7.

MEDICAL EXPENSES
7.1. REIMBURSEMENT OF MEDICAL EXPENSES

Expenses actually incurred in respect of Medical treatment, including hospitalization expenses at

the scales approved from time to time, as under:
i) For Self & Family - 100%
(Cir No. : CDO/P&HRD-IR/58/2017-18 Dated 10/11/2017)
The Bank has made tie-up arrangements for post-treatment payment facility with reputed hospitals
at various centres in the Circles for various ailments which require hospitalization and treatment is
expensive, whereby every patient (officer or a dependent family member) is admitted for treatment
in the appropriate entitled class. However, it is often observed that the treatment packages
stipulated for reimbursement of expenses on account of surgery, etc. are not taking care of the entire
expenses incurred by an officer as the charges are related to his grade. Further, in cases of
emergency when an officer is made to undergo treatment at a hospital, under tie-up or otherwise, the
charges are very often found to be more than the benchmark ceiling prescribed by the Bank for the
said treatment.
Against the backdrop of such constraints in the officers’ entitlement to 100% reimbursement in
terms of SBI OSR, 1992 and the amount actually reimbursed to him as per the schedule of charges
prescribed thereof, a committee was constituted to review / rationalize the Medical Aid Scheme of
the Bank for Supervising Staff.
The recommendations made by the Committee in its report was examined by us in detail and
approval of the Central Human Resources Committee (CHRC) was obtained thereof. Accordingly
it has been decided as under:
I) In respect of treatment taken in empanelled hospitals under post-treatment payment facility,
backed by a credit letter issued as per the officer’s entitlement, the expenses incurred thereof shall
be fully reimbursed for self and family.
ii) The standardization of medical charges will continue, as hitherto, and shall be applicable in
respect of treatment taken at hospitals/ Nursing Homes / Clinics, etc. which are not empanelled with
the Bank.
iii) There will be standardization of Bed charges only as per the grades of the officers in
respect of treatment taken at the Empanelled Hospitals, other charges-as stipulated by the
Circles based on the rates offered by the empanelled hospital shall be paid as per actual. In
other words, for treatment taken in eligible bed, the other charges linked to that bed shall be
reimbursed in full.
iv) All cases of medical implants for self treatment as well as that of the family shall continue
to be referred to Corporate Centre, as hitherto, for prior administrative approval/sanction.

Service Condition 69
v) Consultation charges incurred by the official in an empanelled hospital shall be reimbursed in
full. Other than an empanelled hospital, such reimbursement of charges shall be within a maximum
limit / a ceiling to be fixed by each Circle while determining the standardized rates of Medical
treatment after taking into account the local conditions / the reasonable rates ruling thereat.
However, such charges for consultation shall be reviewed by each Circle every two years.
7.1 (a) TREATMENT IN PLACES OTHER THAN HEADQUARTERS
(Cir. No.: CDO/P&HRD-PM/50/2017-18 Dated 17/08/2017)
In terms of instruction contained in Rule 24 (8) of SBIOSR, an officer of the Bank is entitled for
reimbursement of expenses on medical treatment, only if the treatment is taken at his headquarters.
He/she may avail treatment at other centres only with prior approval of Bank Medical Officer and
the sanctioning authority.
2. The Bank has empanelled hospitals in Metros and major centres, where rates are negotiated by
the Bank. An officer who desires to undergo treatment in an empanelled hospital at any centre,
either for self or for family member, is now permitted, without any prior recommendation from
Bank’s Medical Officer and approval of sanctioning authority. The entitlement of the officer would
be based on his grade and the rate agreed by the Bank with the hospital under tie up arrangement.
This will facilitate our officers to avail the best healthcare facilities in the country, without any loss
of time.
3. Consequently, Rule 24 (8) (viii) is being added to SBIOSR, 1992 as: Notwithstanding, anything
contained in subclause (i) to (vii) of Rule 24 (8) hereinabove, in case of treatment at any empanelled
hospital of the Bank, prior approval from authorised doctor / Bank Medical Officer and prior
permission from sanctioning authority will not be required.
4. Travelling expenses or lodging expenses incurred for availing such outstation treatment shall not
be reimbursed, in any circumstances as already mentioned in SBIOSR, 1992, in Chapter VI, Rule
24 (8) (vi).

7.2 DEFINITION OF FAMILY:

For the purpose of medical facilities and for the purpose of leave fare concession, the expression
‘family’ of an employee shall mean

a) the employee’s spouse, wholly dependent unmarried children (including step children and legally
adopted children) wholly dependent physically and mentally challenged brother/ sister with 40% or
more disability, widowed daughters and dependent divorced/ separated daughters, sisters including
unmarried/ divorced/ abandoned or separated from husband/ widowed sisters as also parents wholly
dependent on the employee.

b) The term wholly dependent family member shall mean such member of the family having a

Service Condition 70
monthly income not exceeding Rs.10,000/- p.m. If the income of one of the parents exceeds
Rs.10,000/- p.m. or the aggregate income of both the parents exceeds Rs.10,000/- p.m., both the
parents shall not be considered as wholly dependent on the officer employee.
c) A married female employee may include her natural parents or parents-in-law under the
definition of family, but not both, provided that the parents/parents-in-law are wholly dependent on
her.
Note: For the purpose of medical expenses reimbursement scheme, for all employees, any two of
the dependent parents/ parents-in-law shall be covered.

7.3 EXECUTIVE HEALTH CHECK UP SCHEME ( EHCS )

In view of growing incidence of cardiac problems, hypertension, diabetes, etc. among our senior
officers, it is felt that if these are detected in time and treated with care, we would have a healthier
profile of senior officers. It has, therefore, been decided that officers in MMGS III and above will
undergo compulsory medical check-up annually

After completion of the medical check-up, each officer will submit the medical report to the Bank’s
Medical Officer.

Officers may be permitted to undergo health check up under the scheme at the place / centre
convenient to him even if such centre is located outside the jurisdiction of his controlling office.
However, no special leave and also no travelling expenses shall be sanctioned for the purpose to the
officer.

Cost ceiling
Ceiling on charges under the scheme are Rs.4000/- and Rs. 4200/- for Male and Female officers
respectively at Major A category centres. For other centres the limit for Executive Health Checkup
shall be fixed by the Circles within the above stipulated amount.

The following four specialized tests have been included under the scheme :
a) PSA (Prostatic Specific Antigen) - For Male Officers
b) HBA 1C for diabetic only - For both Male & Female Officers
c) Vitamin D3 - For both Male & Female Officers
d) Vitamin D12 - For both Male & Female Officers

The above four specialized tests including the existing five specialized tests namely,

Service Condition 71
Echocardiogram, T3,T4,TSH, Pulmonary Function Test, Bone Densitometry and Mammography
will be carried out only if considered essential, based on the specific recommendations of the Bank
Medical Officer.
The above instructions will be effective from 1st April, 2014.

LIST OF COMMON TESTS AS PER THE EHC PACKAGE PLAN

1. Two consultations :
a) Physician / cardiologist
b) Surgeon
2. X-ray Chest (full-size plate)
3. E.C.G.
4. Pathology tests:
a) C.B.C.
b) E.S.R.
c) Blood sugar - Fasting with urine sugar - P.P. with urine sugar
d) Cholesterol
e) H.D.L. Cholesterol /Chol. + Triglycosides + LDL + VLDL ratio
f) Urea
g) Creatinine
h) Uric Acid (males)
i) S.G.O.T.
j) S.G.P.T.
k) Alkaline phosphatase
l) Urine routine
m) Stool examination
n) Blood grouping
o) Pap smear for female officers
5. Dental check-up
6. Ultra Sonography of abdomen & Pelvis
7. Stress test
8. Eye Check up

Service Condition 72
Following tests have been added in the list of tests mentioned above which may be carried out on the
recommendation of Bank’s Medical Officer:
1. Echocardiogram
2. T3, T4, TSH
3. Pulmonary function test
4. Bone Densitometry
5. Mammography
6. PSA ( Prostatic Specific Antigen ) — for Male Officers
7. HBA 1C for diabetic only — for both Male & Female Officers
8. Vitamin D 3 — for both Male & Female Officers
9. Vitamin B 12 —for both Male & Female Officers

BENCHMARK CEILING FOR THE SPECIALISED TESTS

Sr. No. Name of Specialized Test Benchmark Ceiling

1 PSA 500
2 HBA 350
3 Vitamin D 3 800
4 Vitamin B-12 500
5 Echocardiogram 1100
6 T3, T4, TSH 350
7 Pulimonary Function 450
8 Bone Densitometry 1300
9 Mammography 1000

7. 4 GLUCOMETER AND GLUCOSE TEST STRIPS:

The facility of reimbursement of the cost of Glucometer and Glucose test strip will be available to
all officers who are diabetic
The cost of Glucometer will be reimbursed up to a maximum amount of Rs. 1300/- (Rupees one
thousand three hundred only ) on onetime payment basis.
The Bank will not provide for its replacement on account of loss / theft / non- functioning etc.

Service Condition 73
The cost of Glucometer strips will be reimbursed to the officers as per the advice of the attending
Physician / Diabetologist

Employee should claim the reimbursement online through HRMS only

Hospital & Diagnostic Centre where Bank has Health Check Up Arrangements:
1. Hiranandani Hospital, Vashi. Tel : 022 39199300/302/7666160147.
2. Nucleus Diagnostic Centre, Seawood. Tel : 022 27725661/7718802447.
3. Nucleua Hospital Worli. Tel : 022 43151111.
4. Spectrum Health Centre, Nariman point. Tel : 022 22846357/ 22844940.
5. Clinical Diagnostic Centre, Bhulabhi Desai Road/Andheri(East). Tel : 022 23684764/ 66972352/53
6. Apollo Clinic, Colaba. Tel : 022 22021122.
7. Health 360, Marin Lines. Tel : 022 43429999.
8. Nanavati Hospital, Vile Parle. Tel : 022 26121622.
9. Global Hospital, Parel. Tel: 022 67670101.
10. Jupiter Hospital, Thane. Tel : 022 21725555/5547.
11. N. M. Medical Centre, Chowpatty, Bandra, Khar, Mulund, Borivali.
Tel : 022 43425555/43426666/43428888/43427777/43424444.

Service Condition 74
 LIST OF DIAGNOSTIC CENTRES (MUMBAI CIRCLE) - MUMBAI
NAME
DR. PURANDARE’S PATHOLOGY
LABORATORY
DR. MOPKAR’S DIAGNOSTIC
CENTRE
BSES HOSPITAL
ANJALI PATHOLOGY LAB.
ANTIA PATHOLOGY LAB.
SIDHVA X-RAY CLINIC, FORT
DR. SHAH’S DIAG. & MEDICAL
RESEARCH CENTRE
PRAKRUTI POLYCLINIC
CLINILABS (CHAMUNDA
( HEALTH CARE PVT. LTD)
SURYA HOSPITAL
Dr. BASAPURE’S RIDDHI
PATHOLOGY LABORATORY
WAY TO HEALTH DIAGNOSTIC
CENTRE
SANGANI DIAGNOSTIC CENTRE
SUYASH DIAGNOSTIC CENTRE
Service Condition
ACTIVITY ADDRESS & TELEPHONE NO.
Radiology 31-C, Dr. N.A. Purandare Marg, irgaun,
Chowpatty.022-23691520 -2360753
Pathology B/4, Indraprastha Bldg, S.T. Stand Road,
Nallasopara (W), Dist – Thane
95250 – 2400400 3291290
Pathology & S.V. Rd, Andheri (W), Mumbai
Radiology 66487500, 66973994
Pathology & 12/A, Chimanlal Apt, Behind Mamta Hotel,
Radiology Malad West Mumbai. 022-28820467
Pathology Stadium House, Churchgate, Mumbai
022-22855269 22821042
Radiology Thomas Cooks Bldg, D.N. Road, Fort,
Mumbai. 22043755
Pathology & 203/204, Mahavir Commercial
Radiology Complex, Junction of M.G. Rd, Ghatkopar
(E), Mumbai. 022-25010882 25010585
Pathology & Jain Chambers, S.V. Rd, Bandra (W),
Radiology Mumbai. 022-26513971
Pathology C-12, Shailesh Vihar, Opp. Ram Mandir, SVP
Road, Borivali(West),Mumbai 400 301
65710000 022-28946008
Pathology 21/B Plot sector 11, Nerul (E), New Mumbai
27714881 - 882
Pathology Shop No. 1, Laxmi Tower, Plot no.7, Sector-
42, opp. To Seawoods Railway Station, in
between SBI & HDFC Bank, Seawoods,
Nerul (W), Navi Mumbai. 9867747505
9323298737
Radiology & Shop No.4 & 5, shree Radhakrishna CHS,
Sonography Plot No.33, Sector-42/A, Seawoods, Nerul
(w), Navi Mumbai. 022 32719599
Radiology & F-2, B-2 Above VIP Shop, Sector-11
Sonography Market, Opp. To Taxi Stand & Bus Depot
Main Road, Nerul (e) Navi Mumbai.
27702474
Pathology & Centre 6, Swaralata Apts. Gr. Flr.,Gohale
Radiology Rd., Naupada, Thane (W), 022-25405899
25930655
75
 NAME ACTIVITY ADDRESS & TELEPHONE NO.
HEALTHCARE MEDICAL CENTRE & Pathology & Yogi Avenue, 1st floor, Yogi Nagar, Borivali
DIAGNOSTIC CENTRE Radiology (W), Mumbai-400092 28996565 /28991376
SHREE GANGOTRI POLICLINIC Pathology 3/ Gangotri Deen Dayal rd, Behind Everest
Hall Dombivvli (w), Thane 421202.
022-480332
SARAF’S DIAGNOSTIC CENTRE Pathology & 103/104, Vyom Arcade, First Floor, Tejpal
Radiology Scheme Road No. 5, Off. Subhash Road,
Vile Parle (East), Mumbai - 400 057.
26833441, 26833442
ALPHA HEALTHSCIENCES Executive 201, Shyaryans Audeus, Fun Republic
PVT LTD(JUST DIABETES) Helath Check Cinema Lane, Off Veera Desai Road,
up Andheri West), Mumbai - 400 053. 42419000
NAGPUR
CARE HOSPITALS Pathology & 3, Farmland, Pansheel Square, Nagpur-
Radiology 440010. 0712-3012021 -3982222
SHANTIMOHAN HOSPITAL, Pathology & 1st Floor, Opp. Saraf Chambers, Mount
NAGPUR Radioloy Road, Sadar, Nagpur - 440 001
0712-2542094, 2553454, 2541086
PULSE IMAGING & DIAGNOSTIC Pathology & Plot No.23/25, Opp. RTO, Amravati Road,
CENTRE, Radiology Giripeth, Nagpur 440010
0712 2526284, 9372528787
PANAJI
DR. RIVONKAR’S IMAGING CENTRE Pathology 1st floor, Campal Trade Centre, Behind
Military Hospital, Campal, Panaji, Goa
0832-2232691
DR. FONSECA’s PATHOLOGY Pathology Next to St. Sebastian Chapel Fontainhas
LABORATORY 0832-2225806
AURANGABAD
DR. HEDGEWAR RUGNALAYA Pathology & Garkheda, Aurangabad 2331195.
Radiology
APOLLO CLINIC Pathology & Plot No. 50, Jaivishwabharati Colony, Opp
Radiology Sapana Super Market, Aurangabad - 431 005
550413, 9765550401

Service Condition 76
 STATE BANK OF INDIA MUMBAI CIRCLE LIST OF
EMPANELLED HOSPITALS AS ON 01.10.2017

Sr. Name of Hospital Address & Telephone Nos. Facilities

No.
Mumbai
1 Bombay Hospital Marine Lines, Mumbai22067676 All facilities
2 Jaslok Hospital & 36, Dr.G Deshmukh Marg, Mumbai-400036
Research Centre 56573333 All Facilities
3 P D Hinduja National Veer Sarvarkar Marg, Mahim Mumbai
Hospital 24449199 24451515 All Facilities
4 Dr Balabhai Nanavati S V Road, Vile Parle [W], Mumbai - 400056.
Hospital 26182255 All facilities
5 R G Stone Urological 21-A,14-A Road, Ahimsa Marg, Khar [W], Mumbai
Research Institute 26041395/61463500 All facilities
6 Tata Memorial Parel, Mumbai. 022 24161413
Hospital Cancer
7 Fortis Hospital Mulund-Goregaon Link Road, Mumbai-400 078
67994444 All facilities
8 Hiranandani Fortis Mini Seashore, Sector 10-A, Vashi, Navi Mumbai -
Hospital, Vashi 400 703. Tel : 22-39199222 All facilities
9 Jupiter Hospital Eastern Express Highway, Thane (W), 400 601
2172-5555 All facilities
10 Kokilaben Dhirubhai Four Bunglow, Andheri (W), Mumbai- 400053.
Ambani Hospital 022-30999999 All facilities
11 Aditya Jyot Eye Plot no 153,Major Parmeshwaran Road, Wadala,
Hospital Pvt. Ltd. Mumbai 400 031. Tel. : 022-65102690/24177600 Opthalmic
12 Karuna Hospital Jeevan Bima Nagar, Near Bhagwati Hospital,
LIC clony, Boriwali (West) - 400 103
022-61594698/28934698/28953009 All facilities
13 Riddhi Vinayak 559, 1, Riddhi Vinayak Temple Lane, Near
Critical Care & N.L.High School, S.V.Road, Malad (W) 400064
Cardiac Centre 022-28663984-88/ 7498238115/ 7498241425/
9029097695/ 9029097695 All facilities
14 Apollo Hospitals Plot no. 13, Parsik Hill Road, Off Uran Road,
Sector 23 CBD Belapur, opp. nerul Wonders park,
Navi Mumbai 400 614. Tel: 022-33503350, 8767965459 All facilities

Service Condition 77
Sr. Name of Hospital Address & Telephone Nos. Facilities
No.
Aurangabad
15 Kamalnaynan Bajaj Gut No. 43, Satara Parisar Bajaj Marg, Beed
Hospital By-pass Rd. Aurangabad-431005. Tel: 0240-2377999 All facilities
16 Seth Nandlal Dhoot A-1 MIDC Chikal Thana Jalna Rd Aurangabad-431210
Hospital 0240-2489001-10 All facilities
Nagpur
17 K.G. Deshpande 218, North Bazar Road, Gokulpeth, Nagpur
Memorial Centre, 0712-2533777 All facilities
Nagpur
18 KRIMS Hospital, 275 Central Bazar Road, Ramdaspeth,
Nagpur Nagpur - 440010. Tel : 0712-2458685/ 6614564/65 All facilities
19 Platina Heart Near Hotel Hardeo, Sitabuldi, Nagpur – 440 012
Hospital, Nagpur 0712-2566555 All facilities
20 Avanti Institute of 301/B, Neeti Gaurav Complex, 21, Central Bazar Road,
Cardiology Pvt Ltd. Ramdaspeth, Nagpur - 10. Tel : 2448520 2460766
9823056729 Only Cardiac
Pune
21 Aditya Birla Aditya Birla Hospital Marg, P.O. Chinchwad,
Memorial Hospital Pune - 411 033. Tel : 020-30717500 to 04 All facilities
22 Ruby Hall Clinic 40, Sassoon Road, Pune - 411 001
020-26163391 All facilities
23 Poona Hospital and 27, Sadashiv Peth, Pune - 411 030
Research Centre 020-24338477 All facilities
24 Jehangir Hospital 32, Sasoon Road, Pune - 411 030

Service Condition 78
 SCHEDULE OF CHARGES APPLICABLE FOR MUMBAI CIRCLE
GENERAL PRACTITIONERS CHARGES (ALLOPATHIC)

MUMBAI AURANGABAD PANAJI PUNE NAGPUR

Service Condition
1 Consultation at dispensary 300 250 300 250 250
2 Medicines charges for basic medicines same same same same same
3 Visit charges for General Practitioners
(MBBS) to Residence of patients
Routine Day visit 500 350 500 450 350
Night visit/Emergency visit 750 500 750 650 500
SPECIALIST CONSULTANTS CHARGES
1) 1 st Consultation upto 1200 upto 800 upto 1000 unto 1000 upto 800

# Higher charges upto RS.2000/- for very senior consultant/super-specialty consultation at non-empanelled
hospitals may be considered for reimbursement, on merits of each case, as may be priscribed by the Sr. Medical Officer.
# Follow up charges for same illness (for 2 or 3 consultations within a reasonable period) paid upto 50% of the first
consultation fees, may be considered for reimbursement

2) Consultation with ECG upto 1600 upto 1100 upto 1500 upto 1500 upto 1200

3 Visit charges for Specialists/Consultants

i. Routine visit upto 1200 upto 1000 upto 1000 upto 1000 upto 800
ii. Emergency/Night visit upto 2000 upto 1500 upto 1500 upto 1500 upto 1000

79
 HOMEOPATHY MUMBAI AURANGABAD PANAJI PUNE NAGPUR
1 Consultation with the Registered
practitioner holding recognised 300 250 250 250 250
qualifications
2 Consultation with the M.D. Homeopathy 500 400 400 400 400
Practitioner.
3 Medicine charges for medicines 300 250 250 250 250

Service Condition
dispensed by attending physician per week per week per week per week per week
AYURVEDIC
1 Examination by Registered & Recognised
degree holders 300 250 250 250 250
2 Consultation by highly qualified/Post
Graduate Ayurvedic consultant upto 500 upto 400 upto 400 uoto 400 uoto 400
3 Medicine charges 300 250 250 250 250
per week per week per week per week per week
• Panch karma, Steam-bath, Body oil massage charges will not be eligible for reimbursement
• Medicines purchased on advice of the attending Ayurvedic Physician and bought from a reputed Chemist shop will be reimbursible.
NATUROPATHY
1 Consultation charges 200 200 200 200 200
In our opinion both Homeopathy and Aryudeic system of medicines hold equal importance in the eyes of law of the country. We cannot
differentiate between the two systems of medicine. Therefore, cost of medicines dispensed by Ayurvedic / Homeopathic doctor
should be considered at par.
ROOM/BED CHARGES (FOR ALLOPATHIC TREATMENT)
MUMBAI AURANGABAD PANAJI PUNE NAGPUR
JMGS I TO MMGS II 4000 3200 3200 3200 3200
MMGS III TO SMGS IV 6500 5200 5200 5200 5200
SMGSV 7500 6000 6000 6000 6000
TEGS VI & VII 9000 7200 7200 7200 7200
TEGSS I & II 12000 9600 9600 9600 9600
Higher limits of bed charges as mentioned above shall normally be applicable to large Corporate Hospitals. However, in case of
admission in non-empanelled hospitals/small nursing homes/clinics etc., prior permission must be obtained from Senior Medical
Office/regarding bed charges and other charges as stimpulated in these charts.

80
 CHARGES FOR DENTAL TREATMENT APPLICABLE TO MDS AND BD
Charges for Radiology, Diagnosis, treatment plan and procedures
(Range in charges has been given as per the nature and size of filling and surgical procedures implicated )
TYPE OF TREATMENT MUMBAI AURANGABAD PANAJI PUNE NAGPUR
B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S
1. Consultation 300 500 200 400 250 450 250 450 200 400

Service Condition
2. Treatment Planning 400 500 300 400 350 450 350 450 300 400
3. X-Rays
Intra Oral Periapical 150 200 90 140 100 150 100 150 90 140
Intra Oral Bitewing 150 200 90 140 100 150 100 150 90 140
Occlusal View 200 300 140 200 150 250 150 250 140 200
Panoramic View (Orthopantomograph) 400 500 300 400 350 450 350 450 300 400
4. Intral Oral Film One 150 200 90 140 100 150 100 150 90 140
CONSERVATIVE DENTISTRY
1. Restoration (Per Filling)
(A) Temporary, Filling with 400 500 300 400 350 450 350 450 300 400
Kalcinal cement
(B) Silver Amalgam Restoration 800 900 700 800 750 850 750 850 700 800
(C) Silicate cement Restoration 300 400 250 300 250 300 250 300 250 300
(D) Composite Restoration Full Labial 1500 2000 1200 1550 1300 1700 1300 1700 1200 1550
(E) Silver Amalgam Core 800 1000 600 800 700 850 700 850 600 800
building with or without support
(F) Glass losomer Restoration 800 1200 650 900 700 1000 700 1000 650 900
2 (A) CROWNS
Acrylin Jacket 800 1000 650 800 700 850 700 850 600 800
Porcelain Jacket 7000 8000 5500 6500 6000 7000 6000 7000 5500 6500
(B) Temporary Crowns Anterior/Posterior 500 600 400 500 450 550 450 550 400 500
(C) Crowns (Metal)
Nickle Chrome Crown 2000 3000 1550 2400 1700 2600 1700 2600 1550 2400
With Technique Alloy 800 1000 650 800 700 850 700 850 650 800
Dowl Pin 300 500 250 400 250 400 250 400 250 400
Dental Colour Facing Crown 1800 2500 1600 2000 1600 2000 1600 2000 1600 2000
Post & Crome (Cast Metals) 1500 2000 1200 1500 1300 1700 1300 1700 1200 1500
Acid Eiched Metal Unit (Marylard Building) 1000 1500 800 1200 800 1200 800 1200 800 1200
Zirconia Metal free crown 12000 15000 9000 12000 10000 13000 10000 13000 9000 12000

81
 TYPE OF TREATMENT MUMBAI AURANGABAD PANAJI PUNE NAGPUR
B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S
3 Bridges : Charges will be
unit wise one unit one crown
4 ENDODONTICS

Service Condition
(A) Root Canal treatment per tooth.
Anterior Tooth (Canine to Canine) 4000 5000 3100 3900 3400 4250 3400 4250 3100 3900
Posterior Tooth
Premolars - Per Tooth 5000 6000 3900 4700 4250 5100 4250 5100 3900 4700
Molars - Per Tooth 5000 6000 3900 4700 4250 5100 4250 5100 3900 4700
Pulpotomy (Per Tooth) 700 1000 600 800 600 850 600 850 660 800
Pulp Capping (Per Tooth) 700 1000 550 800 600 850 600 850 550 800
(Extra Charges for X-Ray.
atleast 3 X-rays are required
(B) Surgical/laser Uointly with
the maxillofacial oral surgery)
Apisectomy 1000 3500 1000 2500 1000 2500 1000 2500 1000 2500
(Anterior or Posterior Tooth)
Reimplantation 1200 2000 1000 1500 1000 1500 1000 1500 1000 1500
Hemi Section 1200 2000 800 1000 800 1000 800 1000 800 1000
Endodontic Implant 2000 2500 800 1500 800 1500 800 1500 800 1500
Restograde Filling 1000 2000 800 1400 800 1400 800 1400 800 1400
ORTHODONTIA - ORTHODONTICS
1. Extraction Case Nil 45000 Nil 35000 Nil 38000 Nil 38000 Nil 35000
(Treatment Peiod 18 to 28 month)
2. Non Extraction Case 20000 25000 15600 19550 17000 21250 17000 21250 15600 19550
(Treatment period 10 to 15 months)
3. Preventive & Compromise (Short 15000 20000 11750 15500 12750 17000 12750 17000 11750 15600
Term Treatment - Period 3 to 6 months)
4. Retention Plate or simple 3000 5000 2350 3900 2550 4250 2550 4250 2350 3900
orthodontic correction plate

82
 TYPE OF TREATMENT MUMBAI AURANGABAD PANAJI PUNE NAGPUR
B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S
MAXILLOFACIAL & ORAL SURGERY
1 Extraction 1 tooth 1000 1500 800 1100 850 1200 850 1200 800 1100
2 Surgical extraction 1500 2500 1100 1900 1200 2100 1200 2100 1100 1900

Service Condition
3 Surgical extraction of impacted tooth 3000 5000 2350 3900 2550 4250 2550 4250 2350 3900
4 A1voolegtomv one quandrant 3000 6000 2350 4700 2550 5100 2550 5100 2350 4700
5 A1licectomv one tooth 1000 1200 800 1000 800 1000 800 1000 800 1000
6 Extraction of flip pericoronal 1500 2000 1200 1600 1200 1600 1200 1600 1200 1600
7 Frenectomy 800 1000 650 800 650 800 650 800 650 800
8 Surgical Exposure of a tooth 1500 2500 1200 2000 1200 2000 1200 2000 1200 2000
9 1nterdental wiring and splinting 1000 1200 800 1000 800 1000 800 1000 800 1000
10 Bite Plates 1500 1800 1200 1500 1200 1500 1200 1500 1200 1500
11 Treatment of dry socket 1000 1500 800 1100 850 1200 850 1200 800 1100
12 Minor Oral surgery - Cysts 3000 4000 2350 3100 2550 3400 2550 3400 2350 3100
Granulomes, Residual infection
Mucocele, Epulis etc
13 Dressing - Per Dressing 60 100 50 80 50 80 50 80 50 80
14 Submucous injection 100 150 80 120 80 120 80 120 80 120
PERIODONTIA
1 Scaling & Prophylaxiz 1500 2000 1100 1550 1200 1700 1200 1700 1100 1550
2 Sublingual Curetage
(I) Per Tooth 300 400 200 300 250 350 250 350 200 300
(II) Quadrant 1000 1500 750 1100 850 1200 850 1200 750 1100
(III)Crown lengthening procedure 1500 2500 1100 1900 1200 2100 1200 2100 1100 1900
3 Gingivoplasty
(I) Quadrant 1500 2000 1100 1550 1200 1700 1200 1700 1100 1550
(II) Full Mouth 3000 3000 2500 2500 2500 2500 2500 2500 2500 2500
4 Gingivectomy
(I) Quadrant 1500 2000 1100 1550 1200 1700 1200 1700 1100 1550
(II) Full Mouth 3500 4500 2750 3500 3000 3800 3000 3800 2750 3500

83
 TYPE OF TREATMENT MUMBAI AURANGABAD PANAJI PUNE NAGPUR
B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S B.D.S M.D.S

5 Flap Operation
(I) Quadrant 2000 7000 1500 5500 1500 5500 1500 5500 1500 5500
(II) Full Mouth 12000 20000 9500 15600 10200 17000 10200 17000 9500 15600
6 Paooillectomy (Per Quadrant) 500 3000 400 2500 400 2500 400 2500 400 2500

Service Condition
7 Soft Tissue Graft (Per Tooth) 800 1500 650 1200 650 1200 650 1200 650 1200
8 Osteoolastv (Per Quadrant) 800 1500 650 1200 650 1200 650 1200 650 1200
9 Occlusal adiustment 100 200 100 200 100 200 100 200 100 200
10 Bone Graft (Per tooth) 1000 1500 800 1200 800 1200 800 1200 800 1200
11 Membrane (GTR) to prevent Nil 4000 Nil 4000 Nil 4000 Nil 4000 Nil 4000
Epitheliazation
12 Treatment for sensitivity of tooth 800 1200 650 900 700 1000 700 1000 650 900
and gum recession (per quadrant)
PEDODONTIA
(I) Metal Crowns (Performed) 1500 2000 350 900 400 1000 400 1000 350 900
(II) Flourodiaction (Per quadrant) 500 700 400 500 400 500 400 500 400 500
III) Fissure scaling (Per tooth) 300 1000 250 800 250 800 250 800 250 800
IV) General anaesthesia 3000 3000 2300 2300 2500 2500 2500 2500 2300 2300
(For procedures under GA, an
additional Charges per house will be
levied according to the duration

Most Important
1 Before undertaking any of the specialty dental treatment, prior submission of the estimate of charges from the Dental Consultant
and approval thereof from Bank’s Senior Medical officer, is absolutely essential.
2 Specialty dental treatment like Inalays, crowns, bridges and orthodontia will be permitted only after submission of adetailed
certificate from the Consultant Dental Surgeon that such procedure is absolutely essential for treatment an d p r e v e n t i o n o f a
particular disease process and that without such treatment the general health of the patient will be adversely affected in the long run
due to reasons to be given in each case.

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 CHARGES FOR SURGICAL OPERATION
NOTE:
1 Charges are permitted for Consultant surgeons only and not for general practitioners.
2 Higher limits of charges should be allowed only in case of senior and only reputed consultants and in corporate
hospitals, (discretion with authority sanctioning the medical bill)
Charges in eligible class of bed as applicable JMGS I &MMGS II MMGS III & SMGS IV
to (grade of officers)Grade of operations

Service Condition
MINOR OPERATIONS/SURGERY Mumbai Auranga- Panaji Pune Nagpur Mumbai Auranga- Panaji Pune Nagpur
bad bad
Minor operations under L.A.
(Surgeon leam) 4500 3825 3825 3825 3825 5000 4250 4250 4250 4250
Minor surgery under G.A. 5000 4250 4250 4250 4250 5500 4675 4675 4675 4675
(Surgeon fee)
Anaesthesia (G.A.) 2000 1700 1700 1700 1700 2500 2125 2125 2125 2125
Theatre 2000 1700 1700 1700 1700 2500 2125 2125 2125 2125
INTERMEDIATE
2.OPERATIONS/SURGERY
Surgeons fees 15000 12750 12750 12750 12750 17000 14450 14450 14450 14450
Anaesthetist* 5000 4250 4250 4250 4250 5500 4675 4675 4675 4675
Theatre 5000 4250 4250 4250 4250 5500 4675 4675 4675 4675
3. MAJOR SURGERY
Surgeons fees 30000 25500 25500 25500 25500 36000 30600 30600 30600 30600
Anaesthetist* 8000 6800 6800 6800 6800 9000 7650 7650 7650 7650
Theatre 8000 6800 6800 6800 6800 9000 7650 7650 7650 7650
MAJOR PLUS
4. OPERATIONS/SURGERY
Surgeons fees 36000 30600 30600 30600 30600 42000 35700 35700 35700 35700
Anaesthetist* 10000 8500 8500 8500 8500 11000 9350 9350 9350 9350
Theatre 10000 8500 8500 8500 8500 11000 9350 9350 9350 9350
SUPRA MAJOR
5. OPERATIONS/SURGERY
Surgeons fees 45000 38250 38250 38250 38250 53000 45050 45050 45050 45050
Anaesthetist* 11000 9350 9350 9350 9350 12000 11000 11000 11000 11000
Theatre per hour 10000 9000 9000 9000 7500 12000 10200 10200 10200 10200

85
 CHARGES FOR SURGICAL OPERATION
NOTE:
1 Charges are permitted for Consultant surgeons only and not for general practitioners.
2 Higher limits of charges should be allowed only in case of senior and only reputed consultants
and in corporate hospitals, (discretion with authority sanctioning the medical bill)

Charges in eligible class of bed as SMGS V & ABOVE

applicable to (Grade of officer)

Service Condition
Grade of operations
1.MINOR OPERATION/SURGERY Mumbai Aurangabad Panaji Pune Nagpur
Minor operations under L.A.
(Surgeon leam) 6500 5525 5525 5525 5525
Minor surgery under G.A. 9500 8075 8075 8075 8075
(Surgeon fee)
Anaesthesia (G.A.) 4000 3400 3400 3400 3400
Theatre 4000 3400 3400 3400 3400
INTERMEDIATE
2.OPERATIONS/SURGERY
Surgeons fees 19000 16150 16150 16150 16150
Anaesthetist* 6500 5525 5525 5525 5525
Theatre 6500 5525 5525 5525 5525
3. MAJOR SURGERY
Surgeons fees 42000 35700 35700 35700 35700
Anaesthetist* 10000 8500 8500 8500 8500
Theatre 10000 8500 8500 8500 8500
MAJOR PLUS
4. OPERATIONS/SURGERY
Surgeons fees 48000 40800 40800 40800 40800
Anaesthetist* 12000 10200 10200 10200 10200
Theatre 12000 10200 10200 10200 10200
SUPRA MAJOR
5. OPERATIONS/SURGERY
Surgeons fees 65000 55250 55250 55250 55250
Anaesthetist* 18000 16000 16000 16000 16000
Theatre per hour 18000 15300 15300 15300 15300

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 PACKAGES FOR CARDIAC AND NON CARDIAC AILMENTS
Mumbai Aurangabad Panaji Pune Nagpur
(upto Rs.) (upto Rs.) (upto Rs.) (upto Rs.) (upto Rs.)

1 Coronary Angiography 18000 14000 18000 18000 16000

2 Balloon Angioplasty 60000 50000 55000 50000 55000

Service Condition
(procedure charges) only
3 Cost of Medicated stent (upto) As per banks circulars instruction issues from time to time
4 C.A.B.G (By Pass Surgery) 250000 200000 250000 250000 160000
5 Open Heart Valve Replacement Single 250000+ 250000+ 250000+ 250000+ 200000+
(+ cost of valve) cost of valve cost of valve cost of valve cost of valve cost of valve
6 Open Heart Valve Replacement Double 270000+ 270000+ 270000 270000+ 220000+
(+ cost of valve) cost of valve cost of valve cost of valve cost of valve cost of valve
7 Renal Transplant 450000 383000 383000 383000 383000
8 Pacemaker implantation 100000 100000 100000 100000 100000
(single Chamber)
9 Pacemaker implantation 150000 150000 150000 150000 150000
(Double Chamber)
10 Open Heart Surgery for Redo 350000 298000 298000 298000 298000
11 Lasik Surgery (Myopid surgery) 20000 20000 20000 20000 20000
per eye (only as permissible).
12 Cataract including Lens charges 30000 26000 26000 26000 26000
Note: Physiotherapy charges upto Rs. 300/- per session may be reimbursed only on specific recommendation by the
attending specialist.

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