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CGHS Guidelines & Ceiling Rates for Lung Transplant, Heart Transplant surgery

Subject: Guidelines & Ceiling Rates for Lung Transplant, Heart Transplant surgery in respect of CGHS/CS(MA) beneficiaries-reg.

Download CGHS Guidelines & Ceiling Rates for Lung Transplant, Heart Transplant surgery in PDF

File No. Z-42011/11/2021-MG/EHS Government of India Ministry of Health & Family Welfare EHS Section Nirman Bhawan, New Delhi-110011 Dated 1st December, 2023 OFFICE MEMORANDUM

The undersigned is directed to refer to above mentioned subject and to say that proposal for issuing guidelines & ceiling rates for Lung Transplant and Heart Transplant was examined in this Ministry, in consultation with Dte. of CGHS and Dte. General Health Services. The under signed is now, directed to convey the approval of the Competent Authority to issue guidelines for Lung Transplant/ Heart Transplant surgery in respect of CGHS/CS(MA) beneficiaries as per the details given below:


i. The ceiling rates for the surgery are as under:


a) Lungs Transplant - Rs.25 lakhs

b) Heart Transplant - Rs.15 lakhs

c) Heart & Lungs transplant (combined) - Rs.35 lakhs


ii. Government has constituted Standing Committees for consideration of requests for Lung / Heart Transplant cases from CGHS/CS(MA) beneficiaries as per the details given below:


A) Composition of Standing Committee for CGHS beneficiaries:


i. DDG(P) for CS(MA) beneficiaries/ Director, CGHS for CGHS beneficiaries - Chairman

ii. HOD, Respiratory Medicine, AlIMS - Member

iii. HOD, Respiratory Medicine, VMMC & Hospital - Member

iv. HOD, Respiratory Medicine, LHMC- Member

V. HOD, Respiratory Medicine, R&R, Hospital- Member

Vi. HOD, CTVS, AIMS - Member

vii. HOD, CTVS, Safdarjung Hospital - Member

viii. HOD, CTVS, Dr. RML Hospital - Member

ix. CMO (SAS-Ill) for CS(MA) beneficiaries/ AD(R&H) for CGHS beneficiaries -Member Secy.


B) Composition of Standing Committee for CS(MA) beneficiaries:


i. DDG(P) Chairman

i. HOD, Respiratory Medicine, AlIMS Member

iii. HOD, Respiratory Medicine, VMMC & Hospital Member

iv. HOD, Respiratory Medicine, LHMC Member

v. HOD, Respiratory Medicine, R&R, Hospital Member

Vi. HOD, CTVS, AlIMS Member

vii. HOD, CTVS, Safdarjung Hospital Member

viii. HOD, CTVS, Dr. RML Hospital Member

ix. CMO (SAS-III) Member Secy.


iii. Since, Lung/Heart transplant surgery is a planned procedure, prior permission has to be obtained before the surgery is undertaken.


However, if for any reason it was undertaken under medical emergency to save the life of a patient, the Standing Committees shall consider the cases referred to them for consideration of grant of ex-post-facto approval, on a case to case basis.


iv. Procedure for submission of Application:


a. CGHS beneficiaries shall submit the requests for permission for Lung/Heart transplant surgery to the Additional Director, CGHS of concerned city through the concerned Ministry/Department for placing the same before the duly constituted Standing Committee. Pensioner CGHS beneficiaries, etc., shall submit the applications to the additional Director of concerned Zone/City through the Wellness Centre.


b. In case of CS(MA) beneficiaries shall submit the requests for permission for Lung/Heart transplant surgery to the Under Secretary, EHS , MoHFW through the concerned Ministry/Department for placing the same before the duly constituted Standing Committee.


2. These guidelines has the approval of Competent Authority and concurrence of Integrated Finance Division, MOHFW vide CD No. 2401 dated 09.11.2023.


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