Guidelines and Ceiling Rates for Permission/Reimbursement for Bariatric Surgery Procedures under CGHS/CS(MA) Rules

The Ministry of Health & Family Welfare issued guidelines for Bariatric Surgery procedure along with ceiling rates under CGHS and CS(MA) Rules, 1944.

Bariatric Surgery procedures shall be allowed in respect of CGHS/CS(MA) beneficiaries/parients with ‘morbid obesity’ as per the guidelines. Under the guidelines, 

i) Laparoscopic Gastric Banding Surgery; 

ii) Laparoscopic Sleeve Gastrectomy; 

iii) Laparoscopic Gastric Bypass and 

iv) other cases – 

as per examination and recommendation of an Expert Committee, are allowed

Hospitals/Centres approved for Bariatric Surgery are Government Hospitals, Hospitals run by PSUs, Private hospitals empanelled under CGHS/ CS(MA) Rules. However, Bariatric Surgery shall not be allowed in private non empanelled hospitals under CGHS/ CS(MA) Rules. 

Bariatric Surgery procedures are planned/elective procedures and hence, not regarded as emergency procedures. Prior permission has to be obtained from the competent authority on the basis of recommendation given by a Government Specialist before the surgery is undertaken. No ex-post facto approval for reimbursement shall be given. For those Bariatric Surgery procedures requests for prior permission in such cases shall be examined by an Expert Committee on a case to case basis and in consultation with IFD.