CGHS AYUSH Hospital Empanelment

CGHS AYUSH Hospital Empanelment - Complete Guide

📄 Download Official Document

📋 Overview

The Central Government Health Scheme (CGHS) has issued comprehensive guidelines for the empanelment of AYUSH hospitals and day care centers, along with revised treatment rates and procedures. This initiative aims to provide quality AYUSH healthcare services to CGHS beneficiaries across the country.

📅 Recent Updates:

November 2017: Major revision of AYUSH rates and empanelment procedures
September 2023: Clarification on referrals for beneficiaries aged 75+ years
November 2023: Clarification on IPD package rates and treatment intervals

🏥 AYUSH Systems Covered

The empanelment process covers the following systems of medicine:

Ayurveda

Yoga & Naturopathy

Unani

Siddha

✅ Eligibility Criteria for Hospitals

Mandatory Requirements:

NABH Accreditation: Hospital must be NABH accredited OR be a teaching hospital attached to colleges approved by CCIM
Minimum Infrastructure: Minimum 10 beds for each AYUSH system
Electronic Billing: Capability to submit bills and medical records in electronic format
Performance Bank Guarantee: ₹2 Lakh valid for 42 months

⚠️ Important Note: Existing non-NABH accredited AYUSH hospitals empanelled under CGHS must obtain NABH accreditation within one year of notification to continue their empanelment.

📝 Application Process

Required Documents:

Valid NABH Certificate
State Health Authority recognition certificate
Audited balance sheet and P&L account for last 3 years
Legal status and registration documents
Partnership deed/Memorandum & Articles of Association
Statutory requirement certificates:
- BMW disposal management
- Air and Water consent
- Drug License
- Green clearance
- Fire clearance
PAN card photocopy
Bank details with crossed blank cheque
Approved rate list
Staff list including visiting specialists
DD of ₹2,000 in favour of PAO, CGHS New Delhi

📅 Application Review Schedule: Applications are examined quarterly on the last working day of March, June, September, and December.

💰 Package Treatment Rates

What's Included in Package Rates:

Registration charges
Admission charges
Accommodation charges (excluding room rent for IPD)
Diet charges
Cost of medicines
Panch Karma charges
Doctor/Consultant visit charges
Monitoring charges
Operation theatre charges
Procedural charges/Surgeon's fee
Cost of disposable surgical items
Routine investigations
Physiotherapy charges

✅ Room Rent: As per recent clarification (November 2023), room rent is reimbursable in addition to package rates as per beneficiary entitlement for indoor treatment.

Sample Ayurvedic Therapy Rates:

Therapy Name	Unit Cost (₹)
Abhyanga (Full Body)	1,145
Pizhichil/Kayaseka (Full Body)	1,995
Shirodhara (Taila)	1,420
Shirovasthi	970
Vamana	745
Virechana	355
Nasya	600
Kati Vasti	845
Ksharasootra (Low level fistula - Package)	10,000
Agnikarma (Classical)	995

🩺 Common Conditions & Treatment Duration

Disease Condition	System	Likely Duration
Pakshaghata (Paralysis/Hemiplegia)	Ayurveda	14-35 days
Kateegraha, Gridhrasi (Sciatica, Low Back Pain)	Ayurveda	7-28 days
Sandhigatavata (Degenerative Joint Disorders)	Ayurveda	14-28 days
Greevastambha (Cervical Spondylosis)	Ayurveda	7-28 days
Arsha, Bhagandara (Hemorrhoid, Fistula)	Ayurveda	1-7 days
Amavata (Rheumatoid Arthritis)	Ayurveda	14-28 days
Shaqīqa (Migraine)	Unani	7-28 days
Fālij (Paralysis)	Unani	7-28 days
Zaghṭ al-Dam (Hypertension)	Unani	7-28 days
Zayābīṭus Sukkari (Diabetes Type II)	Unani	7-28 days

👥 Beneficiaries Eligible for Credit Facility

On production of valid permission/CGHS card, hospitals shall provide credit facilities to:

Members of Parliament
Central Government Pensioners
Ex-Members of Parliament
Freedom Fighters
Serving CGHS employees
Serving employees of Ministry of Health & Family Welfare
Serving employees of Ministry of AYUSH
Serving employees of Directorate General of Health Services
Other notified categories

Emergency Cases:

In emergency situations, hospitals must provide credit to all CGHS beneficiaries on production of a valid CGHS card, regardless of whether they are serving employees or pensioners.

🏨 Ward Entitlements

Private Ward:

Single patient accommodation
Attached toilet (lavatory and bath)
Complete furnishings: wardrobe, dressing table, bed-side table, sofa set, carpet
Bed for attendant
Air-conditioned

Semi-Private Ward:

2-3 patients accommodation
Attached toilet facilities
Necessary furnishings
Air-conditioned

General Ward:

4-10 patients accommodation
Necessary toilet facilities
Basic furnishings

⚠️ Important: Treatment in higher category accommodation than entitled is not permissible except in emergencies when entitled category is unavailable.

📋 Referral Process & Authorization

Authorization Requirements:

Pensioners, Ex-MPs: Permission from CMO In-charge
Members of Parliament: Rajya Sabha/Lok Sabha Secretariat
Judges: Registrar General of Supreme Court/Registrar of Delhi High Court
Serving Employees: Concerned Ministry/Department/Office
Autonomous Bodies: Concerned autonomous body

Treatment Duration:

CMO/SMO In-charges of AYUSH Wellness Centers shall decide the course of treatment with tentative duration:

General cases: Not more than 2 weeks
Extended cases: Maximum 35 days (on advice of treating doctor)

Special Clarification (September 2023): For beneficiaries aged 75 years and above, physical consultation by Ayurvedic physician is mandatory before treatment, as video conferencing is not appropriate for assessing physical condition and contraindications.

🔄 Treatment Intervals (Yoga & Naturopathy)

Important Update (July 2023):

Before 05.07.2023: Gap rules mentioned in N2 & Y2 of O.M. 2017 apply for pending bill clearance
From 05.07.2023 onwards: New treatment interval guidelines apply
Note: Time intervals for repetition apply to Yoga & Naturopathy only, not to Ayurveda treatments

💼 Performance Bank Guarantee & Penalties

Performance Bank Guarantee:

Amount: ₹2 Lakh
Validity: 42 months
Purpose: Ensure efficient service and safeguard against defaults

Violations Leading to Forfeiture (15% at a time):

Refusal of service
Undertaking unnecessary procedures
Prescribing unnecessary drugs/tests
Over-billing
Reduction in staff/infrastructure/equipment after empanelment
Non-submission or late submission of reports
Refusal of credit to eligible beneficiaries
Discrimination against CGHS beneficiaries

⚠️ Serious Note: Repeated defaults will result in total forfeiture of Performance Bank Guarantee and de-empanelment from CGHS.

📊 Bill Submission & Payment Process

Through Bill Clearing Agency (BCA):

For Pensioners:

Submit physical bill and electronic bill to BCA
BCA processes and makes payment

For Serving Employees:

Electronic bill to BCA
Physical bill to concerned department/employee
Employee claims reimbursement from office

Timeline:

Emergency Admission: Inform BCA within 2 hours; BCA responds in 4 hours
Post Discharge: Upload bills within 72 hours
BCA Processing: Clear bill in 7 working days

BCA Charges:

2% of claimed amount per bill

Minimum: ₹12.50
Maximum: ₹750 per claim
Plus applicable service tax

🖥️ IT Infrastructure Requirements

Hospitals must maintain:

Computer: Dual core/Core 2 Duo processor, minimum 2GB RAM, Windows OS, supported by UPS
Scanner: Dedicated color scanner, minimum 200 dpi resolution
Internet: High-speed connectivity
Security: Necessary security systems
Personnel: Designated Nodal Person for BCA interaction

⚖️ General Obligations & Responsibilities

Hospital Responsibilities:

Maintain valid NABH accreditation at all times
Maintain high quality standards of healthcare services
Obtain all statutory licenses and approvals
Immediately communicate changes in infrastructure/staff to CGHS
Submit monthly reports by 10th of succeeding month
Submit annual reports including referrals, admissions, billing details
Attend periodic meetings held by CGHS authorities
Cooperate during inspections and medical audits
Not make commercial publicity using CGHS/Government of India name
Indemnify CGHS/Government against all claims arising from services

Quality Assurance:

Continuous medical audit of services
Random verification of emergency cases
Inspection of medical records
Appropriateness of treatment verification

📞 Contact Information

Director, CGHS

Address:
CGHS Bhawan
R.K. Puram, Sector-13
New Delhi - 110066

For empanelment inquiries:
Addl. Director, CGHS (HQ), Delhi

Website:
https://cghs.mohfw.gov.in/

📌 Key Highlights Summary

NABH Mandatory

All hospitals must be NABH accredited or teaching institutions

MoA Validity

3 years with possible 1-year extension

Bank Guarantee

₹2 Lakh for 42 months validity

Quarterly Review

Applications reviewed every quarter

Room Rent

Reimbursable additionally as per entitlement

Emergency Credit

Mandatory for all CGHS beneficiaries

⚠️ Disclaimer

Educational and Informational Purposes Only

This article is provided for educational and informational purposes only to help central government employees understand CGHS AYUSH hospital empanelment guidelines. The content has been compiled from official government documents and circulars.

Important Notes:

This is not an official government publication or legal document
Information presented here is based on available official circulars and may be subject to updates or modifications
For official notifications, authorizations, and latest updates, always refer to the official CGHS website at https://cghs.mohfw.gov.in/
For empanelment applications and official procedures, contact CGHS headquarters directly
This website and its administrators are not responsible for any decisions made based on this information
Always verify information from official government sources before taking any action
Consult with appropriate CGHS authorities for specific cases or queries

Source: Content compiled from official CGHS circulars and notifications issued by the Ministry of Health & Family Welfare, Government of India.

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