From Rs 5 OPD to Rs 40,000 Surgery: Maharashtra introduces new rates for Govt Hospitals
Pune: In a move affecting patient care across Maharashtra, the state government has issued a resolution revising user charges at government hospitals. The decision marks a shift from the largely free or nominal-cost care model followed over the past two years, introducing a comprehensive rate structure for clinical, diagnostic, and procedural services.
Issued on January 16, the government resolution stated that patients seeking treatment at state-run facilities, including district hospitals, rural and sub-district hospitals, and women’s hospitals, will now be charged for most services. The revised structure ranges from Rs 5 for outpatient department (OPD) registration to as much as Rs 40,000 for major procedures such as joint replacement surgeries. Though the order has been formally issued, implementation at the hospital level has yet to begin.
According to a report by The Times of India, the newly notified rate card has raised concerns among hospital administrators and healthcare activists.
The government resolution specifies that inpatients will be charged Rs 10 per day for admission, while commonly ordered laboratory investigations such as haemoglobin, total and differential leukocyte count, blood grouping, Rh typing, urine tests, and culture sensitivity will cost Rs 15 each. Imaging and diagnostic procedures have also been assigned fixed rates. An intravenous pyelogram will cost Rs 100 per X-ray, while CT scans have been priced at Rs 300 for head scans and Rs 400 for spine, neck, and chest imaging. MRI scans will be charged at Rs 1,600. Surgical procedures performed under anaesthesia have been categorised with charges ranging from Rs 60 to Rs 160, depending on complexity.
Maternal and critical care services are also included in the revised framework. While the first delivery for a pregnant woman will remain free, the second delivery will cost Rs 50, and the third and subsequent deliveries will be charged at Rs 250 each. ICU care has been priced at Rs 100 per day, haemodialysis at Rs 150 per session, and room charges at ₹150 per day for air-conditioned rooms and Rs 75 for non-AC accommodation in government nursing homes.
The government resolution also outlines charges for non-clinical services. Embalming of bodies handed over to private institutions will cost Rs 1,500. Ambulance services will be charged at Rs 5 per kilometre, with a waiting fee of Rs 30 per hour after eight hours. Among all procedures, joint replacement surgery carries the highest charge at Rs 40,000.
At the same time, the government has reiterated that treatment must not be denied or delayed under any circumstances and has directed that the names of treating doctors be prominently displayed. The resolution also clarifies that several categories will continue to receive free medical care, including government employees and their dependents, doctors and nursing staff of government hospitals, medical and paramedical students, prisoners under judicial inquiry, medico-legal cases referred by police, freedom fighters and their families, inmates of correctional facilities, destitute children, and elected representatives including MPs, MLAs, ministers, and judges.
Despite the detailed rate structure, hospital-level implementation remains uncertain. Civil surgeons across districts have indicated confusion due to conflicting government orders issued in the past. Dr Kailash Pawar, civil surgeon of Thane district, said the government had earlier issued a 2023 resolution stating that all services, including those under public-private partnership models, would be completely free. He said further clarification was needed to reconcile the two orders.
Similarly, Dr Kamlalkar Mudkhedkar, civil surgeon of Chhatrapati Sambhajinagar, said the resolution had only recently reached his office and that implementation had not yet begun. He indicated that hospitals were awaiting operational guidance before enforcing the new charges.
Public health activists have raised concerns about the impact of the decision on vulnerable patients. Sharad Shetty told TOI, "The charges may seem nominal on the face of it. However, people who approach govt hospitals are either desperate and need treatment or belong to the lowest strata of the society. Often, a day's wages is more important to them than treatment. The govt charging money would be a huge deterrent to those availing such healthcare services. The irony is that the GR mentions free treatment for MPs, MLAs and judges who never come to govt hospitals for treatment. The decision must be analysed again. Health must be completely free for all in govt hospitals."
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