Order from CGHS for availing treatment in non empaneled hospitals at CGHS rates

Pl. provide order from CGHS for availing treatment in non empaneled hospitals at CGHS rates.

1 Like
CGHS considers for reimbursement at CGHS rates in case the treatment taken in an emergency from private non empanelled hospitals. The reimbursement shall be restricted to CGHS package rate or actual expenditure whichever is less.
As per Emergencies | CGHS, beneficiaries have the option to go to a nearby Government hospital / empanelled private hospital or even any private hospital, in case of emergency.
However, if treatment is undertaken at private non- empanelled hospitals under emergency, reimbursement will be limited to CGHS rates or actual, whichever may be lower. Since, non-empanelled private hospitals often charge at rates different from the CGHS rates there will be difference in the amount reimbursed if the private hospital charges are higher than CGHS rates.
In general cases, permission is granted only for empanelled hospitals. No reimbursement is allowed for taking planned surgery in a non-empanelled hospital.
Ref: https://www.cghspune.gov.in/images/stories/cghsimages/pdfs/permitreatmentpvt.pdf