Medical policy for PB Employees: For Prasar Bharati Employees recruited after 05/10/2007, the following guidelines are implemented for the medical facility-
A. OPD Treatment:
i) Consultation: – From any doctor recognized by Indian Medical Council or State
medical Council;
ii) Investigation: From any laboratory of choice on the prescription of the doctor;
iii) Medicines: As prescribed by the Doctor, from any medical store;
iv) Reimbursement: Reimbursement would be restricted to a limit laid down in order
dated 22.11.2016 (shown in below table), upon production of original bills and prescriptions by the doctor.
The permissible limit of medical reimbursement under Medical Policy for PB Employees
A. In pursuance of the implementation of the 7th CPC recommendations, in respect of such employees, the following is clarified with regard to the permissible limit of medical re-imbursement for such employees in case of OPD treatment.
| Sl No | Basic Pay of employees recruited after 05.10.2007 as per 7th CPC | Maximum medical reimbursement per annum for OPD treatment |
| 1. | Upto Rs. 60,000/- | Rs. 30,000/- |
| 2. | More than Rs. 60,000/- | 50% of Basic pay subject to a maximum reimbursement of Rs. 75,000/- |
B. The reimbursement towards OPD treatment would not be restricted as per CGHS Rates and would be as per actuals (subject to the limit indicated above) on the production of original bills and prescriptions by the Doctor. It is as per the medical policy for PB Employees.
B. Indoor Treatment:
i) Treatment in Govt.lCGHS recognized/CS(MA) recognized/PSU empanelled hospital;
ii) Permission for treatment in a private hospital recognized under CGHS/CS(MA) or empanelled under PSUs would be given by Head of Office on the recommendation of GovtlCGHS/CS(MA) or PSU empanelled hospital;
iii) Payment of advance up to 90% of CGHS rates for the procedure as per CGHS Guidelines vide OM No. S-14025/18/2015-MSS/EHSS dated 17.10.2016;
iv) Reimbursement for indoor treatment is to be restricted to CGHS rates only;
v) Reimbursement of treatment taken in an emergency will be restricted to a maximum of CGHS rates (Upon production of emergency certificate);
vi) Reimbursement above Rs.1 lakh would be in consultation with IFD (of concerned Directorates). The cost of the implant including Hearing Aids is to be reimbursed as per limits fixed by Government for CGHS beneficiaries.
Medical Orders and Medical Policy for PB Employees
Order Dated: 22nd Nov 2016
1st General Medical order for Prasar Bharati Employees
Order Dated: 06th Oct 2017
Clarification of Order Dated 22nd Nov 2016
Order Dated: 16th May 2018
Reimbursement Limitation as per 7th CPC Recommendation
Order Dated: 04th Dec 2018
Provisions for Outdoor/indoor Treatment in respect of Prasar Bharati employees recruited after 05.10.2007
Order Dated: 28th Dec 2018
Agreement with private hospitals for OPD/IPD treatment
Order Dated: 05th June 2024
Clarification on OPD reimbursement of order dated 16.05.2018
Also Read:
Clarification on Medical Reimbursement for Prasar Bharati Employees: Medical Policy for PB Employees
