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Revision of Ceiling Rates for Knee and Hip Implants under CGHS and CS(MA) Rules

Revision of Ceiling Rates for Knee and Hip Implants under CGHS and CS(MA) Rules

No:Z.15025/74/2017/DIR/CGHS/EHS
Government Of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS Section
Nirman Bhawan, New Delhi 11011
Dated the 26th September,2017
OFFICE MEMORANDUM

Subject: Revision of Ceiling Rates for Knee and Hip Implants under CGHS and CS(MA) Rules

with reference to the above mentioned subject the undersigned is directed to draw attention to this Ministry’s OM No.S.11018/1/95-CGHS (P), dated the 7th March, 1995 vide which ceiling rates for Knee and Hip implants under CGHS and CS(MA) Rules have been prescribed and to state that it has now been decided by competent authority to revise the ceiling rates and guidelines for Knee and Hip implants under CGHS and CS(MA) rules as per the details given under the succeeding paragraphs.
2. (A) PRIMARY KNEE REPLACEMENT SYSTEM
(*Ceiling Price in Rs.)
Applicable to all variants FEMORAL COMPONENT BY
WHATSOVER NAME/ SPECIFICATIONS
TIBIAL COMPONENT BY
WHATOVER NAME/ SPECIFICATIONS
ARTICULAR SURFACE/ INSERT
BY WHATSOVER NAME/ SPECIFICATIONS

(Any Material)
PATELLA COMPONENT BY
WHATSOVER NAME/ SPECIFICATIONS
1.       Titanium
alloy coated
38,740 24,280 9550 4090
2.       Oxidized
Zirconium (OxZr) alloy
38,740 24,280
3.       Hi-flex 25,680
4.       Cobalt
Chromium (CoCr) alloy and other than at 1,2, and 3 above
24,090 16,960

COMPONENT HAVING TIBIAL TRAY AND INSERT COMBINED AS SINGLE UNIT BY WHATOSOVER
NAME SPECIFICATION
Polyethylene or cross-linked polyethylene or highly
cross linked polyethylene or any other material
12960
Tibial: Metallic Insert: Polyethylene or cross linked polyethylene or highly cross linked
polyethylene or any other material
26,546

* plus GST wherever Paid or payable


(B) REVISION KNEE
IMPLANT SYSTEM
(*Ceiling Price in Rs.)
FEMORAL COMPONENT BY
WHATSOVER NAME/ SPECIFICATIONS
TIBIAL COMPONENT BY WHATSOVER
NAME/ SPECIFICATIONS
ATRICULAR SURFACE/INSERT
BY WHATSOVER NAME/ SPECIFICATIONS
(Any Material)
PATELLA COMPONENT BY
WHATSOVER NAME/ SPECIFICATIONS
62,770 31,220 15,870
4,090
* plus GST wherever paid or payable
(C) HIP IMPLANT – Rs.40,000/- + GST, wherever paid or payable
3. The rates prescribed shall be valid till further orders and are applicable to Implants of any name/category/comented/non-cemented.
4. The ceiling rates are applicable for treatment taken in government hospitals/ private empanelled hospitals/ other private hospitals.
5. Institutions such as hospitals utilizing knee implants shall specifically and separetely mention the cost of the knee implant component-wise along with its brand name, name of manufacturer/importer/batch no./specifications and other details, if any in their estimate/proforma invoice/final billing,etc.,
6. Prior permission of Competent Authority may be obtained before undergoing knee/hip Implant surgery.
7. This issues with the approval of competent authority and concurrence of Integrated Finance Division vide Dy.No.C.No.3119442, dated 30.08.2017.
Sd/-
(Sunil Kumar Gupta)
Under Secretary to the Government of India

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