATH
Coaractation dilatation
Permanent pacemaker implantation-VVI
Permanent pacemaker implantation- DDD
Permanent pacemaker implantation Biventricular
AICD implantation
Combo device implantation
Electrophysiological studies.
Endomyocardial biopsy
IABP
Intra vascular coils one coil( additiol coil charges extra)
196650
161000
155250
155250
57500
86250
57500
86250
28750
28750
184000
184000
184000
201250
184000
161000
95450
70150
69000
13800
57500
57500
86250
69000
127650
57500
115000
103500
46000
46000
18400
13800
17250
28750
69000
74750
103500
132250
25300
46000
28750
57500
167153
140000
125000
100000
50000
75000
50000
75000
25000
25000
150000
160000
160000
125000
125000
125000
95450
61000
60000
12000
50000
50000
75000
60000
127650
50000
100000
90000
40000
46000
18400
13800
15000
25000
50600
65000
90000
115000
25300
40000
25000
50000
196650
161000
155250
155250
57500
86250
57500
86250
28750
28750
184000
184000
184000
201250
184000
161000
95450
70150
69000
13800
57500
57500
86250
69000
127650
57500
115000
103500
46000
46000
18400
13800
17250
28750
69000
74750
103500
132250
25300
46000
28750
57500
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
R.F.ablation
Septostomy
AVBD/PVBD
Digital substraction angiography-Pheripheral artery
Digital substraction angiography- venogram
Venous DSA
C.T Guided biopsy
Sinogram
Cine -Barium
CT guided PTA
DSA + PTA
Embolisation
IVUS
Vascular stent
Aortic stent graft for aortic aneurysm
IVC Filter
ASD/VSD/PDA closure device
ECG
43700
50000
40000
16100
12000
10000
10000
3000
3000
4500
7000
6000
8000
15000
50000
41400
43700
80500
57500
46000
18515
13800
11500
11500
3450
3450
5175
8050
6900
9200
17250
57500
47610
57500
553
TMT
554
555
echocardiography echo adultHolter alysis
TEE(Transoesophageal echo
80500
57500
46000
18515
13800
11500
11500
3450
3450
5175
8050
6900
9200
17250
57500
47610
57500
Listed under
Investigations
Listed under
Investigations
920
1455
800
1265
1725
1455
556
557
558
559
560
561
562
563
564
Stress Echo -erercise
Stress Echo- Dobutamine
Stress Thallium - exrercise
Stress Thallium - pharmacological
Corory angiography
CT corory angiography
Cardiac CT scan
Cardiac MRI
MR angiography.
Obstetrics and Gyecology
Normal delivery or with Episiotomy & P. repair
vaccum delivery
Low Forceps
Low midcavity forceps
Cesarean Section
Cesarean Hysterectomy
Rupture Uterus, closure & repair with Tubal Ligation
Perforation of Uterus after D/E ,Laparotomy & Closure
1455
1455
2300
2875
8625
10120
10120
3450
6900
1265
1265
2000
2500
7500
8800
8800
3000
6000
8625
12075
16100
13225
13225
26450
26450
26450
7500
10500
14000
11500
11500
23000
23000
23000
20700
20700
15525
8050
14950
18975
18975
17825
28750
31625
9775
18000
18000
13500
7000
13000
16500
16500
15500
25000
27500
8500
13800
12000
585
586
587
Laparotomy for Ectopic Rupture
Laparotomy-peritonitis Lavage and Draige
Laparotomy-failed laparoscopy to explore
Salphingectomy
Salphingo-Oophorectomy
Ovarean Cystectomy-laparoscopic.
Ovarean Cystectomy -laparotomy.
Ophorectomy-laparoscopic
Oophorectomy-laparotomy
Broad Ligment Haemotoma Draige
Exploration of perineal Haematoma & Resuturing of
Episiotomy
Exploration of abdomil Haematoma (after laparotomy +
LUCS)
Interl podalic veion and breech extraction
Manual Removal of Placenta
3rd stage Complication from extra-institutiol delivery etc
2553
6325
4600
2220
5500
4000
588
589
590
591
592
593
594
595
Examition under aesthesia
But-abdomen Repair
Gaping Pareneal Wound Secondary Suturing
Gaping abdomil wound Secondary Suturing
Complete perineal tear-repair
Exploration of PPH-tear repair
Destructive Operation
Suction evacuation vesicular mole, Missed abortion D/E
6325
2875
15525
2300
4600
4600
5980
14375
5500
2500
13500
2000
4000
4000
5200
12500
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
Colpotomy-draige P/V needling EUA
Repair of post-coital tear, perineal injury
Excision of urethral caruncle
Shirodhkar, Mc. Dolds stich
Abdomil Hysterectomy
Vagil Hysterectomy
Myomectomy -laparotomy
Myomectomy -laparoscopic
Vaginoplasty
Laparotomy for Ectopic Pregncy
Vulvectomy -Simple
Vulvectomy-Radical
RVF Repair
Manchester Operations
Perineorrhaphy
Colporrhaphy with mesh.
Colporrhaphy without mesh.
Enterocoel repair
Shirodkar’s sling Operation or other sling operations for
prolapse uterus
8050
5750
5463
5175
2300
3450
23575
20125
23000
23000
20700
29325
34500
29325
20700
20700
25300
20700
14950
7000
5000
4750
4500
2000
3000
20500
17500
20000
20000
18000
25500
30000
25500
18000
18000
22000
18000
13000
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
1455
1455
2300
2875
8625
10120
10120
3450
6900
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
Laparoscopic sling operations for prolapse uterus
Diagnostic Curettage
Fractiol Curettage
D & C and Cervical Biopsy
Polypectomy
Other-Minor Operation Endometrial
Excision Vagil Cyst/Burtholin Cyst
Excision Vagil Septum
Laparoscopy -Diagnostic with chromopertubation
Laparoscopy Sterilisation
Laparoscopy Operative
Laparoscopy LAVH
Total lapacopic hysterectomy
Drilling of Overy
Laparascopic treatment of Ectopic pregncy- salpingectomy
23000
34500
4600
5175
5750
2875
5750
5750
5750
8050
8625
23000
39675
34500
21850
20000
30000
4000
4500
5000
2500
5000
5000
5000
7000
7500
20000
34500
30000
19000
630
631
632
633
634
Laparotomy treatment of Ectopic pregncy.
Conisation of cervix
Trachleorraphy of cervix for early CA cervix
Hysteroscopic cannulation
Laparotomy recannulation of Fellopian tubes- (Tubuloplasty)
48300
43700
30475
29900
17250
42000
38000
26500
26000
15000
635
Laparoscopic recannulation of Fellopian tubes- (Tubuloplasty)
34500
30000
636
637
638
639
640
641
642
Colposcopy
LEETZ(Large Loop Excision of Transformation Zone)
Loop Electro Surgical procedures.
Chorionic Villi sampling
Interventiol Ultrasonography
Amneocentosis
Karyotyping
34500
9200
28750
34500
17250
4600
Listed under
Investigations
30000
8000
25000
30000
15000
4000
643
644
645
646
647
648
649
650
651
652
653
654
655
Hysteroscopic endometrial ablation
Thermal ballon ablation.
Ultrasonographic myolysis
Laparoscopic cystectomy
Intra Uterine Insemition
ICSI
Anti Retroviral Therapy.
Laparotomy abdomil scaro-colpopexy
Laparotomy Vault suspension
Lapacopic abdomil scaro-colpopexy
Laparoscopic Vault suspension
Laparotomy radical Lymphedenectomy
Laparoscopic radical Lymphedenectomy
17250
28750
11500
34500
15000
25000
10000
30000
5750
11500
34500
34500
34500
34500
34500
5000
10000
30000
30000
30000
30000
30000
656
Pap smear
657
658
Endometrial aspiration cytology
Transvagil sonography (TVS for Follicular
monitioring,aspiration)
laparoscopic treatment for stress incontinence
Transvagil tubes for Stress incontinence
trans-obturator tubes for Stress incontinence
Interventiol radiographic arterial embolisation
Diagnosticcystoscopy
Staging laparotomy surgery for CA Overy
Interl Iliac ligation
stepwise devascularisation
Assisted breech delivery
Cordocentesis
Intra-uterine fetal blood transfusion
Hysteroscopy TCRE
Hysteroscopy Removal of IUCD
Hysteroscopy Removal of Septum
Hysteroscopy Diagnostic
Listed under
Investigations
633
11500
550
10000
690
34500
17250
17250
28750
5750
48300
35650
23000
21275
11500
600
30000
15000
15000
25000
5000
42000
31000
20000
18500
10000
20700
11500
15525
18000
10000
13500
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
12075
37950
6900
6900
7475
7475
5175
8625
2530
690
345
575
460
10500
33000
6000
6000
6500
6500
4500
7500
2200
600
300
500
400
64883
27025
32200
27025
32200
23000
28750
25300
56420
23500
28000
23500
28000
20000
25000
22000
695
Werthimas Hystrectomy for Cancer cervix
Sterilisation Post ertum
Sterilisation Intravagil
Abortion- D & C
Abortion- Evacuation
MTP- 1st Trimester
MTP - 2nd Trimester
Triple test
Quadriple test
Biophysical score
Fetal nuechal translucency
HPV testing
BLCG
Nephrology and urology.
Partial Nephrectomy -open
Partial Nephrectomy-laproscopic/endoscopic
Nephrolithomy -open
Nephrolithomy -laproscopic/endoscopic
Pyelolithotomy-open
Pyelolithotomy -laproscopic/endoscopic
Operations for Hydronephrosis -pyeloplasty open
Operations for Hydronephrosis -pyeloplasty
Lap/endoscopic
Operations for Hydronephrosis Endoplyelotomy antegrade
33350
29000
696
Operations for Hydronephrosis Endoplyelotomy retrograde
33350
29000
697
698
699
700
37950
37950
37950
14950
33000
33000
33000
13000
701
702
703
704
705
706
707
708
709
710
711
Operations for Hydronephrosis -ureterocaliomy
Operations for Hydronephrosis-Ileal ureter
Open Draige of Perinephric Abscess
Percutaneous Draige of Perinephric Abscess - Ultrasound
guided
Cavernostomy
Operations for Cyst of the Kidney -open
Operations for Cyst of the Kidney -Lap/endoscopic
Ureterolithotomy -open
Ureterolithotomy-Lap/Endoscopic
Nephroureterectomy open
Nephroureterectomy -Lap/Endoscopic
Operations for Ureter for -Double Urete
Operations for Ureter -for Ectopia of Single Ureter
Operations for Vesico- ureteric Reflux -Open
Operations for Vesico- ureteric Reflux-Lap/Endoscopic
34500
20700
18400
40114
17250
46000
17250
40057
28750
32200
36225
30000
18000
16000
34882
15000
40000
15000
34832
25000
28000
31500
712
Operations for Vesico- ureteric Reflux-with bulking agents
63250
55000
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
Ureterostomy - Cutaneous
Uretero-Colic astomosis
Formation of an Ileal Conduit
Ureteric Catheterisation
Biopsy of Bladder (Cystoscopic)
Diathermy Destruction of Bladder Neoplasm
Cysto-Litholapexy
Operations for Injuries of the Bladder
Suprapubic Draige (Cystostomy/vesiomy)
Simple Cystectomy
Diverticulectomy -open
Diverticulectomy- Lap/Endoscopic
Diverticulectomy -Endoscopic incision of neck
Augmentation Cystoplasty
Operations for Extrophy of the Bladder- Single stage repair
40057
23000
23000
23000
8625
8625
12650
26019
8775
11500
32200
31050
37950
37950
32775
34832
20000
20000
20000
7500
7500
11000
22625
7630
10000
28000
27000
33000
33000
28500
728
Operations for Extrophy of the Bladder- Multistage repair
28750
25000
729
Operations for Extrophy of the Bladder- simple cystectomy
with uriry diveion
Repair of Ureterocoel -Open
37375
32500
41400
36000
687
688
689
690
691
692
693
694
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
Repair of Ureterocoel -Lap/Endoscopic
Repair of Ureterocoel -Endoscopic incision
Open Suprapubic Prostatectomy
Open Retropubic Prostatectomy
Transurethral Resection of Prostate (TURP)
Urethroscopy/ Cystopanendoscopy
Interl urethrotom -optical
Interl urethrotomy -Core through urethroplasty
Urethral Reconstruction -End to end ansatamosis
Urethral Reconstruction - substitution urethroplasty
Posterior Urethal Valvu fulguration.
Operations for Incontinence of Urine - Male -Open
Operations for Incontinence of Urine - Male -Sling
Operations for Incontinence of Urine - Male-Bulking agent
18400
57500
46000
27600
27600
28750
6900
14950
28750
28750
40250
28750
25300
34500
16000
50000
40000
24000
24000
25000
6000
13000
25000
25000
35000
25000
22000
30000
745
746
747
Operations for Incontinence of Urine - Female -Open
Operations for Incontinence of Urine - Female-Sling
Operations for Incontinence of Urine - Female-Bulking agent
46000
25300
34500
40000
22000
30000
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
Reduction of Paraphimosis
Circumcision
Meatotomy
Meatoplasty
Operations for Hypospadias + Chordee Correction
Operations for Hypospadias - Second Stage
Operations for Hypospadias - One Stage Repair
Operations for Crippled Hypospadias
Operations for Epispadias _primary repair
Operations for Epispadias-crippled epispaedias
Partial Amputation of the Penis
Total amputation of the Penis
Orchidectomy-Simple
Orchidectomy -Radical
Orchidectomy -Post orchidectomy retroperitoneal lynpy node
dissection.
Epididymectomy
Adreneclectomy Unilateral/Bilateral for Tumour/For
Carcinoma- Open
Adreneclectomy Unilateral/Bilateral for Tumour/For
Carcinoma -Lap/Endoscopic
Operations for Hydrocele - Unilateral
Operations for Hydrocele - Bilateral
Vasectomy (Should be free for Family Welfare)
Operation for Toion of Testis
Micro-surgical Vasovasostomy /Vaso epidedymal
ansatamosis.
Operations for Varicocele Palomo’s Unilateral- Microsurgical
15021
3450
6900
4025
5750
11500
9200
11500
17825
34500
34500
14950
21275
14950
28750
13062
3000
6000
3500
5000
10000
8000
10000
15500
30000
30000
13000
18500
13000
25000
92000
14950
80000
13000
23000
20000
69000
8625
12075
15021
15525
60000
7500
10500
13062
13500
20700
18000
Operations for Varicocele Palomo’s Unilateral Lap/Endoscopic
Operations for Varicocele Palomo’s Bilateral -- Microsurgical
14950
13000
27600
24000
Operations for Varicocele Palomo’s Bilateral Lap/Endoscopic
Block Dissection of Inguil Nodes - One Side
Block Dissection of Inguil Nodes - Both Sides
Excision of Filarial Scrotum
Emergency Dialysis Femoral Puncture
Emergency Dialysis Subclavian Puncture
Fistula/Shunt
Dialysis Femoral Catheterisation Bilateral
Haemo Dialysis-For sero negative cases
Haemo Dialysis -FOR SERO POSITIVE CASES
Double Lumen Sub Clavian Catheter
Continuous Arterio Venus Haemofiltration
Subclavian Access
Femoral Access
27600
24000
27600
28750
34845
18975
2070
2300
8625
1610
2875
3450
2300
5750
2875
24000
25000
30300
16500
1800
2000
7500
1400
2500
3000
2000
5000
2500
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
Plasma Exchange
Donor Nephrectomy -Open
Donor Nephrectomy-Lap/Endoscopic
Renal Transplantation
Lymphocoel Post transplant
Transplant Nephrectomy
Bilateral Nephrouretectomy (tive)
Vascular Prosthetic Graft
CAPD
PCNL - Unilateral
PCNL - Bilateral
Endoscopic Bulking agent Inject
Testicular Biopsy
Gil-Verner’s Extended Pyelolithotomy
Radical Nephrectomy Nephrectomy -Open
Radical Nephrectomy Nephrectomy -Lap/Endoscopic
1725
2070
48300
115000
5750
21275
29900
29900
43700
13800
11270
28175
34500
5750
26450
25300
1500
1800
42000
100000
5000
18500
26000
26000
38000
12000
9800
24500
30000
5000
23000
22000
49000
75000
300770
5000
87500
87500
50750
28000
59500
89250
42000
6500
3500
65000
65000
804
805
Radical Nephrectomy plus IV thrombus
Radical Nephrectomy plus IV thrombus plus cardiac bypass.
34500
126500
30000
110000
65000
175000
806
807
808
809
810
811
812
813
345000
23575
34500
46000
21275
26450
14950
20125
300000
20500
30000
40000
18500
23000
13000
17500
49000
65000
87500
42000
65000
28000
17500
32500
13800
13800
18400
29900
15021
14950
13800
16675
16100
18975
11500
17250
12000
12000
16000
26000
13062
13000
12000
14500
14000
16500
10000
15000
32500
31500
42000
35000
37500
17500
35000
26250
45000
15000
23800
27300
826
827
828
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845
Vasico Vagil Fistula Repair
Radical Cystectomy -Ileal conduit
Radical Cystectomy - continent diveion.
Nephrectomy Simple -Open
Nephrectomy Simple-ap/Endoscopic
Nephrostomy -Open
Nephrostomy -Lap/Endoscopic
Ureteric Reimplant for Megaureter,Vesicoureteric
reflex,uterocoel
Ureteric Reimplant
Partial Cystectomy
TURP & TUR Bladder Tumour
TURP with Cystolithotripsy
Closure of Urethral Fistula
Orchidopexy - Unilateral -Open
Orchidopexy - Unilateral- Lap/Endoscopic
Orchidopexy - Bilateral -Open
Orchidopexy - Bilateral -Lap/Endoscopic
Cystolithotomy -Suprapubic
Endoscopic Removal of Stone in Bladder
Resection Bladder Neck Endoscopic /Bladden neck
incision/transurethral incision on prostrate
Ureteroscopic Surgery
Urethroplasty 1st Stage
Exploratory Scrototomy
Perineal Urethrostomy
Dilatation of Stricture Urethra under G.A.
Dilatation of Stricture Urethra under LA
Retroperitoneoscopy Nephrectomy
Retroperitoneoscopy partial Nephrectomy
Retroperitoneoscopic nephrolithotomy
Retroperitoneoscopic pyelolithotomy
Retroperitoneoscopic operation for Hyderonephrosis
Retroperitoneoscopic surgery for renal cyst
Retroperitoneoscopic ureterolithotomy
Retroperitoneoscopic Nephroureteroectomy
Laproscopy aassisted orchidopexy
Laproscopic operation for varicocele
Lithotripsy Extra corporeal shock wave.
Uroflow Study (Micturometry)
Urodymic Study (Cystometry)
Cystoscopy with Retrograde Catheter -Unilateral /RGP
25000
25000
17500
25000
5400
2500
6060
65000
60000
50000
45000
69000
40057
57500
69000
23000
19550
460
1742
3835
21250
21250
14875
21250
4590
2125
46180
55250
51000
52436
38250
60000
34832
50000
60000
20000
17000
400
1515
3335
25000
25000
17500
25000
5400
2500
54330
65000
65000
61690
80000
61950
57430
78730
42500
35000
95000
950
5700
9000
846
Cystoscopy with Retrograde Catheter - Bilateral /RGP
5589
4860
12000
847
Cystoscopy with Bladder Biopsy
3381
2940
12500
814
815
816
817
818
819
820
821
822
823
824
825
848
Voiding-cysto-urethrogram and retrograde urethrogram
414
360
3670
849
850
851
852
Radical prostratectomy-Open
Radical prostratectomy-Laproscopic
Radical prostratectomy- Robotic
Hilioum Laser Prostrate surgery/ Optical Interl
urethrotomy/Core through/Stone lithotrypsy/Bladder tumour
17825
32200
40250
17250
15500
28000
35000
15000
75000
95000
220100
65000
853
4600
4000
220100
46000
40000
856
857
High Intensity Focus Ultrasound (HIFU) Robotic for
Carcinoma prostrate and renal cell carcinoma
Prosthetic surgery for uriry incontinence
Ultra sound guided Biopsy
Neuro-surgery
Craniotomy and Evacuation of Haematoma -Subdural
Craniotomy and Evacuation of Haematoma -Extradural
86595
30188
75300
26250
86595
75300
858
Evacuation /Excision of Brain Abscess by craniotomy
33810
29400
97750
859
Excision of Lobe (Frontal, Temporal, Cerebellum etc.)
35018
30450
157400
860
861
862
863
864
865
Excision of Brain Tumou -Supratentotial
Excision of Brain Tumou -Infratentorial
Surgery of spil Cord Tumou
Ventriculoatrial /Ventriculoperitoneal Shunt
Twist Drill Craniostomy
Subdural Tapping
39123
53130
53130
40469
24150
15564
34020
46200
46200
35190
21000
13534
133925
133925
78200
35190
23460
35190
854
855
866
867
868
Ventricular Tapping
Abscess Tapping
Placement of ICP Monitor -
4025
4025
4025
3500
3500
3500
35190
35190
23460
869
870
871
872
873
874
875
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
Urokise Therepy for ICH Skull Traction Application
Lumber Pressure Monitoring
Vascular Malformations
Theco-peritoneal Shunt
Meningo Encephalocoeleexcision and repair
Meningomyelocoel
C.S.F. Rhinorrhaea
Cranioplasty
Posterior Cervical Dissectomy
Anterior Cervical Dissectomy
Brachial Plexus Exploration Microsuturing
Median Nerve Decompression
Peripheral Neurectomy (Tirgemil)
Trigemil Rhiotomy
Cranial Nerve Astomosis
Peripheral Nerve Surgery – Major
Peripheral Nerve Surgery Minor
Ventriculo-Atrial Shunt (without valve)
Nerve Biopsy
Brain Biopsy
Anterior Cervical Spine Surgery with fusion
Anterior Lateral Decompression of spine
Brain Mapping
Cervical or Doal or Lumbar Laminectomy
Combined Trans-oral Surgery & CV Junction Fusion
C.V. Junction Fusion procedures
Depressed Fracture
Discectomy
Endarterectomy
R.F. Lesion for Trigemil Neuralgia Spasticity Surgery Spil Fusion Procedure
Spil Intra Medullary Tumou
Spil Bifida Surgery Major
Spi Bifida Surgery Minor
3450
2300
6900
6969
6969
6969
24995
28980
38640
35650
29900
29900
20700
10120
20700
20700
17250
16261
11615
10120
5808
16261
38640
38640
4646
34500
60950
43470
33810
32240
29900
4646
48300
45425
46000
25875
3000
2000
6000
6060
6060
6060
21735
25200
33600
31000
26000
26000
18000
8800
18000
18000
15000
14140
10100
8800
5050
14140
33600
33600
4040
30000
53000
37800
29400
28035
26000
4040
42000
39500
40000
22500
35190
23460
23460
133950
35190
97750
64515
97750
97750
58650
58650
97750
35190
8800
133950
133950
64515
8800
83100
97750
83100
58650
157400
107525
83100
58650
97750
58650
107525
127100
107525
78200
905
906
907
908
909
910
911
912
913
914
915
916
917
918
919
920
921
922
923
924
925
926
927
928
Stereotaxic Procedures- biopsy/aspiration
Trans Sphenoidal Surgery
Trans Oral Surgery
Implantation of DBS -One electrode
Implantation of DBS -two electrodes
Endoscopic adueductoplasty
Facial nerve reconstruction
Recanelisation of venous sinuses
Carotid stenting
Cervical disc arthroplasty
Lumbar disc arthroplasty
Corpus callosectomy
Hemishpherectomy
Endoscopic CSF rhinorrhea rapair
Burr hole evacuation of chronic subdural haematoma
Microsurgical excision of Acoustic tomour
Microsurgical excision of meningomas
Epilepsy surgery
RF lesion for facet pain syndrome
Cervical laminoplasty
Lateral mass C1-C2 screw fixation
Microsurgical decompression for Trigemil nerve
Cerebellar stimulation for hemifacial spasm
Cerebellar stimulation for other cranial nerve neuralgia
25875
8050
56350
5980
51750
86250
100050
67850
42263
30188
92000
67850
64400
103500
46345
33350
33408
36225
86595
41688
48300
26623
4646
35650
22500
7000
49000
5200
45000
75000
87000
59000
36750
26250
80000
59000
56000
90000
40300
29000
29050
31500
75300
36250
42000
23150
4040
31000
83100
133950
157400
157400
157400
97750
55000
140000
133950
127075
127075
133950
157400
133950
64515
97750
157400
157400
75300
78200
107525
97750
133950
929
930
931
IC EC bypass procedures
Steriotactic guided craniotomy
Baclofen pump implantation lesioning for movement
disorder including Parkinsonism
Programmable VP shunt
Endoscopic sympathectomy
Lumber puncture
Exterl ventricular draige
Image guided surgeryExcision of tethored
Endoscopic 3rd ventriculostomy
Endoscopic cranial surgery/Biopsy/aspiration/aneurysm
coiling
Endoscopic discectomy
Aneurysm coiling
Endoscopic spil procedure- aneurysm coiling
Surgery for groving skull fractures-aneurysm coiling
carpel Tunnel decompression
Clipping of intracranial aneurysm with use of stent
Surgery for intracranial Arteriovenous malformarions(AVM)
46000
80500
80500
40000
70000
70000
133950
133950
97750
95565
38100
10120
743
28980
112413
181010
83100
33130
8800
646
25200
97750
157400
83100
97750
8800
35190
35621
18320
35708
41458
40469
24150
21793
30975
15930
31050
36050
35190
21000
18950
58650
15930
133950
Endovascular procedure/embolisation
4 vessels cerebral angiography
Foramen magnum decompression
Foramen magnum decompression with
syringosubarachnoid shunt
Doal column stimulation for bachache in failed back
syndrome
Surgery for recurrent disc prolapse/epidural fibrosis
Surgery for brain stem tumou
Programmable shunts
Decompressive cranectomy for hemishpherical acute
53188
112413
34500
35708
46250
97750
30000
31050
69400
97750
97750
133950
70150
61000
57500
15410
35621
92000
50000
13400
30975
80000
92000
80000
32545
41458
69000
28300
36050
60000
83100
75300
57500
50000
210000
19550
14450
25000
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959
960
subdural haematoma/brain swelling/large infarct
Intra arterial thrombolysis with tPA for ischemic stroketTpaactivated thromboplastin)
steriotactic aspiration of intracerebral haematoma
Endoscopic aspiration of intracerebellar haematoma
Steriotactic Radiosurgery for brain pathology(X
kinfe/Gamma knife - ONE session
Steriotactic Radiosurgery for brain pathology(X
kinfe/Gamma knife -Two or more sessions
Chemotheraphy wafe for malignt brain tumou
97750
157400
35190
157400
18950
78200
13400
64515
133950
Paediatric surgery
Excision of thyroglossal Duct/Cyst
Diaphragmatic Hernia Repair (Thoracic or Abdomil
Approach)
Tracheo Oesophageal Fistula (Correction Surgery)
Colon Replacement of Oesophagus
Omphalo Mesenteric Cyst Excision
Omphalo Mesenteric Duct- Excision
Meckels Diverticulectomy
Omphalocele 1st Stage (Hernia Repair)
Omphalocele 2nd Stge (Hernia Repair)
Gastrochisis Repair
Inguil Herniotomy
Congenital Hydrocele
Hydrocele of Cord
Toion Testis Operation
Congenital Pyloric Stenosis- operation
Duodel- Atresia Operation
Pancreatic Ring Operation
Meconium Ileus Operation
Malrotation of Intestines Operation
Rectal Biopsy (Megacolon)
Colostomy Transvee
Colostomy Left Iliac
Abdomil Perineal Pull Through (Hichaprugis Disease)
Imperforate Anus Low Anomaly -Cut Back Operation
Imperforate Anus Low Anomaly - Perineal Anoplasty
Imperforate Anus High Anomaly -Sacroabdomino
Perineal Pull Through
Imperforate Anus High Anomaly - Closure of Colostomy
16100
23000
14000
20000
23000
36800
33350
25875
23575
23575
20700
23000
23575
17250
17250
17250
22425
20125
22425
42550
23000
25875
4359
23000
23000
29900
14950
20125
20000
32000
29000
22500
20500
20500
18000
20000
20500
15000
15000
15000
19500
17500
19500
37000
20000
22500
3790
20000
20000
26000
13000
17500
27876
24240
13938
25875
12120
22500
29900
29900
29900
29900
29900
26000
26000
26000
26000
26000
33350
25875
25875
29900
33350
29900
24725
24725
29000
22500
22500
26000
29000
26000
21500
21500
1003
1004
1005
1006
1007
1008
1009
1010
1011
1012
Intususception Operation
Choledochoduodenostomy for Atresia of Extra Hepatic
Billiary Duct
Operation of Choledochal Cyst
Nephrectomy for -Pyonephrosis
Nephrectomy for - Hydronephrosis
Nephrectomy for -Wilms Tumour
Paraortic Lymphadenoctomy with Nephrectomy for
Wilms Tumour
Sacro-Coccygeal Teratoma Excision
Neuroblastoma Debulking
Neuroblastoma Total Excision
Rhabdomyosarcoma wide Excision
Congenital Atresia & Stenosis of Small Intestine
Muconium ileus
Mal-rotation & Volvulus of the Midgut
Excision of Meckle’s Deverticulum
Burns and Plastic surgery
Primary Suturing of Wound
Injection of Keloids - Ganglion
Injection of Keloids - Haemangioma
Free Grafts - Wolfe Grafts
Free Grafts - Theirech- Small Area 5%
Free Grafts - Large Area 10%
Free Grafts - Very Large Area 20% and above.
Skin Flaps - Rotation Flaps
Skin Flaps - Advancement Flaps
Skin Flaps - Direct- cross Leg Flaps- Cross Arm Flap
3450
1150
1150
1725
10350
10350
12650
16100
14375
17825
3000
1000
1000
1500
9000
9000
11000
14000
12500
15500
1013
1014
1015
1016
1017
1018
Skin Flaps - Cross Finger
Skin Flaps - Abdomil
Skin Flaps - Thoracic
Skin Flaps - Arm Etc.
Subcutaneous Pedicle Flaps Raising
Subcutaneous Pedicle Flaps Delay
19550
19550
19550
19550
21850
10925
17000
17000
17000
17000
19000
9500
961
962
963
964
965
966
967
968
969
970
971
972
973
974
975
976
977
978
979
980
981
982
983
984
985
986
987
988
989
990
991
992
993
994
995
996
997
998
999
1000
1001
1002
1019
1020
1021
1022
1023
11500
13800
13225
16100
18975
10000
12000
11500
14000
16500
10925
9500
10925
9500
1026
Subcutaneous Pedicle Flaps Transfer
Cartilate Grafting
Reduction of Facial Fractures of Nose
Reduction of Facial Fractures of Maxilla
Reduction of Fractures of Mandible & Maxilla - Eye Let
Splinting
Reduction of Fractures of Mandible & Maxilla - Cast
Netal Splints
Reduction of Fractures of Mandible & Maxilla - Gumming
Splints
Interl Wire Fixation of Mandible & Maxilla
11500
10000
1027
Cleft Lip - repair.
17250
15000
1028
Cleft Palate Repair
20700
18000
1029
Primary Bone Grafting for alveolar cleft in Cleft Lip
20700
18000
1030
Secondary Surgery for Cleft Lip Deformity
15525
13500
1031
Secondary Surgery for Cleft Palate
15525
13500
1032
Reconstruction of Eyelid Defects - Minor
18400
16000
1033
Reconstruction of Eyelid Defects - Major
13800
12000
1034
Plastic Surgery of Different Regions of the Ear - Minor
17250
15000
1035
Plastic Surgery of Different Regions of the Ear - Major
12075
10500
1036
Plastic Surgery of the Nose - Minor
16100
14000
1037
Plastic Surgery of the Nose - Major
12075
10500
1038
16100
14000
1039
Plastic Surgery for Facial Paralysis (Support with
Reanimation)
Pendulous Breast - Mammoplasty
27600
24000
1040
Underdeveloped Breast Mammoplasty
27600
24000
1041
After Mastectomy (Reconstruction)Mammoplasty
24725
21500
1042
Syndactyly Repair
24725
21500
1043
Dermabrasion Face
24725
21500
1044
upto 30% Burns 1st Dressing
17250
15000
1045
upto 30% Burns Subsequent Dressing
932
810
1046
30% to 50% Burns 1st Dressing
702
610
1047
30% to 50% Burns Subsequent Dressing
1162
1010
1048
Extensive Burn -above 50% Frist Dressing
702
610
1049
Extensive Burn -above 50% Subsequent dressing
2323
2020
1024
1025
Orthopedics
Plaster Work
1050
Finge (post, slab)
771
670
1051
Finge full plaster
345
300
1052
Colles Fracture - Below elbow
345
300
1053
Colles Fracture - Full plaster
1265
1100
1054
Colles fracture Ant. Or post. slab
978
850
1055
Above elbow full plaster
1265
1100
1056
Above Knee post-slab
575
500
1057
Below Knee full plaster
771
670
1058
Below Knee post-slab
575
500
1059
Tube Plaster (or plaster cylinder)
575
500
1060
Above knee full plaster
1265
1100
1061
Above knee full slab
575
500
1062
Minerva Jacket
2990
2600
1063
Plaster Jacket
3220
2800
1064
Shoulder spica
2760
2400
1065
Single Hip spica
2588
2250
1066
Double Hip spica
2760
2400
Strapping
1067
Strapping of Finger
179
156
1068
Strapping of Toes
230
200
1069
Strapping of Wrist
230
200
1070
Strapping of Elbow
345
300
1071
Strapping of Knee
345
300
1072
Strapping of Ankle
460
400
1073
Strapping of Chest
460
400
1074
Strapping of Shoulder
621
540
1075
Figure of 8 bandage
633
550
1076
Collar and cuff sling
633
550
1077
Ball bandage
518
450
1078
Application of P.O.P Casts for Upper & Lower Limbs
633
550
1079
1080
1081
1082
1083
1084
1085
1086
1087
1088
Application of Functiol Cast Brace
Application of Skin Traction
Application of Skeletal Tractions
Bandage & Strappings for Fractures
Aspiration & Intra Articular Injections
Application of P.O.P Spices & Jackets
Close Reduction of Fractures of Limb & P.O.P
Reduction of Compound Fractures
Open Reduction & Interl Fixation of Fingu & Toes
Open Reduction offracture of Long Bones of Upper / Lower
Limb -iling & Exterl Fixation
Open Reduction of fracture of Long Bones of Upper /
Lower Limb -AO Procedures
Tension Band Wirings
Bone Grafting
Excision of Bone Tumou
Excision or other Operations for Scaphoid Fractures
Sequestrectomy & Saucerisation
1438
2070
1610
2875
276
1208
4600
4600
5175
8050
1250
1800
1400
2500
240
1050
4000
4000
4500
7000
11270
9800
11270
6601
9660
12880
8050
9800
5740
8400
11200
7000
1089
1090
1091
1092
1093
1094
1095
1096
1097
1098
Sequestrectomy & Saucerizations -Arthrotomy
Multiple Pinning Fracture Neck Femur
il Plate Fixations for Fracture Neck Femur
A.O.Compression Procedures for Fracture Neck Femur
9971
12880
16100
19550
8670
11200
14000
17000
1099
Open Reduction of Fracture Neck Femur Muscle
Pedicle Graft and Interl Fixations
Close Reduction of Dislocations
Open Reduction of Dislocations
Open Reduction of Fracture Dislocation & Interl Fixation
19550
17000
9971
4025
4600
8670
3500
4000
Neurolysis/Nerve repair
Nerve Repair ing
Tendon with Transplant or Graft
Tendon Lengthening/Tendon repair
Tendon Transfer
Laminectomy, Excision Disc and Tumou
Spil Ostectomy and Interl Fixations
Anterolateral decompression for tuberculosis/ oTransveectomy
Antereolateral Decompression and Spil Fusion
Corrective Ostectomy & Interl Fixation - short bones
Corrective Ostectomy & Interl Fixation - long bones
Arthrodesis of - Minor Joints
Arthrodesis of - Major Joints
Soft Tissue Operations for C.T.E.V.
Soft Tissue Operations for Polio
Hemiarthroplasty- Hip
Hemiarthroplasty- Shoulder
Operations for Brachial Plexus & Cervical Rib
Amputations - Below Knee
Amputations - Below Elbow
Amputations - Above Knee
Amputations - Above Elbow
Amputations - Forequarter
Amputations -Hind Quarter and Hemipelvectomy
Disarticulations - Major joint
Disarticulations - Minor joint
Arthrography
Arthroscopy - Diagnostic
Arthroscopy-therapeutic: without implant
Arthroscopy-therapeutic: with implant
Soft Tissue Operation on JOINTS -SMALL
Soft Tissue Operation on JOINTS -LARGE
Myocutaneous and Fasciocutaneous FlaP Procedures for
Limbs
Removal of Wires & Screw
Removal of Plates/IL
Total Hip Replacement
Total Ankle Joint Replacement
Total Knee Joint Replacement
Total Shoulder Joint Replacement
Total Elbow Joint Replacement
Total Wrist Joint Replacement
Total finger joint replacement
Tubular exterl fixator
Ilizarov's exterl fixator
Pelvi-acetebular fracture -interl fixation
Physiotherapy
Ultrasonic therapy
S.W. Diathermy
Electrical stimulation (therapeutic)
Muscle testing and diagnostic
Infra red
U.V. Therapeutic dose
Intermittent Lumbar Traction
16100
16675
24150
9971
9775
12880
24150
32200
14000
14500
21000
8670
8500
11200
21000
28000
29325
32200
16100
13225
12880
9971
9775
8050
11500
74750
20786
8050
8050
13225
13225
19550
24150
20786
18400
13225
13800
20700
20786
20700
20700
25500
28000
14000
11500
11200
8670
8500
7000
10000
65000
18075
7000
7000
11500
11500
17000
21000
18075
16000
11500
12000
18000
18075
18000
18000
9971
8625
103500
112125
126500
19550
19550
115000
23000
44850
46000
46000
8670
7500
90000
97500
110000
17000
17000
100000
20000
39000
40000
40000
127
127
127
155
155
58
127
110
110
110
135
135
50
110
1100
1101
1102
1103
1104
1105
1106
1107
1108
1109
1110
1111
1112
1113
1114
1115
1116
1117
1118
1119
1120
1121
1122
1123
1124
1125
1126
1127
1128
1129
1130
1131
1132
1133
1134
1135
1136
1137
1138
1139
1140
1141
1142
1143
1144
1145
1146
1147
1148
1149
1150
1151
1152
1153
1154
103500
112125
126500
19550
19550
115000
23000
1155
1156
1157
1158
1159
1160
1161
1162
1163
1164
1165
1166
1167
1168
1169
1170
1171
1172
1173
1174
1175
1176
1177
1178
1179
1180
1181
1182
1183
1184
1185
1186
1187
1188
1189
1190
1191
1192
1193
1194
1195
1196
1197
1198
1199
1200
1201
1202
1203
1204
1205
1206
1207
1208
1209
Intermittent Cervical traction
Wax bath
Hot pack
Breathing Exercises & Postural Draige
Cerebral Palsy – exercise
Post – polio exercise
Nuclear Medicine.
RADIO-ISOTOPE THERAPY
131-lodine Therapy
131-lodine Therapy <15mCi
131-lodine Therapy 15-50mCi
131-lodine Therapy 51-100mCi
131-lodine Therapy >100mCi
Phosphorus-32 therapy for metastatic bone pain palliation
Samarium-153 therapy for metastatic bone pain palliation
Radiosynovectomy with Yttrium
Radiotherapy and Chemotherapy
Cobalt 60 therapy
Radical therapy
Palliative therapy
Linear accelerator
Radical therapy
Palliative therapy
3 D Planning
2 D Planing
IMRT(Intensity Modulated radiotherapy)
SRT (Stereotactic radiotherapy)
S(Stereotactic radio surgery)
IGRT(Image guided radiotherapy)
Respiratory Gating-alongwith Linear accelerator planning
Electron beam with Linear accelerator
Tomotherapy
Brachytherapy- High Dose radiation
Intracavitory
Intetitial
Intralumil
Surface moul
GLIADAL WAFER
Chemotharapy
Neoadjuvant
Adjuvant
Concurrent-chemoadiation
Single drug
Multiple drugs
Targeted therapy
Chemoport facility
PICC line (peripherally inserted Central canulisation)
List of procedures/ tests in Gastroenterology
A) Endoscopic procedures
a.
Upper G.I. Endoscopy + Lower G.I. Endoscopy
a.
Diagnostic endoscopy
b.
Endoscopic biopsy
c.
Endoscopic mucosal resection
d.
Oesophageal stricture dilatation
e.
Balloon dilatation of achalasia cardia
f.
Foreign body removal
g.
Oesophageal stenting
h.
Band ligation of oesophageal varices
i.
Sclerotherapy of oesophageal varices
j.
Glue injection of varices
k.
Argon plasma coagulation
l.
Pyloric balloon dilatation
m. Enteral stenting
n.
Duodel stricture dilation
o.
Single balloon enterocopy
p.
Double balloon enteroscopy
75
75
127
58
161
127
65
65
110
50
140
110
8300
5130
12000
15000
18000
7130
10690
7055
4361
10200
12750
15300
6061
9087
29325
25500
60000
57500
5000
5000
103200
62400
82400
150400
125000
89060
51000
50000
4250
4250
87720
53040
70040
127840
106250
75701
95000
57500
8910
6530
129000
78000
103000
188000
12000
34880
10000
4750
107830
10200
30330
8500
4038
91656
23750
3450
5750
552
2070
2760
9200
9200
3000
5000
480
1800
2400
8000
8000
3450
5750
590
2070
2760
9200
9200
2513
1035
1212
3450
5181
6900
3657
6647
4985
3657
4653
8050
8050
46000
5181
34500
34500
2185
900
1054
3000
4505
6000
3180
5780
4335
3180
4046
7000
7000
40000
4505
30000
30000
3000
1225
1425
8300
5130
18800
18800
21700
7130
10690
89060
14250
4750
107830
6100
4300
7820
5865
4300
5475
6100
1210
1211
1212
1213
1214
1215
1216
1217
1218
q.
r.
s.
t.
u.
v.
w.
x.
y.
b.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
B.
a.
b.
Capsule endoscopy
Polypectomy
Piles banding
Colonic stricture dilatation
Hot biopsy forceps procedures
Colonic stenting
Junction biopsy
rrow band imaging
Conjugal microscopy
ERCP
Diagnostic ERCP
Endoscopic sphincterotomy
CBD stone extraction
CBD stricture dilatation
Biliary stenting (plastic and metallic)
Mechanical lithotripsy of CBD stones
Pancreatic sphincterotomy
Pancreatic stricture dilatation
Pancreatic stone extraction
Mechanical lithotripsy of pancreatic stones
Endoscopic cysto gastrostomy
Balloon dilatation of papilla
Endoscopic ultrasound
Diagnostic ultrasound
Colored doplar
1254
c.
d.
e.
f.
C.
a.
b.
c.
d.
e.
f.
g.
h.
i.
D.
a.
b.
c.
d.
e.
f.
E.
F.
G.
a.
Ultrasound guided FC
Ultrasound guided abscess draige
PTBD
Biliary stenting
Angiography
Diagnostic angiography
Vascular embolization
TIPS
Trans jugular liver biopsy
IVC graphy + hepatic veinography
Balloon angioplasty
Muscular stenting
BRTO
Portal haemodymic studies
Manometry and PH metry
Oesophageal PH metry
Oesophageal manometry
Small bowel manometry
Anorectal manometry
Colonic manometry
Biliary manometry
Sengstaken blackenesse tube tempode
Lintas machles tube tempode
Bichemistry ,Serology and Molecular biology
D-xylase test
1255
b.
Fecal fat test/ fecal chymotrypsin/ fecal elastase
1256
c.
Breath tests
1257
d.
H pylori serology for ciliac disease
1258
e.
HBV genotyping
1259
f.
HCV genotyping
1268
1268
1270
H.
a.
b.
I.
Extra corporeal shortwave lithotripsy
CBD stones
Pancreatic duct stones
Liver biopsy
1219
1220
1221
1222
1223
1224
1225
1226
1227
1228
1229
1230
1231
1232
1233
1234
1235
1236
1237
1238
1239
1240
1241
1242
1243
1244
1245
1246
1247
1248
1249
1250
1251
1252
1253
57500
3657
4985
20700
6900
34500
18400
34500
34500
50000
3180
4335
18000
6000
30000
16000
30000
30000
5865
5750
8602
8602
9286
10925
9286
34500
8602
15525
18400
34500
5100
5000
7480
7480
8075
9500
8075
30000
7480
13500
16000
30000
4300
5865
6900
10120
10120
10925
29325
10925
10120
29325
1045
Listed under
Investigations
1955
1150
1150
at S.No.1223
34500
1495
23000
46000
28750
28750
1700
1000
1000
970
970
29690
30000
1300
20000
40000
25000
25000
14500
16860
57500
57500
34500
34500
50000
50000
30000
30000
28750
28750
28750
28750
28750
28750
28750
28750
Listed under
Investigations
Listed under
Investigations
Listed under
Investigations
Listed under
Investigations
Listed under
Investigations
Listed under
Investigations
28750
633
32200
36800
25000
25000
25000
25000
25000
25000
25000
25000
25000
550
28000
32000
1293
1294
1295
1296
1297
1298
i.
ii.
iii.
Plasma Exchange
Donor nephrectomy- Open
Donor nephrectomy- Lap/ endoscopic
Renal Transplantation
Lymphocoel Post Transplant
Transplant Nephrectomy
at S.No.788
at S.No.789
at S.No. 790
at S.No.791
at S.No. 792
at S.No. 793
at S.No.789
at S.No.790
at S.No. 791
at S.No.792
Note:
Package rate is defined as lump sum cost of inpatient treatment or diagnostic procedure for
which a patient has been referred by competent authority or CGHS to Hospital or Diagnostic
centre. This include all charges pertaining to a particular treatment/procedure including admission
charges, Accommodation charges, ICU/ICCU charges, monitoring charges, operation charges,
anesthesia charges, operation theatre charges, procedural charges/surgeon’s fee, cost of
disposable, surgical charges and cost of medicine used during hospitalization, related routine
investigations, physiotherapy charges etc.
The package rate does not include diet, telephone charges, T.V. charges and cost of cosmetics,
toiletry, tonics and medicines advertised in mass media. Cost of these, if offered, on request of
patient will be realized from the individual patient and are not to be included in package charges.
The recognized hospitals/diagnostic centre will not charge more than the package rate from the
beneficiary.
1. 12 days for specialised procedure.
2. 7- 8 day for other procedures.
3. 3 days for laproscopic surgery.
4. 1 days for day care/minor procedures (OPD)
No additional charge on account of extended period of stay shall be allowed if the
extension is due to infection on the consequences of surgical procedure or due to any improper
procedure and is not justified.
In case, there are no CGHS prescribed rates for any test/procedure then AIIMS rates
are applicable. If there are no AIIMS rates then reimbursement is to be arrived at by calculating
admissible amount item-wise (e.g. room rent, investigations, cost of medicine, procedure charges
etc.) as per approved rates/actual, in case of investigations.
However if the beneficiary has to stay in the hospital for his/her recovery for more than
the period covered in the package rate, the additional reimbursement shall be limited to room rent
as per entitlement, cost of the prescribed medicines and investigations, Doctors visit (not more
than 2 times a day) for additional stay.
4) a) The entitlement for indoor treatment would be as under:
i)
Group D-
General Ward.
Ii)
Group C-
Semi Pvt. Ward.
iii)
Group B & Gr A ( Upto STS)
Private Ward ( Non A.C.)
iv)
Group A JAG and above
Private Ward with A.C.
V)
CMD & Board Directors ( Full Time)
Deluxe room with A.C.
b) Package rate offered to CGHS for treatment in Semi Pvt. Ward is mentioned and indicated in
the rate list at Annexure-C
c) It has further been decided that the CGHS beneficiaries taking treatment in the above
mentioned hospitals with the prior permission of the CGHS will be entitled for reimbursement
as per the package rates given in the Annexure-C.( PART III schedule for quoting rates). The
rates for indoor treatment mentioned in attached Annexure are for Semi Private Category. For
private Ward there will be an increase of 15% and for General Ward there will be a decrease
of 10%.
d) The implant shall be reimbursed as per actual except for the items where ceiling is defined.
5) A Private Hospital/Diagnostic centre whose rates for a procedure/test/facility are lower than the
approved rates shall charge the beneficiaries as per actual
6). a. The maximum room rent for different categories would be
.
General
Rs. 500/- per day
Semi Private
Rs. 1000/- per day
Private
Rs.1500/- per day
Day care(6-8 hours admission)
Rs. 500 per day (Same for all categories)
b..Room rent is applicable only for treatment procedures for which there is no CHGS
prescribed package rates.
c. Normally the treatment in higher category of accommodation than the entitle category is
not permissible. However, in case of emergency when the entitle category
accommodation is not available, admission in the immediate higher category may be
allowed till the entitle category accommodation becomes available . however, if a
particular hospital does not have the ward as per entitlement of the beneficiary, then the
hospital can only bill as per entitlement of the beneficiary even though the treatment
was given in higher type of ward.
7
The beneficiary will have the option of availing specialized treatment/diagnostic tests at
BSNL panel Hospital/Diagnostic Centre of Kalyan SSA of his/her choice after the
Specialist of panel Hospital Medical Officer recommends the procedure/test.
8.
In case of an emergency the recognized private hospital shall not refuse admission or demand
advance from the beneficiary and shall provide credit facilities to the concerned patient on the
production of valid BSNLMRS Card. The recognized Hospital/Diagnostic Centre shall submit the
bill for reimbursement subject to the ceilng of approved rate to the BSNL.
9.
The recognized hospitals/diagnostic centres will provide necessary medicines and all disposable
sundries of standard quality and will not get them purchased through CGHS beneficiaries.
10. If one or more treatment procedures form part of the major treatment procedure package charges
would be made against the major procedures and only one half of approved charges quoted for
the other procedures would be added to the package charges of the first major procedure.
11. Treatment taken in branches of the recognized hospitals will not be admissible for the
reimbursement.
12. Any legal liability coming out of such services shall be dealt by the hospital diagnostic centre and
it shall be responsible alone.
I/We have read this tender documents carefully before quoting the aforesaid rates, and undertake to
abide all terms and conditions enunciated therein.
Signature:
Name of the Authorized person:
Capacity in which signed above:
Name & Address of the Hospital:
Telephone No.
(O):
(R):
Fax:
END OF PART –III
PART IV
ANNEXURE-A
AGREEMENT
(To be executed on stamp paper of Rs. 100=00)
For providing medical facilities to BSNL employees & their Dependants
This agreement made at Kalyan on _____ day of ___________ 200
BETWEEN:
M/S. BHARAT SANCHAR NIGAM LTD. a Govt. of India Enterprise, having its registered office
at B148, Statesman house, Barakhamba road, New Delhi-110001 & SSA Head Quarters at The
Principal General Manager Telecom, Telephone Bhavan, Kala Talav, Kalyan (West)-421 301
(hereinafter referred to as “the BSNL” for short, which expression shall where the context so admits,
include its succession and assigns) of the ONE PART.
AND
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
a hospital registered and approved by the local authority (hereinafter referred to as ‘the hospital’ for
short, which expression shall, where the context so admits, include its Successors & Assigns) of the
OTHER PART.
WHEREAS ‘the BSNL’ is in desire of formulating a ‘Scheme of providing medical facilities
to its existing and retired Employees so also to their Dependent family members, keeping in
view of the Health & Welfare of its Employees’ during the course of their employment and even
after their retirement, for that matter.
AND WHEREAS the BSNL, was on the look out for having a tie-up arrangement with a
Hospital, which could undertake to provide medical treatment facilities, to its Employees regularly and
for the said purpose, approached with a concrete proposal, the aforesaid Hospital.
AND WHEREAS the hospital has accepted the proposal given by the BSNL and agreed to
provide medical treatment facilities to BSNL Employees and to their family Dependents, covered
under the ‘Scheme’ formulated by the BSNL.
AND WHEREAS the BSNL & the Hospital, herein mentioned have agreed to enter into this
Formal Agreement, recording the terms and conditions on which the aforesaid tie-up arrangement is
to be worked out and implemented.
NOW IT IS AGREED BETWEEN THE PARTIES HERETO AS FOLLOWS :
1)
It is agreed that the BSNL, will issue “Medical Cards” to all its eligible persons for availing the
medical facilities provided in the said hospital covered under the Scheme
2)
The Hospital will entertain the patients provisionally on producing Medical cards issued by the
BSNL and immediate Medical treatment will be given without insisting for any advance
payment. However, the Hospital can forward the bill immediately to the BSNL for
reimbursement, as per the scheme hereby agreed.
3)
The hospital shall treat all cases involving indoor treatment referred to it by BSNL.
4)
The nominated nodal officer of BSNL shall verify the genuineness of beneficiary in all indoor
treatment(s). He will issue certificate after verification.
5)
The hospital will charge the BSNL serving & retired employees & their dependent family
members within the ceiling limits as described & contained in the schedule of CGHS approved
charges which are detailed (as approved by G.O.I., Ministry of Health & Family Welfare, New
Delhi in their letter No. F.No.S.11011/23/2009-CGHS D.II. /Hospital Cell/Part-I dtd.
28.08.2011).issued from time to time or the Charges quoted in the offer submitted in
expression of willingness whichever is less.
6)
All the charges to the working or retired employees of BSNL shall be at the schedule rates
fixed by CGHS vide G.O.I. Ministry of Health & Family Welfare, New Delhi in their letter No.
F.No.S.11011/23/2009-CGHS D.II. /Hospital Cell/Part-I dtd. 28.08.2011)and if any charges are
made other than the schedule rates, it has to be done generally with prior written consent of
BSNL
7)
----------------------------------------------------------Hospital will send the bills directly to BSNL in
duplicate to the concerned Drawing & Disbursing Officers (DDOs) of the office which has
issued the authorization letters. The bills should contain the copy of authorization letter,
verification certificate issued by Nodal officer.
8)
Payment of the bills shall be made after due scrutiny & certificate of BSNL within one month
from the date of receipt of the bill.
9)
The authorization letters are to be sent in original by BSNL (required detailed clarification).
10)
Where due to surgical procedure or for any other reason stay in the hospital beyond
schedule is necessitated the hospital shall inform BSNL in advance.
11)
The schedule of rates as per rates quoted by you or CGHS rates whichever are lowest shall
form an integral part of this agreement.
12)
Admission sought by the patients on Saturdays, Sundays, General Holidays & in case
of Emergency may be permitted on the basis of Medical Card/Identity Card provisionally. The
authorization letters are produced on next working day. In such cases the hospital may issue a
certificate about the emergency condition of the patient and send the same along with the
monthly bill.
13)
The Hospital shall also provide reports in the prescribed format to the BSNL Office in
respect of the beneficiaries treated on monthly basis by the 10 th day of the succeeding
calendar month in proforma enclosed.
14)
“During in-patient treatment of the “Any liability on account of default or negligence on
the part of the Hospital in providing or performing the medical services, arises, the
Hospital shall alone be responsible for such deficiency of service and the BSNL will no
way be responsible for the same.
15) “In case of charging excess amount or any discrepancy found in the bill amount, the
BSNL is entitled to make factual enquiry pertaining to the case against which the bill is
raised and the decision taken by the BSNL shall be final, in respect of its payment.
16) “During in patient treatment of the BSNL persons covered under the scheme, the hospital
shall not ask the eligible person to purchase medicines from outside, but will have to be
arranged and provided by the Hospital itself as a package deal, at the approved rate by
the CGHS vide G.O.I. Ministry of Health & Family Welfare, New Delhi in their letter No.
F.No.S.11011/23/2009-CGHS D.II. /Hospital Cell/Part-I dtd. 28.08.2011)) which includes
the cost of drugs, surgical instruments and other medicines etc.
17) “This agreement shall, remain in force for a period of ONE/TWO YEARS from the date of
execution by both parties or finalization of new panel whichever is earlier”.
18) “In case of any breach of the terms of this agreement, either party by giving one month
Notice (clear 30 days to be counted from the receipt of the Notice) in writing to the other,
can terminate this contract. Such Notice will have to be sent by Registered A.D. on the
specific address of the parties given as under.
(a) The Principal General Manager Telecom, Telephone Bhavan, Kala Talav,
Kalyan-421 301 (West). BHARAT SANCHAR NIGAM LTD.
(b) (Name of the hospital)
_________________________________________________________
_________________________________________________________
19) The BSNL shall have a lien and also reserve the right to retain and set off against any
sum which may, from time to time be due to and payable to the hospital hereunder, any
claim which the BSNL may have against the hospital under this or any other agreement.
20) The Hospital shall pay all legal expenses incidental to the preparation and stamping of
this agreement.
21) “All questions, disputes or difference arising out of this agreement, relating to the
interpretation of this agreement or concerning or relating to the rights, duties or liabilities
of the parties (whether during the continuance of the agreement or after its completion
and whether before or after the determination or breach of the contract), shall be referred
to the decision of a Sole Arbitrator who shall be Nominee of the BSNL. This reference
shall be deemed to be a reference to arbitration within the meaning of the Arbitration &
Conciliation Act 1996.
22) The original copy of this agreement shall be kept at the office of The Principal General
Manager Telecom, Telephone Bhavan, Kala Talav, Kalyan(West)-421 301 and a true
copy shall be retained in the office of the hospital.
23) “The Hospital shall provide access to the financial and medical records to BSNL, for the
purpose of enquiry, assessment and review of any case, as and when required by BSNL
on its specific request in writing.
24) The hospital with regard to indoor treatment of BSNL employees and medical bill
therefore shall be complied as per Annexure-H.
IN WITNESS WHEREOF the parties hereunto have put their respective hands on the day and year
first hereinabove written.
DATED this ______ day of ________________ 2010.
SIGNED & DELIVERED BY THE
WITHINNAMED
BHARAT SANCHAR NIGAM LTD.
The party of the ONE PART, through
The Asstt. General Manager (Admn)
O/o PGMT,BSNL, Kalyan
_____________________________
In the presence of
_____________________________
SIGNED & DELIVERED by the
Within named hospital
_____________________________
the party of the OTHER PART
through its :
Chief Medical Officer
_____________________________
In the presence of
____________________________
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
OPINION CERTIFICATE
Annexure-O
ON LETTER HEAD OF ISSUING AUTHORITY
Certified that -------------------------------------hospital having its address-------------------------------------------------------------------------------------------------------------was examined on ------------------- and found
that the information submitted by Dr -----------------------------------------in Annexure G of BSNL is correct
and there are basic facilities for treatment of common illness and -------------------- specialist.
Dr ---------------------------------------is senior doctor and is capable of treating emergencies also.
Medical Officer Health.
Seal
ANNEXURE -D1
CERTIFICATE OF HOSPITALISATION
(to be completed in the case of patients who are admitted to hospital for treatment)
Certificate granted to Mrs./Mr./Miss …………………………………..………..
husband/wife/son/daughter/mother/father of Mrs./Mr. ……………………………. Employed in the office
………………………………..…., BSNL.
PART-‘A’
I, Dr. ……………………………………………….. hereby certify:
(a) that the patient was admitted to hospital on ………………………….
(b) that the patient has been under treatment at ………………………. And that the under
mentioned medicines prescribed by me in this connection were essential for the
recovery/prevention of serious deterioration in the condition of the patient.
(c) that the patient is/was suffering from …………………. and is/was under treatment
from………………..….. to …………………..
(d) that the X-ray, laboratory tests, etc. for which an expenditure of Rs. ………… was incurred were
necessary and were undertaken on my advice at ………………… ………………… (name of
hospital or laboratory)
Signature and Designation of the
Medical Officer-In-Charge of the
Case at the hospital
ANNEXURE-V
CERTIFICATE OF VISIT BY BSNL NODAL OFFICER
Proforma attached with Order No. BSNL/Admn.I/15-2/05 (Pt.) Dt. 8th August 2005
As per the instructions of …………………………………………………….…, I visited
the…………………………………………………. hospital at ……………... AM/PM
on……………………(date) and found that ………………… ……………… (name of the patient) is
undergoing treatment/was undergone treatment under Dr. …………………………., under
Registration No.…………………….… in ward No. …………..……….. and observed/verified from the
hospital record the following particulars of the patient.
Date of admission: ………………………………..
Name of Disease: ………………………………..
Name of employee ………………………………
Relationship with the employee …………………………
BSNLMRS Card No. ……………………………………..
The patient/the employee is satisfied with the treatment being given. As per the documents
available with him/her, he/she is found to be the authorized beneficiary to take treatment under the
BSNLMRS.
Signature
Name of the Officer
Date: ……………………
Place: …………………..
To
AO(Claims)
O/O PGMT, Telephone Bhavan,
Kala talav, Kalyan,421301
Annexure-F
BHARAT SANCHAR NIGAM LTD
(A Government of India Enterprise)
Office of the
Principal General Manager Telecom,
Administration Section,Telephone Bhavan, Kala Talav ,
Kalyan (W).
No. ……………………………………………………………
Dated………………..
Authorization Letter for Treatments in Hospital
This is to certify that Shri/Smt. ……………………………………….. (Name of the patient),Age
……………………… is the Husband/Wife/Son/Daughter/ Mother / Father of
Shri/Smt.………………………………………., an employee of BSNL. He/She may be admitted in
(Hospital’s Name) ………………………… ……………………………….. as per his/her room
entitlement, i.e., ……………… …………..
He/She may be charged as per agreed rates with BSNL.
Bills as per agreed rates may be sent to AO (Claims),O/O PGMT, Telephone Bhavan, Kala
talav, Kalyan for payment.
( Signature & Stamp of the Competent Authority)
Annexure-G
RELEVANT INFORMATION FOR PROCESSING CASE FOR EMPANELMENT OF HOSPITALS
1.Name of the Hosital
:
Whether the hospital is recognized by the State Government for treatment of its employee and
if so, a copy of the order thereof.
2. Location/Address of the Hospital
:
Map of the city/town showing the excat location of the hospital to be attached.
3. (I) Names of Govt hospital(s) recognized hospital(s) within a radius of 4 kms.
(II) Clinical facilities available in the above hospitals.
4. Indoor facilities :
( I) No of beds in the hospital – specially wise.
(II)
(III)
(IV)
Gneral Wards
5. Number
6. Size
7. No of beds in each size
8. Amenities provided
9. Rates
Semi private wards
10. Number
11. Size
12.
No of beds in each size
13. Amenities provided
14. Rates
Private wards
15. Number
16. Size
17. No of beds in each size
18. Amenities provided
19. Rates
(V) Operation theatre
20.
Number
21. Size
22. Equipment
23. Rates
(VI) Diagnostic facilities
24. Pathological
25. Radiological
26. Others
27. Rates
(VII) Details of the blood bank
(VIII) ICU & ICCU
5. Emergency and Trauma services
I)
No of ambulances available.
II)
No of Doctors available with particular reference to emergency and Trauma
services.
6. Specialised services
I)
Nature of specialized service
II)
Name of specialists with qualifications and field of specialization.
III)
Facilities of clinical investigation.
7. Facilities for family planning services.
8. Doctors.
I)
II)
III)
IV)
List of Doctors available and their biodata.
Terms and conditions of the employment of doctors with particular reference to
-pay
-duration of the appointment whether part time or full time.
Private practice whether allowed or not
The names of hospitals or clinical centers the said doctors are associated with
9. Paramedical Staff
I)
Condition of employment of paramedical personnel
28. Full time/part time
29. Pay
30. Duration for which appointed
10. Average OPD attendance during last one year.
11. Schedule of charges (schedule of charges of nearby Govt. hospitals and one nearby
recognized hospital are to be furnished for comparison purpose)
12. Particulars of casualty services in the hospitals
13. Percentage of free treatment in OPD and also reserved beds for poor patients
14. Inventory equipments
15. Residential Physicians and residential Surgeons
16.
I)
II)
III)
IV)
Doctors-patient ratio
Doctors – Nurses ratio
Nurses – patients ratio
Bed Occupancy rate at presen
Signature of in-charge of the Hospital with seal
LETTER FOR AGREEING CGHS RATES ON HOSPITAL LETTER HEAD.
No ----------------------------------------------------------------------------------------To,
The Asstt. General Manager (Admn),
O/o PGMT,BSNL, Kalyan 421001.
Sub- Agreeing of CGHS Rates for empanelment of Hospital.
Sir,
I, Dr.--------------------------------------------------- , Name of Hospital--------------------------------------------------------- gone through the CGHS Rates and agree for the same.
Thanking you,
DatePlace-
Signature
Name
Name of Hospital with seal.
ANNEXURE-H
01) For the payment of inpatient treatment, minimum one day’s halt is required.
02) In case of angioplasty, it is necessary to enclose pouch of the stent packet along with
sticker in which details of stent are printed. The same holds good whenever any implant
is made.
03) Check list should be attached along with every bill (copy enclosed).
04) The bill should contain the name of package and serial number of CGHS rates.
05) The patient should be identified on the photo copy of the MRS card and certified by the
doctor with hospitals Seal.
06) Signature of the doctor-in-charge of the hospital to be furnished on the reverse side of the
cash memos with hospital Seal.
O7) Discharge report is to be attached with the claim in original with specific mention about
the name of the treatment,name of the Doctor,Registration No.with hospital seal.
08) The serial no.of the CGHS rate should be mentioned against rates claimed.
09) Supporting documents are to be enclosed in case of investigation/tests done.
10) ‘Annexure D-1’ form to be submitted with signature and designation of the medical
officers incharge (with hospital Seal).
11) ‘Annexure-D’ form duly signed by the concerned employees to be submitted along with
the hospital bill.
12) Claims may be submitted within six months from the date of discharge. Claims submitted
after six months cannot be entertained.
13)
Claims may be submitted along with documents mentioned in the check list (copy enclosed).
14)
Revised rates are available on CGHS website (www.mobfw.inc.in/chgs.html). The same may
be followed. For any further difficulty kindly contact Accounts Section of BSNL office to whom
the bills sent for payment.
15)
Please ensure that the claims are submitted as per correct procedure, so that payment can be
released by the office at the earliest.
16)
The medicine invoice with prescription of the duty doctor need to be invariably attached in
respect of other than package rated treatment/procedures.
17)
Extending stay of in-patient beyond ten days needs consent of BSNL by referring to the
Authority who has issued the original authorization for admission of the patient.
CHECK LIST OF THE DOCUMENTS TO BE SUBMITTED BY THE HOSPITAL ALONG WITH
CLAIMS.
Name of the hospital:-
Name of the patient:-
Date of Admission:-
Date of discharge:-
Bill No.
Sl.No.
1
2
3
4
5
6
7
8
9
Details of documents
Authorization letter(s) in original
Copy of BSNL MRS card duly indentifying the patient by doctor
(with hospital seal)
Annexure-D(duly filled up)
Annexure-D-1 (with hospital seal)
Original consolidation bill with break up of item-wise rates of tests
carried out if any.
Cash memos with prescription duly signed by hospital authorities
on reverse side.
Discharge summary card
Investigation report
Outer pouch of stent along with sticker in case of angioplasty.
Note:- all the above documents to be submitted in original to BSNL office.
Submitted by:-
Yes/No