Grant of Medical Advance for all treatment (OPD and IPD) under CGHS / CS(MS) Rules – Clarification by CGHS

Grant of Medical Advance for all treatment (OPD and IPD) under CGHS / CS(MS) Rules – Clarification by CGHS

F-No. Z.15025/8/2021/DIR/CGHS
Government of India
Ministry of Health & Family Welfare
Department of Health

Nirman Bhawan, New Delhi
Dated the    September, 2021

OFFICE MEMORANDUM

Sub: Grant of Medical Advance for all treatment (OPD and IPD) under CGHS / CS(MS) Rules – clarification regarding

The undersigned is directed to refer to this Ministry’s O.M. No 14025/18/2015-MS/EHSS dated 17.10.2016 on the subject mentioned above and to say that a numbers of references seeking clarification on grant of medical advance to CGHS/CS(MA) beneficiaries in respect of treatment procedures for which there are no prescribed CGHS package Dates, are being received in this ministry.

View: Grant of 90% medical advance for all treatments (IPD and OPD) under CGHS and CS(MA) Rules, 1944

2. In view of the difficulties being faced by CGHS / CS(MA) beneficiaries, the matter has been examined in this Ministry and it has been decided that in case of treatment procedures without Package rates, the admissible amount is calculated item-wise at CGHS rate. Item(s) for which there are no CGHS rates, AIIMS rates shall be considered. If there is no CGHS/AIIMS rate, actual estimate for the procedure shall be considered.

3. The Hospital seeking advance shall provide item-wise break-up of the estimate to facilitate processing of the requests for medical advance, 90% of the admissible rates arrived at, as per para (2) above, would be considered for grant of Medical advance.

4. The other terms and conditions mentioned in the OM No 14025/18/2015-MS/EHSS dated 17th October 2016 shall remain unchanged.

Signed by Rajender Kumar
Date: 22-09-2021 11:37:15
Reason: Approved
(Rajender Kumar)
Under Secretary to Government of India

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