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Centre revises rate of 2,000 medical procedures

The rates have, for the first time, been rationalised based on hospital accreditation, city classification and hospital type

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After a decade, the Union Health Ministry has revised the package rates for nearly 2,000 medical procedures, which will take effect from October 13. The rates have, for the first time, been rationalised based on hospital accreditation, city classification and hospital type.

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Hospitals have long argued that the government-set package rates were too low and did not reflect the rise in inflation since 2014.

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While the revision brings a nominal increase in charges for some medical procedures, there is a substantial hike in the rates for surgical interventions.

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For instance, the rate for complicated tooth extraction under local anaesthesia has been revised from Rs 115 to Rs 800 in NABH-accredited health facilities. The rate for MRI mammography (a test to detect breast cancer) has increased from Rs 2,550 to Rs 4,250 in non-NABH-accredited hospitals, and to Rs 5,000 in NABH-accredited facilities. Retinal detachment surgery per eye will now cost Rs 27,500 in NABH-accredited and Rs 23,375 in non-NABH-accredited hospitals. Similarly, the rate for skull surgeries has been raised from Rs 46,000 to Rs 76,000 in NABH-accredited hospitals.

The new package rates are based on admission to a semi-private ward. For general ward patients, rates will be 5 per cent lower, while for private ward entitlement, a 5 per cent increase will apply. Charges for outpatient consultations, investigations, day-care procedures and radiotherapy will remain uniform across all ward categories.

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For cancer surgeries, existing CGHS rules and rates will continue. However, the revised rates will apply to chemotherapy, investigations and radiotherapy. Healthcare facilities in tier-2 and tier-3 cities will have rates that are 10 per cent and 20 per cent lower, respectively, than those in tier-1 cities.

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