Haryana Government Gazette
EXTRAORDINARY
Published by Authority
© Govt. of Haryana
No. 68–2020/Ext.] CHANDIGARH, WEDNESDAY, MAY 20, 2020 (VAISAKHA 30, 1942 SAKA)
HARYANA GOVERNMENT
HEALTH DEPARTMENT
Notification
The 20th May, 2020
No. 3/78/92-3HB-III.— In supersession of Government notification issued vide even No. dated 7.7.2017 the Governor of Haryana is pleased to order "Standardized and revised Hospital fee and charges:-
| Sr. No. | Item | Type of Facility | Approved Charges | Exempted categories |
| 1. | OPD purchee fee | Civil Hospital/SDH /FRU/CHC ( Sub centres & PHCs are exempted) | Rs. 5/- (Valid for 1 calendar year) | 1. BPL of Haryana/Antyodaya Anna Yojna (AAY) scheme beneficiary 2. Antenatal/Postnatal women (upto 42 days after delivery) 3. Infants (upto 1 year)/Beneficiaries of national programmes e.g. RBSK & DEIC 4. RTA/Unconscious/Unknown patients 5. Domestic violence/Sexual assault survivors 6. Medical examination of prisoners/as per court orders/for persons in police custody 7. Freedom fighters 8. Beneficiaries of old age pension scheme/disability pension scheme/widow pension scheme of government of Haryana 9. Holders of Ayushman Bharat – PMJAY gold card |
(701)702 HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
| 2. | Indoor Admission fee | Civil Hospital/ SDH /FRU/CHC ( Sub centres & PHCs are exempted) | Rs. 10/- for each admission | 1. BPL of Haryana/Antyodaya Anna Yojna (AAY) scheme beneficiary 2. Antenatal/Postnatal women (upto 42 days after delivery) 3. Infants (upto 1 year)/Beneficiaries of RBSK & DEIC 4. RTA/Unconscious/Unknown patients 5. Domestic violence/Sexual assault survivors 6. Medical examination of prisoners/as per court orders/for persons in police custody 7. Freedom fighters 8. Beneficiaries of old age pension scheme/disability pension scheme/widow pension scheme of government of Haryana 9. Holders of Ayushman Bharat – PMJAY gold card 10. All family planning procedures (Minilap, Laproscopic tubectomy, NSV, IUCD insertion etc.) 11. All Haryana Government employees, pensioners and their dependents as per Haryana Civil Service rules (valid for Indoor Patients only) |
| 3. | Hospital Bed Charges - General Ward | Civil Hospital/ SDH/FRU/ CHC ( Sub centers & PHCs are exempted) | Rs. 10/- per day | |
| 4. | Hospital Bed Charges - Private room | Civil Hospital/ SDH/ FRU/CHC | Rs. 250/- per day | None |
| 5. | Hospital Bed Charges - HDU | Civil Hospital | Rs. 350/- per day | 1. BPL of Haryana/Antyodaya Anna Yojna (AAY) scheme beneficiary 2. Antenatal /Postnatal women (upto 42 days after delivery) 3. Infants (upto 1 year)/Beneficiaries of RBSK & DEIC 4. RTA /Unknown patients 5. Domestic violence/Sexual assault survivors 6. Medical examination of prisoners/as per court orders/for persons in police custody 7. Freedom fighters 8. Beneficiaries of old age pension scheme/disability pension scheme/widow pension scheme of government of Haryana 9. Holders of Ayushman Bharat – PMJAY gold card 10. Cases with complications due to family planning procedures (Minilap, Laproscopic tubectomy, NSV, IUCD insertion etc.) |
| 6. | Hospital Bed Charges - ICU | Civil Hospital | Rs. 500/- per day | |
| 11. All Haryana Government employees, pensioners and their dependents- applicable as per Limited Cashless Medical Facility of state Government. | ||||
| 7. | MLC Charges | Civil Hospital/ SDH/FRU/ CHC | Rs. 250/- per MLR | 1. BPL of Haryana/Antyodaya Anna Yojna (AAY) scheme beneficiary 2. Antenatal/Postnatal women (upto 42 days after delivery) 3. Infants (upto 1 year)/Beneficiaries of RBSK & DEIC 4. RTA/Unconscious/Unknown patients 5. Domestic violence/Sexual assault survivors 6. Medical examination of prisoners /as per court orders/for persons in police custody 7. Freedom fighters 8. Beneficiaries of old age pension scheme/disability pension scheme/widow pension scheme of government of Haryana 9. Holders of Ayushman Bharat – PMJAY gold card |
| 8. | Duplicate copy of MLR | Civil Hospital/ SDH/ FRU/CHC | Rs. 250/- | If requested by Court or Police and Domestic violence/Sexual assault survivors |
| 9. | Post Mortem Examination | Civil Hospital/ SDH/FRU | Free for all | |
| 10. | Charges for keeping dead body in Mortuary | Civil Hospital/ SDH/FRU | Rs. 300/- per day | For bodies kept for post mortem examination |
| 11. | Duplicate copy of postmortem report | Civil Hospital/ SDH/FRU | Rs. 100/- | If requested by Court or Police |
| 12. | Laboratory Investigations (biochemistry, pathology & microbiology) not covered in assured list of MMIY and non Haryana residents | Civil Hospital/ SDH/FRU/ CHC | The lab investigation, surgical package charges and dental procedure charges will be applicable as proposed in MMIY notification while the procedures not covered in MMIY will be as per Annexure I-V. | 1. BPL of Haryana/Antyodaya Anna Yojna (AAY) scheme beneficiary 2. Antenatal/Postnatal women (upto 42 days after delivery ) 3. Infants (upto 1 year)/Beneficiaries of national programmes e.g. RBSK & DEIC 4. RTA/Unconscious/Unknown patients 5. Domestic violence/Sexual assault survivors 6. All Haryana Government employees, pensioners and their dependents as per Haryana Civil Service rules. 7. Medical examination of prisoners/as per court orders/for persons in police custody |
| 13. | Surgical package and dental procedure charges not covered in assured list of | Civil Hospital/ SDH/FRU/ CHC | ||
| MMIY and non-Haryana residents | 8. Freedom fighters 9. Beneficiaries of old age pension scheme/disability pension scheme/widow pension scheme of government of Haryana 10. Holders of Ayushman Bharat – PMJAY gold card | |||
| 14. | Service entry medical examination and re- medical examination fee • State of Haryana | Class- I & II | Rs. 500/- (including all individual tests & x-Rays) | None |
| Class- III | Rs. 200/- (including all individual tests & x-Rays) | |||
| Class- IV | Rs. 100/- (including all individual tests & x-Rays) | |||
| • Central Government employee or private sector employee | Rs. 500/- each (including all individual tests & x-Rays) | |||
| 15. | Driving license fee /Arms license fee/Medical Examination as a prerequisite for entry to school, colleges, institutions etc. for students | Rs. 100/- (including all individual tests & x-Rays) | None | |
| 16. | Birth and death certificate and their copies | As per provision of birth & death registration Act. |
*OPD registration charges in Shri Krishna Ayurvedic College Kurukshetra have also been rounded off to Rs. 5/-
Note: If an unknown patient is identified during the course of his/her treatment, he/she will be charged according to the approved charges.
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA) 705ANNEXURE- I
[List of Tests which are: (1) Free in Notification No. 3/78/1992-3HB-III dated 07.07.2017 as per MMIY
| Sr. No. | Name of the Test | Charges (INR) |
| CLINICAL PATHOLOGY | ||
| 1. | Haemoglobin Estimation (Hb) | Free |
| 2. | Total Leukocyte Count (TLC) | Free |
| 3. | Differential Leukocyte Count (DLC) | Free |
| 4. | MP (Slide Method) | Free |
| 5. | ESR | Free |
| 6. | PBF | Free |
| 7. | Blood Group (ABO-RH Typing) | Free |
| 8. | Total Eosinophil Count (TEC) | Free |
| 9. | Bleeding Time (BT)** | Free |
| 10. | Clotting Time (CT)** | Free |
| BIO CHEMISTRY | ||
| 11. | Blood Sugar (Fasting/ Random/Post Prandial) | Free |
| 12. | Glucose Tolerance Test (GTT)** | Free |
| 13. | Blood Urea | Free |
| 14. | S. Creatinine | Free |
| 15. | S. Uric Acid | Free |
| RFT* | Free | |
| 16. | S. Bilirubin (Total/ Direct/Indirect#) | Free |
| 17. | SGOT | Free |
| 18. | SGPT | Free |
| 19. | S. Alkaline Phosphatase | Free |
| 20. | S. Total Protein | Free |
| LFT* | Free | |
| SEROLOGY | ||
| 21. | HIV Rapid Test | Free |
| 22. | Sputum for AFB | Free |
| 23. | Dengue (Rapid) Test | Free |
| 24. | Widal Test** | Free |
| 25. | HBsAg (Rapid) Test | Free |
| URINE ANALYSIS | ||
| 26. | Urine Complete | Free |
| 27. | Urine Pregnancy Test (UPT) RDK | Free |
| 28. | Urine Microscopy | Free |
| STOOL ANALYSIS | ||
| 29. | Stool for Ova and Cyst | Free |
| 30. | Stool for Occult Blood** | Free |
| RADIOLOGY | ||
| 31. | X-Ray (Without Contrast) | Free |
| 32. | USG | Free |
| CARDIOLOGY | ||
| 33. | ECG | Free |
These tests will be done free of cost at Government Health Institutions where available.
*This test is a group of the free tests.
#This test is the resultant of other two tests mentioned together and it is usually done as a part of the group of tests covered in the list of free tests, thus added in the list.
**Need based inclusion in the list though these were chargeable in Notification No. 3/78/1992-3HB-III dated 07.07.2017 and unspecified in Free Diagnostics Services Initiative of MoHFW, GoI.
ANNEXURE- II
[Tests which were chargeable as per Notification No. 3/78/1992-3HB-III dated 07.07.2017 but now covered in
| Sr. No. | Name of the Test | Charges (INR) |
| CLINICAL PATHOLOGY | ||
| 1. | CBC | Free |
| 2. | Prothrombin time test INR | Free |
| 3. | Cell Count and Bio-chemistry (CSF, Pleural and Ascitic Fluid) | Free |
| 4. | Semen Analysis | Free |
| BIO CHEMISTRY | ||
| 5. | S. Electrolytes- Serum Sodium/Chloride**/Potassium/Calcium | Free |
| 6. | Troponin I/Troponin T | Free |
| 7. | S. LDH | Free |
| 8. | S. Amylase | Free |
| 9. | S. Total Cholesterol | Free |
| 10. | S. Triglycerides | Free |
| 11. | S. HDL | Free |
| Lipid Profile* | Free | |
| 12. | Serum TSH | Free |
| SEROLOGY | ||
| 13. | Rheumatoid Factor (RA) | Free |
| 14. | Anti Streptolysin – O (ASLO) | Free |
| 15. | S. CRP | Free |
| 16. | VDRL Rapid Test | Free |
| MICROBIOLOGY | ||
| 17. | Blood Culture (Bactec) | Free |
| 18. | Urine Culture | Free |
| 19. | Histopathology- Biopsy and/Bone marrow aspiration Exfoliative Cytology/Cytopathology) | Free |
| RADIOLOGY | ||
| 20. | X-Ray (With Contrast) eg. Barium Meal/Barium Enema/IVP etc. | Free |
These tests will be done free of cost at Government Health Institutions where available.
*This test is a group of the free tests.
** Need based inclusion as test is done as part of group of S. electrolytes covered in list of free tests.
ANNEXURE- III
[List of Tests which were unspecified in Notification No. 3/78/1992-3HB-III dated 07.07.2017 and now
| Sr. No. | Name of the Test | Charges (INR) |
| CLINICAL PATHOLOGY | ||
| 1. | Total Red Blood Cell Count | Free |
| 2. | Platelet Count by cell counter | Free |
| 3. | Packed Cell Volume (PCV) | Free |
| 4. | Coomb's test-Direct | Free |
| 5. | Coomb's test-Indirect | Free |
| BIO CHEMISTRY | ||
| 6. | S. Albumin | Free |
| 7. | S. Globulin# | Free |
| 8. | S. Albumin Globulin ratio# | Free |
| 9. | S. VLDL | Free |
| 10. | S. LDL# | Free |
| SEROLOGY | ||
| 11. | RPR Rapid Test | Free |
| 12. | Malaria (Rapid) Test | Free |
These tests will be done free of cost at Government Health Institutions where available. #This test is usually done as a part of/together with the group of tests covered in the list of free tests, thus added in the list.
ANNEXURE- IV
[List of Tests which were free in Notification No. 3/78/1992-3HB-III dated 07.07.2017 and unspecified in Free Diagnostics Services Initiative of MoHFW, GoI]
| Sr. No. | Name of the Test | Charges (INR) |
| CLINICAL PATHOLOGY | ||
| 1. | AFB Culture | Free |
| 2. | Cervical Pap Smear | Free |
| 3. | Audiometry Test | Free |
These tests will be done free of cost at Government Health Institutions where available.
708 HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)ANNEXURE -V
[List of Tests which were chargeable in Notification No. 3/78/1992-3HB-III dated 07.07.2017 and unspecified
| Sr. No. | Name of the Test | Charges (INR) |
| 1. | PTT - K | 60 |
| 2. | HbA1C | 100 |
| 3. | Serum Gamma Glutaryl Transferase (SGGT) | 50 |
| 4. | Serum Lithium | 25 |
| 5. | Serum Phosphorus | 25 |
| 6. | Serum B12 Assay | 100 |
| 7. | Serum Iron | 25 |
| 8. | Serum Ferritin | 100 |
| 9. | Serum Iron, TIBC & Serum Ferritin | 150 |
| 10. | Folic Acid | 100 |
| 11. | Homocysteine | 700 |
| 12. | Vitamin-D | 400 |
| 13. | Serum T3 * | 80 |
| 14. | Serum T4 * | 80 |
| 15. | Free T3 | 150 |
| 16. | Free T4 | 150 |
| 17. | Anti TPO antibodies | 250 |
| 18. | Parathyroid Hormone (PTH) | 500 |
| 19. | CPK * | 135 |
| 20. | CPK MB * | 160 |
| 21. | G-6-PD | 40 |
| 22. | Serum FSH * | 100 |
| 23. | Serum LH * | 100 |
| 24. | Serum Prolactin * | 80 |
| 25. | Serum Progesterone | 200 |
| 26. | Serum Estradiol | 200 |
| 27. | Serum Testosterone | 350 |
| 28. | Serum Lipase | 50 |
| 29. | Prostate Specific Antigen (Total/Free PSA) | 100 |
| 30. | Serum Human Chorionic Gonadotropin (HCG) | 100 |
| 31. | Serum Alpha-Fetoprotein (AFP) | 250 |
| 32. | CA- 125 | 250 |
| 33. | CEA | 150 |
| 34. | TORCH Complex | 250 |
| 35. | Water examination (Bacteriological) * | 100 |
| 36. | HPLC for Drug Monitoring | 250 |
| 37. | LE Cell | 40 |
| 38. | LD Bodies | 20 |
| 39. | Fungus Culture * | 50 |
| 40. | Pus /Semen/Stool/CSF Culture * | 50 per test |
| 41. | Urinary Bence Jones Proteins | 25 |
| 42. | Urine Creatinine (24 Hrs. Quantitative) | 25 |
| 43. | Urine Urobilinogen (Qualitative) | 50 |
| 44. | Microalbuminuria | 250 |
| 45. | Bone marrow with iron stain | 50 |
| 46. | Fluro image | 20 |
| 47. | Mammography * | 100 |
| 48. | Bone Density Measurement Dexa scan * | 300 |
| 49. | 2 D-Echocardiography * | 200 |
| 50. | Stress Echocardiography | 250 |
| 51. | Colour doppler | 150 |
| 52. | Exercise TMT * | 250 |
| 53. | ABP (Ambulatory blood pressure monitoring) | 250 |
| 54. | Holter * | 250 |
| 55. | EEG | 100 |
| 56. | Electro Convulsive Therapy (E.C.T.) | 100 |
| 57. | ABG | 50 |
| 58. | ABG Along with Electrolytes (Na +/ K +) | 100 |
| 59. | Fibreoptic Endoscopy | 100 |
| 60. | Sclerotherapy without Anaesthesia | 100 |
| 61. | Sclerotherapy with General Anaesthesia | 180 |
| 62. | Fibreoptic Bronchoscopy | 200 |
| 63. | Rigid Bronchoscopy | 500 |
| 64. | Complete Lung Function assessment including body Plethysmography | 150 |
| 65. | Special Pulmonary function Tests (PFT) (Lung volumes, Airway resistance compliance etc.) | 200 |
| 66. | Tracheostomy /Thoracocentesis (chest tube insertion) | 150 |
| 67. | Colposcopy | 150 |
| 68. | Estrogen Receptor | 270 |
| 69. | Progesterone Receptor | 270 |
| 70. | Psychological Test : IQ testing | 100 |
| 71. | Blood components (PRBC, Platelets, FFP etc.) for transfusion | As proposed by NACO |
| 72. | CT/MRI * | On Public-Private Partnership (PPP) to be charged as per the approved rates. |
| 73. | ESWL, Laser Therapy * | |
| 74. | Haemodialysis | |
| 75. | Cath Lab Procedures |
*The cost of these tests is as per Annexure F of MMIY Guidelines. Charges for the investigations, surgical packages and dental procedures not covered in the MMIY guidelines, are in accordance with PGIMS Rohtak and PGIMER Chandigarh rate list.
Note: If any test/service is free as per the guidelines of any National Health Programme then it will supersede the above notification as per the guidelines of that Programme.
This notification will come into force w.e.f. date of the notification in the Official Gazette.
RAJEEV ARORA, Additional Chief Secretary to Government of Haryana, Health Department.
8771—C.S.—H.G.P. Pkl.