Parliament Question: Consultation Fees to Visit Empanelled Hospitals

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 4771 TOBE ANSWERED ON20THMARCH,2026 CONSULTATIONFEES TO VISITEMPANELLED HOSPITALS 4771. SHRIASHOKKUMAR RAWAT: Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate: (a) whether it is a fact that in all empanelled hospitals in Delhi/NCR including BLK-MAX super speciality hospital under various Central Government Health Schemes, regular patients are required to pay consultation fees at every visit including for consultations with different specialist doctors, evenfor follow-up treatment, hospital-wise; (b) if so, the details thereof along with the reasons therefor and the guidelines issued by the Government inthisregard; (c) whether the Government is aware that repeated charging of consultation fees from regular/follow-up patientsiscausing financialburdentobeneficiaries,if so, the details thereof; (d) whether the Government proposed to issue directions to empanelled hospitals to waive or regularconsultationfeesfor follow-up visits within a specified period; and (e) if so, the details thereof along with the corrective steps taken or proposed to be taken by the Government inthisregard? ANSWER THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILYWELFARE (SHRIPRATAPRAO JADHAV) (a)to(e): As per OM No. 5-34/CGHS/HEC(HQ)/2025 dated 22.12.2025, each OPD consultationisvalidfor a period of 7days, providedit pertainstothe same speciality. Under the Central Government Health Scheme (CGHS), pensioner beneficiaries are entitled to cashless (credit) facility and are not required to pay any out-of-pocket consultation fee at empanelled Health Care Organizations (HCOs) for services covered under CGHS. The empanelled hospitals raise bills directly to CGHS as per prescribed rates and terms and conditions of empanelment. Similarly, serving beneficiaries submit Medical Reimbursement Claimstotheirrespective Departments, asperCGHS norms.Further, vide OM dated 28.06.2024, the referral guidelines for consultation, investigations and treatment at empanelled HCOs have been simplified. A referral issued by a CGHS Wellness Centre for specialist consultation is valid for three months, during which a beneficiary may avail up to six consultations, including with up to three specialists, if so recommendedbythe primary specialist. CGHS monitors the functioning of empanelled HCOs through feedback and grievance redressal mechanisms. Complaints regarding overcharging or denial of entitled services may be lodgedonthe CGHS portal or CPGRAMS andare acteduponasperextantguidelines. *****