(701)
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:-
Table A
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
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
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
703
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
704
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
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)
705
ANNEXURE- I
[List of Tests which are: (1) Free in Notification No. 3/78/1992-3HB-III dated 07.07.2017 as per MMIY
guidelines and (2) Also covered in Free Diagnostics Services Initiative of MoHFW, GoI]
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
706
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
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
Free Diagnostics Services Initiative of MoHFW, GoI]
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
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
707
Sr. No.
Name of the Test
Charges (INR)
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
covered under Free Diagnostics Services Initiative of MoHFW, GoI]
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
in Free Diagnostics Services Initiative of MoHFW, GoI]
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
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
709
Sr. No.
Name of the Test
Charges (INR)
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
710
HARYANA GOVT. GAZ. (EXTRA.), MAY 20, 2020 (VYSK. 30, 1942 SAKA)
Sr. No.
Name of the Test
Charges (INR)
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.