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DEPARTMENT OF HEALTH CARE, HUMAN SERVICES & FAMILY WELFARE

GOVERNMENT OF SIKKIM

TASHILING, GANGTOK

Memo No. 58/HC,HS & FW

Dated:05/10/2010

NOTIFICATION

The Governor of Sikkim is pleased to revise and fix the user charges for tests/investigations/medical & surgical procedures and to prescribe the criteria for admissibility of free supply of drugs and medicines in the government hospital and health centres in Sikkim, as follows, with immediate effect. This Notification supercedes all previous Notifications/orders on the subject.

1

Revised rate of user charges for various investigation/test procedure in government hospitals and health centres in Sikkim are as under:-

Sl.no.

Name of investigation/test/medical & surgical procedure

Rate (in rupees)

Remarks

I

Haematology

1

Total Leukocyte Count

10.00

2

Differental Count

10.00

3

ESR

5.00

4

Haemoglobin

10.00

5

HB %, TLC,DLC,ESR

25.00

6

Malarial Parasite

10.00

8

Peripheral Blood Picture (GBP)

20.00

9

Platelet Count

10.00

10

PCV (Packed Cell Volume)

Free

11

Test for Sickling

Free

12

Bleeding Time

10.00

13

Clotting Time

10.00

14

Prothrombin Time

25.00

15

Reticulocyte Count

20.00

16

ABO & RH Grouping

20.00

17

Coombs Test (Direct)

20.00

18

Coombs Test (indirect)

20.00

19

Activated Partial Thromboplastin Time (APTT)

25.00

20

Glycosylated Haemoglobin

50.00

21

CPK(CK-MB)

15.00

II

Infertility Tests

1

Semen Analysis

50.00

Free in case of NSV Cases

III

Immunological

1

Widal Test

30.00

2

Antisreptolysin O Titres

50.00

3

Rheumatoid Factor

50.00

4

Mantoux Test

Free

5

VDRL

Free

6

C-Reactive Protein

30.00

7

Urine for HCG

30.00

8

HBsAG

50.00

9

Anti HCV

50.00

Sl.no.

Name of investigation/test/medical & surgical procedure

Rate (in rupees)

Remarks

10

Rapid Test for Typhoid

50.00

11

TPHA

50.00

IV

Cardiology

1

ECHO

400.00

2

TMT

400.00

3

Holter Monitor

400.00

4

Cardiac Markers

1500.00

V

Metabolic Function

1

Serum Glucose (F/PP/Random)

15.00

Each

2

Serum Uric Acid

15.00

3

Serum Calcium

15.00

4

Inorganic Phosporus

15.00

VI

Psychiatry

1

Electroencephalogram (EEG)

300.00

VII

Renal & Prostrate Functions

1

Serum Urea

15.00

2

Serum Creatinine

15.00

3

Serum Acid Phosphatase

15.00

4

Bence Jones Protein

15.00

5

24 Hours Proteinuria

50.00

6

Serum Sodium

15.00

7

Serum Potassium

15.00

8

Serum Chloride

15.00

VIII

Liver Function Tests

1

Serum Bilirubin (Total & Direct)

15.00

2

Serum Protein (Albumin + Globulin)

15.00

3

SGPT

15.00

4

SGOT

15.00

5

Serum Gamma Glutamyl Transferase

15.00

6

Serum Alkaline Phosphatase

15.00

7

Complete Liver Function Test

100.00

IX

Lipid Profile

1

Serum Cholosterol

15.00

2

HDL

15.00

3

Triglcerides

15.00

4

Complete Lipid Profile (inluding VLDL/LDL)

100.00

Each

X

Serum Enzymology

1

Serum Amylase

15.00

XI

Bacteriology

1

All Cultures (sputum,Urine,Stool,Pus,Throat SW AB)

30-100

2

Zeihl Nelson Stain

10.00

3

Grams Stain

10.00

4

Leprosy Test

Free

5

KOH Preparation (Microscope)

15.00

6

Fungal Culture

50.00

7

Blood Culture

100.00

Sl.no.

Name of investigation/test/medical & surgical procedure

Rate (in rupees)

Remarks

XII

Urine Examination

1

Routine ALB/Sugar/Microscopy

20.00

2

Bile Salt

10.00

3

Bile Pigment

10.00

4

Ketone Bodies

10.00

5

Porpoblinogen

10.00

6

Urobilinogen

20.00

7

Urinary Uric Acid

20.00

8

Creatinine Clearance

50.00

XIII

Stool Examination

1

Routine (OVA/CYST)

10.00

2

Occult Blood

10.00

3

Reducing Substance

XIV

Special Investigation

Thyroid Profile

1

T3 T4 TSH

100.00

2

Free T3, Free T4, TSH

150.00

3

TSH only

50.00

4

ALPH Feto Protein

100.00

5

Anti Nuclear Antibodies

100.00

6

Biopsy (Small)

100.00

7

ADA

100.00

8

Biopsy (Large)

100.00

XV

Cytology

1

FNAC

50.00

2

PAP Smear

50.00

3

Cytology or Sputum/Fluids

50.00

4

Ascitic Fluid, Pleural Fluid, Synovial Fluid

50.00

each

XVI

Radiology

1

X-Ray (per plate)

30.00

2

Dental X-Ray

30.00

3

Ultrasound

200.00

4

CT Scan

600.00

5

MRI

2000.00

XVII

Dental Procedures

1

RCT

200.00

2

Complete Denture - Upper& Lower

1000.00

3

Orthodontic Treatment - Braces

2000.00

4

Implant Denture - Single

5000.00

5

Ceramic Crown -Single

600.00

6

Crown & Bridge (FPD)= 3 Unit

1800.00

7

RPD -Single

100.00

8

Light Cure Resin Filling - Single

100.00

9

Enucleation/Marsupialisation

1000.00

10

Reduction & Stabilization of fracture of mandible/maxilla

1000.00

11

Surgical Extration of tooth

1000.00

12

Apisectomy of teeth

1000.00

13

Extration & Scaling of teeth

100.00

14

GI/Silver Amalgam Filling

100.00

Sl.no.

Name of investigation/test/medical & surgical procedure

Rate (in rupees)

Remarks

XVIII

Medical & Surgical Procedures

1

Medicines, Drugs and Consummable items

As per approved Schedule of Rates of Central Health Stores Organisation (CHSO).The rates shall be applicable for dental procedures also.

2

Minor Operations/Procedures such as, Incision & drainage(minor), Lumber Puncture, Plural Effusion,Aspiration(Therapeutic), Abdominal Aspiration (Therapeutic), Bone Marrow Aspiration, Inter Costal Drainage, Liver Biopsy, Foreign Body Removal & any other type of minor operation/procedures certified by the treating/operating Specialist/Medical Officer as minor operation/procedure.

300.00

2

Major Operations/Procedures such as, Laparscopic Cholecystectomy , Appendicectomy, Ceasarean Section, Hysterectomy, Major Orthopaedic Operations or any other Operation/Procedure certified by the Operating Specialist as Major operation/procedure.

5000.00

XIX

REGISTRATION FEE

10.00

XX

ROOM/BED CHARGES

1

Private Ward (per room)

400.00

2

ICCU (per room)

200.00

3

General (per bed)

150.00

For health insurance claims & medical reimbursement clams only.

XXI

Ambulances Charges

1

STNM Hospital and District Hospital : Rs.10.00 per Kilometer without fuel within a radius of 5 (five) Kilometers from Hospital and Rs.2.00 per Kilometer with fuel beyond 5 (five) kilimeters.

2

Free supply of drugs and medicines shall be provided in the government hospitals and health centres in sikkim subject to following:

(i)

Indoor patient

Free tests/investigations and medical/surgical procedures including supply of drugs/medicines/consumables as per norms shall be provided to any indoor patient subject to submission of the following certificates duly attested by authorised person:-

(1)

Sikkim Subject Certificate, or

(2)

Certificate of Idendification, or

(3)

Voter Identify Card of Sikkim

(ii)

Outdoor patients:

Free supply of drugs/medicines as per norms shall be provided to any outdoor patient on the basis of prescription issued by Medical Officer of the hospital/health centre concerned in prescribed OPD Card bearing valid registration number subject to submission of the following certificates duly attested by authorised person:-

(1)

Sikkim Subject Certificate, or

(2)

Certificate of Idendification, or

(3)

Voter Identify Card of Sikkim.

NB:

The quantum of free supply of drugs and medicines to outdoor patient shall not exceed a period of 7 (seven) days only for any acute ailment/disease and a maximum period of 30 (thirty) days only in case of chronic ailment/disease.

(iii)

Diagnostic test/investigations (Pathology, Microbiology, Radiology etc., and Medical procedures: Except in case of (i) above all tests/investigations shall be provided on cost as per para 1 above.

Exceptions: The above will not apply to following category outpatient:

(a)

Senior Citizens (65 (sixty five years of age and above having proof of residence in Sikkim).

(b)

BPL patients (as per list notified by DESME)

Differently abled patient with more than 40% Disability on submission of requisite certificate issued by the competent authority.

(iv)

Emergency Cases: All treatment on emergency shall be provided free of cost as per norms as long as the patient is in the emergency ward and once the patient is stabilized and is shifted to any other ward he/she shall be liable to pay user charges as applicable or in vogue forthwith.

(v)

Government servants and their dependents: Government servant and their dependents, eligible for reimbursement of expenses under Sikkim Services (Medical Facilities) Rules shall not be provided free drugs/medicnies or tests and investigations in any government health institutions in the state. However in case of emergency, above (iv) shall apply.

(iv)

Consultancy Fees: No charge for services such as consultancy fees shall be levied in the hospitals and health centres.

(v)

Registration Fee: Registration fee shall be compulsory to all and no exception shall be allowed.

BY ORDER AND IN THE NAME OF GOVERNOR.

Sd/

(Vijay Bhushan Pathak) IAS

Commissioner-cum-Secretary to the Government of Sikkim

File No.GOS/H/Acctts/06/10-11

Memo No:68-76

Dated:5:10:2010

Copy to:

1

All Secretaries/ Heads of Departments

2

Principal Secretary to Governor

3

Principal Secretary to Chief Minister

4

PS to all Ministers

5

PS to Chief Secretary

6

Accountant General, Sikkim

7

Principal Director, Treasury, Pay & Accounts Office

8

Director-Cum-Medical Superintendent, STNM Hospital, Gangtok

9

Joint Secretary, Home Department for publication in the official Gazette

10

Chief Medical Officer, East, West, North & South District

11

File &

12

Guard file

(S.RAI)SCS

Additional Secretary to the Government of Sikkim