Hospital Charges Above Package Amount: What to Do Next

Reviewed on: 2026-05-30.

If hospital charges above package amount, collect the account, application, transaction, policy, property, employee, pension, scholarship or bill reference and send one precise written complaint to the office that can correct the record or release the money. Ask for a written reason if the request is refused or kept pending. Escalate with the same evidence bundle to hospital billing desk, medical records department, insurer desk and consumer forum. Use RTI only for records held by a public authority: file movement, deficiency notes, dispatch records, sanction details, payment advice, inspection reports or reasons recorded on file.

Use the correct external forum. Use National Medical Commission or the other official source linked below where it fits the subject. For consumer-service disputes, consider National Consumer Helpline and e-Daakhil. For public departments, CPGRAMS, state grievance portals and RTI may help. For high-value or time-sensitive cases, take professional advice before limitation expires.

• National Medical Commission
• National Consumer Helpline
• MoHFW

• /practical-guides/
• /practical-guides/category/healthcare-billing/
• /practical-guides/fixed-deposit-lien-not-removed-after-settlement/
• /practical-guides/hospital-refuses-medical-records-reasonable-time/
• /practical-guides/life-insurance-maturity-payment-delayed/
• /practical-guides/employer-not-giving-salary-slip/

Hospitals often overcharge patients above the approved package rates. Here is the complete guide:

1. Step 1: What are package rates? (a) CGHS (Central Government Health Scheme): fixed package rates for listed procedures, (b) PMJAY (Ayushman Bharat): fixed package rates for listed procedures (1,929 procedures), © state health schemes: fixed rates, (d) the hospital cannot charge the patient above the package rate for the listed procedure.
2. Step 2: Common overcharging issues. (a) hospital bills the patient for items included in the package (e.g., consultation, diagnostics, implants), (b) hospital charges for “upgraded” room or services not requested, © hospital refuses to accept CGHS/PMJAY and demands private rates, (d) hospital adds miscellaneous charges not in the package, (e) hospital charges for post-operative care that is included in the package.
3. Step 3: CGHS overcharging. (a) if a CGHS-empanelled hospital charges above the package rate: file a complaint with the CGHS AD (Additional Director), (b) the hospital can be derecognized for overcharging, © the patient should not pay above the CGHS rate — the hospital must bill CGHS directly, (d) if forced to pay: keep all bills and file for reimbursement.
4. Step 4: PMJAY overcharging. (a) PMJAY is completely cashless — the patient should NOT pay anything, (b) if the hospital demands money: call the PMJAY helpline 14555, © file a complaint on the PMJAY portal (nha.gov.in), (d) the hospital can be removed from the empanelled list for overcharging, (e) the NHA (National Health Authority) takes strict action against errant hospitals.
5. Step 5: Private hospital overcharging. (a) if there is no package rate (private treatment): the hospital must provide an itemized bill, (b) the patient can demand a break-up of charges, © if the hospital overcharges beyond the estimate: file a consumer complaint (deficiency in service), (d) file a complaint with the state health department.
6. Step 6: How to complain. (a) first: file a written complaint with the hospital's grievance officer, (b) if not resolved: file with CGHS AD / NHA / state health department, © if still not resolved: file a consumer complaint (medical overcharging is deficiency in service), (d) file RTI with CGHS/NHA asking for action taken.
7. Step 7: File RTI. File RTI with CGHS / NHA asking for: (a) the number of overcharging complaints received, (b) the action taken against hospitals, © the number of hospitals derecognized.

See Hospital Overcharging and Critical Illness Insurance.