Guidelines i.r.o. IPD treatment in COVID situation under WBHS

Government of West Bengal
Medical Cell, Finance Department
Writers’ Building

No. 80-F (MED) WB Dated- 06/08/2020


Sub: Guidelines in respect of In-Patient Department (IPD) treatment in the COVID pandemic situation under WBHS

All kinds of In-Patient Department (IPD) treatments are admissible for the beneficiaries under West Bengal Health Scheme. Now, with the outbreak of COVID-19, the admissible cost of some components of IPD treatment under WBHS has been felt necessary to revise in consonance with the capping of these items as determined by the Health and Family Welfare Department, Government of West Bengal vide their Order No. 189-Secy.(H&FW)/20, dated 26.06.2020

As such, now, in cancellation of Finance Department Order No. 58-F (MED) WB dated 14.05.2020 and in continuation of all other Orders of Finance Department related to IPD treatment under WBHS, the Governor is pleased to issue a fresh guidelines for reimbursement towards the cost of any IPD treatment including COVID-19 cases in the following manner for the benefit of members enrolled under West Bengal Health Scheme:-

1. Codes and rates of COVID-19 Test, PPE & Other Protective Gears and Consultation Fees for COVID-19 treatment are as follows:-

Sl. No.ParticularsName of Hospital
Tata Medical Center, RajarhatOther Empanelled Private Hospital
CodeRate (Rs.)CodeRate (Rs.)
aCOVID-19 Test (Through RT-PCR, CBNAAT and TRUENAT method)060096742250/-020152242250/-
bPPE & Other Protective Gears060070181000/-010010401000/-
cConsultation Fees (All) per day for COVID- 19 patient.06016015600/-010010411000/-

2. Admissibility of PPE & Other Protective Gears Charges and total nos. of COVID-19 Test for each IPD treatment has been fixed as hereunder:-

Sl. No.Category of TreatmentNos. of days for which PPE & Other Protective Gears is admissible.Maximum nos. of admissible COVID-19 test.
aConservative treatment of COVID-19 Patient.All days of hospitalization3 (Three).
bConservative treatment of Non-COVID-19 Patient.First 2 (Two) days of hospitalization.1 (One).
cPlanned Surgical Package/Procedural treatment of Non-COVID-19 PatientNil.Nil.
dNon-Planned Surgical Package/Procedural treatment of Non-COVID-19 PatientFirst 2 (Two) days of hospitalization.1 (One).
eConservative treatment where COVID-19 and Non-COVID-19 medication exist.All days for COVID-19 treatment.3 (Three).

3. When a beneficiary under WBHS gets admitted through Emergency in a hospital without COVID-19 test, s/he shall be allowed Private/Isolation Bed for first two days of hospitalization irrespective of bed entitlement mentioned in his/her enrolment certificate. The beneficiary shall be shifted immediately to his/her entitled bed, when COVID report comes negative. And if COVID-19 report comes positive, the treatment of the beneficiary shall be continued keeping in Private/ Isolation Bed.

Charges of Private/ Isolation Bed for both the occasions will be admissible as per rate of WBHS.

4. But for the purpose of availing the planned surgical Package/Procedural treatment, the employee/pensioner or his/her dependent beneficiary shall produce the copy of COVID-19 Report to the hospital at the time of admission. The employee/pensioner may claim such cost of COVID-19 test as per clause 9 of WBHS for reimbursement if it is done at any Empanelled Private Hospital or Diagnostic Centre under West Bengal Health Scheme.

This will come into effect from the date of issuance order.

Sd/- Aloke Kumar Mukherjee, WBA & AS
OSD and Ex Officio Joint Secretary
to the Government of West Bengal
Finance Department

No. 80-F dated 06.08.2020, Source

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