CGHS_Circulars

COMPILATION OF CIRCULARS ISSUED FROM 01/01/2011 TO 31/12/2020.

COMPILATION OF CIRCULARS ISSUED IN THE YEAR 2023.

CGHS CIRCULARS AND ORDERS - FROM 01/01/2020:

103. Rate Revison For Nuro Implants-MoH-OM Dated 09/09/24

102. Conversion to CGHS from CGHIS - ED Mumbai Letter Dated 04/09/2024.

101. Clarification on 50% Reimbursement of Lifetime Subscription - CO-MTNL OM Dated 03/09/2024.

100. Standard Operating Procedure to be followed by HCOs - Director OM Dated 02/09/2024.

99. Reiterating the Guidellines for treatment in HCOs - MoH OM dated 05/08/2024.

98. Functioning of HCOs - Notification by AD-CGHS-Pune-290724.

97. Revised procedure for referral process - MoH OM dated 28/06/2024.

96.Revised Procedure for submission of MRC Claims - CGHS OM dated 28/06/2024.

95. New Guidelines for issuing new CGHS cards to employees and pensioners - MoH OM dated 27/06/2024.

94. Linking of CGHS Card is kept in Abeyance until further orders - MoH OM dated 25/06/2024.

93. Revised Guidelines for submission of Bills by Empanelled Hospitals - MoH Letter dated 26/04/2024:

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92..Decentralisation of printing of CGHS plastic cards - MoH OM dated 26/03/2024.

91. Annual Health check up at empanelled hospitals - MoH OM Dated 18/03/2024.

90. Latest instructions to all HCOs - AD Mumbai Letter dated 14/03/2024.

89. Withdrawal from empanelment by Bombay Hospita - AD Mumbai Letter dated 14/03/2024.

88. Revision of Rates for General Surgery - MoH OM Dated 01/02/2024.

87. Correction in Cardiology Procedures - MoH OM Dated 12/01/2024.

86. Delegation of Financial Powers for Reimbursement Claims - MoH OM Dated 27/12/2023.

85.Revised Rates for Cardiology Procedures - MoH OM Dated 19/12/2023

84. Revised Rates for Lungs and Hearts Transplant Surgery - MoH OM Dated 01/12/2023.

83. Enhancement of Refund of CGHS Subscription - CO Letter Dated 16/11/2023.

82. Revised Ward Entitlements & Mapping of Pay Scales - MoC OM Dated 21/07/2023.

81. New Guidelines for availing CGHS facilities - ED, MTNL Mumbai Letter dated 11/07/2023.

80. Treatment at AIIMS Delhi by CGHS Beneficiaries - OM Dated 30/06/2023.

79. CGHS Rates for KNEE & HIP implants effective as on date (20/06/23) - OM Dt. 26/09/2017.

78. CGHS Rates for Cardiac Treatment effective as on date (20/06/2023) - OM Dt 06/08/2018.

77. CGHS Rates for Cancer Surgery effective as on date (20/06/2023) - MoH OM Dt. 07/09/2015.

76. Empanelment of D Y Patil Hospital, Newmumbai - MoH OM Dated 12/06/2023.

75. CGHS Rates Effective As on Today (20/06/2023) - MoH OM Dated 28/08/2011.

74. Insulin Infusion Pump Therapy - MoH OM Dated 16/05/2023.

73. Prescription of only Generic Medicine - MoH OM Dated 12/05/2023.

72. Reimbursement of Joint Replacement Surgery - MoH OM Dated 08/05/2023.

71. MR Claims can be given in the city of treatment - MoH OM Dated 08/05/2023.

70. CGHS Card is valid throughout India - MoH OM Dated 01/05/2023.

69. Empanelment of Bombay Hospital - AD, Mumbai OM Dated 24/04/2023

68. Revision of rates of Consultation charges etc. - MoH OM Dated 12/04/2023.

67. Referral Memo for Empanelled Hospitals without physical presence - MoH OM Dated 31/03/2023.

66.New Empanelled Hospital at Andheri East - AD, CGHS Mumbai OM Dated 20/03/2023.

65. Setting up of Grievance / Advisory Committee at Dispensary Level - MoH OM Dated 17/03/2023.

64. Linking of CGHS Beneficiary ID with ABHA - MoH OM Dated 11/01/2023.

63. Revision of ward entitlements after 7th CPC - MoH OM Dated 22/11/2022.

62. Clarifications on billing by Empanelled Hospitals - MoH OM Dated 10/11/2022.

61. List of Empanelled Hospitals in Chennai, Puduchery, Tiruchirapalli and Tirunelveli as on 20/09/2022.

60. Cancer Traetment at TATA Memorial Hospital - MoH letter Dated 13/09/2022.

59. New Empanelled Hospital for Cancer Treatment - AD letter Dated 12/09/2022.

58. New Empanelled Hospital at Mahim - AD letter Dated 17/08/2022.

57. Areas Covered under CGHS Dispensaries at Mumbai & Suburban Areas.

56. List of Empanelled Private Hospitals added from 01/07/2022. - MoH OM Dated 01/07/2022.

55. MINUTES OF MEETING DATED 28/04/2022.

54. Extension of Period of Empanelled Hospitals upto 30/09/2022 - MoH Office Order Dated 29/03/2022.

53. Increase of FMA from Rs.1000 to Rs.3000 - MoP OM Dated 16/02/2022.

52. Launching of 'myCGHS' Mobile App - MoH OM Dated 17/02/2022.

51. Storage of CGHS Card on Digilocker App - MoH OM Dated 27/01/2022.

50. Grant of Medical Advance for treatment under CGHS - MoH OM Dated 30/09/2021.

49. Reimbursement of OPD Medical Bills - Time Extended upto 31/10/2021 - MoH OM Dated 10/08/2021.

48. LIST OF RECOGNISED HOSPITALS AS ON 01/08/2021.

47. CGHS FACILITIES TO PRORATA PENSIONERS - MTNL ORDER DATED 15/07/2021.

46. Digitization of CGHS CLAIMS - MoH OM Dated 16/06/2021.

45. Rate List for Various treatments updated as on 15/05/2021.

44. Simplified Procedure for Covid-19 Treatment - MoH OM Dated 20/05/2021.

43. Treatment in Emergency - MoH OM Dated 26/04/2021.

42. Reimbursement of OPD Medical Bills - Time Extended upto 31/07/2021 - MoH OM Dated 15/04/2021.

41. Guidelines regarding Administration of COVID Vaccine to the CGHS Beneficiaries - MoH OM Dated 26/03/2021.

40. Guidelines for availing CGHS Facility by Retirees. - MTNL Letter Dated 20/03/2021.

39. Reimbursement of OPD Medical Bills - Time upto 28/02/2021 - MoH OM Dated 29/12/2020.

38. Reimbursement of Cost of Hearing Aids - MoH OM Dated 01/12/2020

37. Treatment in Govt Hospitals - MoH OM Dated 09/10/2020.

36. Reimbursement of OPD Medical Bills - Special Sanction - MoH OM Dated 24/08/2020

35. Procedure to claim 50% of Subscription - ED, Mumbai Letter Dated 24/08/2020.

34. Payment of CGHS Subscriptions through online - MoH OM Dated 21/07/2020.

33. Rates for Covid19 treatment at empanelled hospitals - MoH OM Dt 17/07/2020.

32. Rates for Covid19 treatment at empanelled hospitals - MoH OM Dated 10/07/2020.

31. Extension of Period to Empanelled Hospitals - MoH OM Dated 29/06/2020.

30. Revision of Time Limit for submission of claims - MoH Letter Dated 01/06/2020.

29. Reimbursement of the cost of 'Pulse Oximeter' to Covid Positive Patients - MoH OM Dated 16/06/2020

28. Guidelines for Tele Homecare of Covid-19 Patients - MoH OM Dated 16/06/2020.

27. Treatment for COVID-19 Patients in Empanelled Hospitals - MoH Letter dated 09/06/2020.

26. Advisory in view of Corona Virus Infection - Guidelines - MoH & FW Letter dated 15/04/2020 .

25. Empanelment of New Eye Hospital at Mulund - AD, CGHS, Mumbai Letter dated 20/02/2020.

24. Non-Eligibility for CGHS Facility to Direct Recruited Staff - DGM(Pen) orders dated

23. Eligibility of Disabled sons - MoH order dated 01/01/2020

22. Revised Rates for some tests - MoH order dated 14/01/2020.

21. List of Approved Rates for various treatments as on 01/01/2020

20. List of Empanelled Hospitals in Mumbai As On 01/01/2020

CGHS CIRCULARS AND ORDERS Prior to 2020:

--Time for Submission of Final Claim for Reimbursement revised from 3 months to 6 months. MoH OM Dated 27/05/2015.

1. ED, Mumbai Circular dated 10/07/2016, Please Click Here.

2. DOT OM DATED 31/08/2016 conveying mapping of Scales.

3. ED Mumbai Circular dated 02/02/2017.

4. ED Mumbai Circular dated 03/08/2017 for extension of date for opting CGHS.

5. ED Mumbai Revised Circular dated 19/07/2017 and addendum dated 02/08/2017

with forms etc.

6. MoH OM Dated 09/11/2017 - Simplified Procedure for Treatment at Private Empanelled

7. ED MUMBAI CIRCULAR DATED 15/12/2017. FINAL OPTION.

8. MoH OM Dated 15/01/2018 - Simplification of Referral System.

9. MoH OM Dated 22/05/2018 - Reimbursement in excess of Approved rates pertaining to

Medical Claims.

10. MoH OM Dated 21/02/2019 - OPD Treatment in CGHS Empanelled Hospitals.

11. DOT OM Dated 07/03/2019 - Reimbursement of Medical Claims to MTNL Retirees.

12. MoH OM Dated 29/05/2019 - Consultation by Sr. Citizens without referral.

13. MoH OM Dated 21/06/2019 - CGHS Card to be allowed throughout India.

14. DoT OM Dated 01/07/2019 - Revised Mapping of Scales for determining Subscription

and Ward Entitlements

15. MoH order dated 19/08/2019 for issue of OPD medicines for CGHS beneficiaries going

16. MoH order dated 21/08/2019 for treatment from Government Hospitals without

17. MoH order dated 13/09/2019 for Emergency Treatment in CGHS Empanelled Hospitals

without reference.

18. Supreme Court Judgement dated 13/04/2018 regarding disposal of reimbursement

claims.

19. MoH order dated 18/09/2019 regarding revised guidelines for disposing Medical

Reimbursement Claims.

MAPPING OF SCALES - CAT CASE:

1. CAT CASE JUDGEMENT DATED 12/09/2019.

2. IMPLEMENTATION OF JUDGEMENT -AD-CGHS(HQ) LETTER DATED 30/01/2020.

3. IMPLEMENTATION OF JUDGEMENT - MTNL-CO LETTER DATED 21/03/2020.

4. MAPPING OF SCALES FOR SUBSCRIPTION AND WARD ENTITLEMENT - DOT OM DATED 31/08/2016.

5. REVISED MAPPING OF SCALES FOR SUBSCRIPTION AND WARD ENTITLEMENTS - DOT OM DATED 01/07/2019.

CGHS COMPILATION .

MERITS AND DEMERITS OF CGHS AS ON 01/08/2018:

AREAWISE LIST OF RETIRED OFFICIALS AND LIST OF CGHS DISPENSARIES WITH

COVERING LOCATIONS.

1. VARIOUS ORDERS ISSUED BY MTNL .

2. STEP BY STEP PROCEDURE TO APPLY.

3. CGHS FORM B - FORMAT.

4. INSTRUCTIONS FOR FILLING UP OF FORM-B.

5. CERTIFICATE OF RECEIVING GOVERNMENT PENSION - FORMAT.

6. CGHS FACILITIES.

8. CGHS TEMPORARY CARD - MODEL.

9. CGHS DISPENSARIES.

10.CGHS EMPANELLED HOSPITALS FOR INDOOR TREATMENT.

11.SIMPLIFICATION OF REFERRAL SYSTEM - OM DATED 15/01/2018.

12.REVISED FORMAT OF CERTIFICATE FOR RECEIVING GOVT. PENSION W.E.F.

01/08/2018 WITH APPLICATION FORM.

13.Procedure for feeding application for CGHS Card through online.

14. Proforma for applying refund of 50% of CGHS Contribution.

15. List of Supporitng Staff for Feeding CGHS Application through online.

16. Medical Reimbursement Claim Submission:

DETAILED PROCEDURE: Please CLICK HERE.

17. Steps in case of Admissions to empanelled Hospitals:

a. In case of emergency the patient can be admitted to any of the empanelled Hospital or private /Government Hospitals in their entitled wards.

b. Admissions during emergency in entitled wards will make you eligible for reimbursement for claim as per CGHS Approved rates.

c. Wherever possible try to communicate with the dispensary attached to and obtain reference from attached dispensary as early as possible.

d. In normal course of time: first take advise /reference from the dispensary. Ensure that the reference issued is properly signed and stamped with "Credit facility" for taking treatment in the empanelled hospitals. On each occasion get proper reference so that there will not be any objection from CGHS.

e. Claim Forms as detailed in point 16 above need to be submitted to the dispensary.

f. Get proper acknowledgement from the dispensary on submission for followup. Normally it takes 4 to 5 months for dispensary to release the claim. Enquiry of Bill settlement / status can be had over telephone number 02222018600.

g. Medicine prescribed by Private Doctors can be obtained from the dispensary. Request private doctors to mention the Generic names of drugs prescribed as CGHS normally issue Generic medicine. Ask CGHS Doctors to know which medicine is issued against medicine prescribed by your doctors.

h. If the medicine in not in stock, CGHS will place order for supply of the medicine. This supply will take minimum of two to three days. If stock is not available in CGHS, CGHS doctors may be asked to permit purchase of these medicine locally, get reference and purchase in local market and submit claims in forms mentioned at Serial number 16 above.

18. PROCEDURE FOR ENROLLING IN CGHS BEFORE ISSUE OF PPO.

19. CGHS ENROLLMENT PROCEDURE AS ON 26/06/2020.

20. CGHS Approved Rates and other Circulars

21. PROFORMA FOR ADDITION/DELETION OF MEMBERS IN THE CGHS-CARD.

22. PROCEDURE FOR SELF-PRINTING OF CGHS CARD.

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