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Apr 28, 2010

CGHS - Procedure for Reference

CGHS/ Govt. Specialist / CMO i/c advises specific treatment procedure / test.
Permission to undergo same at one of the recognized Hospitals / Diagnostic
centre is granted by CMO i/c in case of pensioner CGHS beneficiaries / ex-
Members of Parliament / Freedom Fighters / ex- Governors , etc., by CMO i/c of
Concerned dispensary and by Rajya Sabha Secretariat as the case may be in case
of Hon'ble Members of Parliament and by HOD in case of Serving Govt. employees
and by Autonomous bodies in case of serving employees and pensioners of
Autonomous bodies covered under CGHS.

CGHS HELPLINE 011-66667777 Email: helpline-cghs@nic.in

If the beneficiary seeks permission from a CGHS recognized hospital in another
CGHS city , other than the city where he is registered , permission shall be
granted by Addl. Director / Joint Director CGHS of concerned city. However , no
TA/DA shall be permitted if treatment facilities are available in the city of
residence; TA as per entitlement is permitted if no treatment facilities are
available in city of residence.

OPD treatment in private recognized hospitals is not permitted except in case of
Satellite cities of Delhi , viz., Noida, Gurgaon, Faridabad and Ghaziabad ,
wherein the

CMO i/c can directly refer the beneficiaries to recognized hospitals and in post
operative follow up cases of Cardiac surgery, Cancer treatment, Kidney
transplantation, Hip/Knee Joint Replacement , Neurosurgery and Accident cases.

OPD medicines are to be collected through concerned dispensary except in case of
emergency , in which case reimbursement shall be considered by HOD of department
/ Joint Director/Addl. Director of CGHS in case of pensioners , etc.,

In permitted post operative cases , for conditions as stated above, the
beneficiaries may purchase from chemist and claim reimbursement. However, an
utilization certificate from the treating doctor is required to be submitted.

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