Guidelines for reimbursement/settlement of Ayurvedic

treatment expenditure claims under insurance coverage.

Following benchmarks for insurance coverage of Ayurvedic treatment may be

applicable for settlement/reimbursement of insurance claims.

1. Eligible hospitals for Ayurvedic treatment-

a) Central or state Government hospitals
b) NABH accredited Ayurvedic hospitals
c) Teaching hospitals attached to Ayurvedic colleges recognized by Central
Government/ Central Council of Indian Medicine
d) Ayurvedic hospitals having registration with a Government Authority under
appropriate Act in a State/UT, minimum fifteen beds, minimum five
qualified and registered Ayurvedicdoctors, adequate number of qualified
paramedical staff, dedicated Ayurveda therapy sections and daily maintenance
of medical records.

2. Tentative list of diseases/disease conditions needing

hospitalization of the patients, indicative therapies and likely duration
of hospitalization-
Sl. Disease Condition Indicated therapies required Likely
No needing as per the condition of patient duration
hospitalization of
hospitaliz
ation

1. SwasaRoga,  Breathing Snehapana, Abhyanga, 7- 28

KasaRoga difficulty Nadeesweda, Vamana, DAYS
 Cough Virechana, Kavala,
(Restrictive  Fever Dhoomapana, Nasya, Pizhichil,
/Obstructive Thakra Dhara, Urovasthi, Taila
Pulmonary Vasthi, Kashaya Vasthi,Pichu,
Diseases, Thailam, Kashay Dhara,
Bronchial Asthma, Dhanyamla Dhara, Lepam
Emphysema,
COPD..etc)

2 Greevastambha,  Persisting or Abhyanga, Lepa, Upanaha, 7- 28

1
 Greevashundana radiating pain Jambeerapindasweda,, DAYS
in cervical Kukkutandapindasweda,
(Cervical region Shashtikapindasweda,
spondylosis,  Restricted neck Churnapindasweda, Pizhichil,
Cervical movements
Pathrapindasweda,
spondylitis,  Tenderness
Dhanyamlapindasweda,
Ankylosing  Numbness
 Vertigo Dhanyamladhara, Pichu,
spondylitis of Valukasweda, Aanchanam,
cervical spine, Sthanika Sekam, Nadeesweda,
Cervical disc Greevavasthi, Nasya, Kavala,
prolapse.etc) Dhoomapana,

Sirovasthi,
Snehapana,Vamana, Virechana,
Kashaya Vasthi,
Thailavasthi,Thalam,Veshtanam,
Dhanya Pindasweda, Valuka
Sweda

3 Kateegraha,  Persistent or KatiVasthi, PrishtaVasthi, 7- 28

gridhrasi, radiating back Agnikarma, Kati-pichu, DAYS
kateesoolatrikapri pain SiraVyadha/Siravedha,
stakateegraha,  Restricted Virechana
movements of
(Sciatica, Low low back/ hip Abhyanga, Lepa, Upanaha,
Back Pain/Ache, region Jambeerapindasweda,
 Tenderness
I.V.D.P, Kukkutandapindasweda,
 Burning
Spondylolysthesis sensation Shashtikapindasweda,
…etc) Churnapindasweda, Pizhichil,
Pathrapindasweda, Dhanyamla
Pindasweda, Dhanyamla Dhara,
Pichu, Valukasweda,
Aanchanam, Sthanika sekam,
Nadeesweda, Kati Vasthi,
Avagaha,

Snehapana, Virechana,
Thailavasthi, Kashayavasthi,
Ksheeradhara, PrIshtasandhi-
marma abhyanga (Lumbar
manipulation), Veshtana,
Dhanya pindasweda, Valuka
sweda

4 Apabahuka,  Radiating or Agnikarma, Abhyanga, Lepa, 7-28 DAYS

Viswachi local pain in Upanaha, Veshtanam,
shoulder region Jambeerapindasweda,
2
 (Frozen shoulder,  Restricted Kukkutandapindasweda,
Periarthritis, shoulder Shashtikapindasweda,
Tendinitis, movements Churnapindasweda, Pizhichil,
Brachial  Tenderness Pathrapindasweda,
neuralgia……etc)  Numbness
Dhanyamlapindasweda,
 Muscle wasting
Dhanyamladhara, Pichu,
Valukasweda, Aanchanam,
Sthanika sekam, Nadeesweda,
Greevavasthi, Nasya, KaVala,
Dhoomapana,

Sirovasthi, Snehapana,
Vamana, Thailavasthi,
Kashayavasthi, Dhanya
pindasweda, Valuka sweda,
Mamsa pindasweda

5 Pakshaghata  Weakness of virechana, 14 – 35

one side of the DAYS
(Paralysis, body kashaya vasthi, taila vasthi,
 Stiffness of shashtikapindasweda, pathra
Hemiplegia, muscles pindasweda, choorna
Hemiparesis…etc)  Muscle pindasweda, jambeera
weakness pindasweda, dhanyamla
 Numbness pindasweda, sirovasthi,
 Pain
thalapothichil,
 Tremor
 Difficulty in pichu,seka,
speech
nasya, kabala, dhoomapana,

abhyanga, thalam,
moordhathailam, pizhichil,
thailadhara, kashayadahara,
ksheeradhara, ksheera
dhoomam, jihwalepam,
nadeeswedam, valuka sweda,
mamsa pindasweda

6 Kampavata(Neuro  Tremor pizhichil, nasya, kabala, 14- 28

-spastic  Stiffness of gandoosha, dhoomapana, DAYS
conditions, muscles sirovasthi, ushmasweda, pichu,
Parkinson’s  Muscle choornapindasweda,
disease..etc) weakness pathrapindasweda,
 Walking
jambeerapindasweda,
difficulty
 Sluttering shashtikapindasweda,lepa,abhy
movements anga,
3
  Difficulty in nadeesweda,ksheeradhooma,
speech thailavasthi, kashayavasthi,
ksheeradhara-full body (different
varities), dhanyamlapindasweda,
dhanyapindasweda,
mamsapindasweda

7 Ardita  Weakness of murdhataila, nasya, kabala, 7- 21

facial muscles dhoomapana, mukhabhyanga, DAYS
(Facial  Drooping of nadeesweda,
Paralysis..etc) eye lids gandushaksheeradhooma,
 Numbness of karnapoorana, akshitharpana,
facial muscles
thalam, thailadhara,thakradhara,
 Salivation
sirovasthi, pichu,
thalapothichil/sirolepa,
virechana, tailavasthi,
kashayavasthi,
choornapindasweda,
pathrapindasweda, annalepa/
navaratheppu- sthanika

8 Vatarakta (gouti  Joint pain kashaya vasthi, thaila vasthi, 14-28

arthritis ischaemic  Swelling DAYS
limb, sle,  Tenderness virechana,
rheumatoid  Deformity
parisheka, rakthamoksham-
arthritis..etc),  Burning
sensation jaloukavacharana, siravedha,
kroshtukasheersh patra pinda sweda,
 Discolouration
a
nadee

sweda,

veshtana,

valuka sweda, choorna pinda

sweda, shashtika pinda sweda,
dhanyamla dhara, dhanyamla
pinda sweda, ksheera dhara,
kashaya dhara,lepana,
upanaha, avagaha, snehapana,
pizhichil

9 Amavata  Heaviness of virechana, kashaya vasthi, thaila 14-28

(Connective tissue body vasthi, DAYS
disorder,  Body ache
Rheumatic  Immobility valuka sweda, choorna pinda
fever..etc)  Fever sweda, dhanyamla pinda sweda,

4
  Swelling dhanyamla dhara,
 Pain in low rakthamokshana, upanaha,
back lepana, dhanya pindasweda,
nadee swedam

10 Sarvanga Vata  Generalized Shastikapidna 14-28

(Cerebral pain DAYS
atrophy, Cerebral  Stiffness sweda,
Diplegia, Motor-  Numbness
 Weakness Kaya Seka/Pizhichil,
Neuron diseases, Annalepana/Navaratheppu,
M.N.D, M.S,  Feeling of
coldness Abhyanga,
C.P..etc), SUPTHI
(Neurological Kashayavasthi, thailavasthi,
disorders,
Fibromyalgia..etc) Shiropichu, Snehapana,
ChoornaPindasweda,
DhanyamlaDhara,
DhanyamlaPindaSweda,
PathraPindaSweda,

Thailadhara, ThakraDhara,
Sirolepam, Nasyam,
Ksheeradhara,
MamsaPindasweda

11 Sandhigatavata  Joint pain Januvasti, Kashaya vasthi, 14-28 Days

(DEGENERATIVE  Restricted joint Thaila Vasthi, Prushta Vasthi,
JOINT DISORDERS, movements Katee Vasthi, Greeva Vasthi,
TENNIS ELBOW),  Stiffness Jaloukavacharana,
VATHAKANDAKAM
(CALCANEAL SPUR)
 Crepitus
Choorna Pindsweda, Pathra
Pinda Sweda, Shashtika Pinda
Sweda, Sthanika Annalepa,
Sthanika Vasthi, Upanaha,
Lepa, Pichu, Snehapana,
Parisheka, Veshtana,
Mamsakkizhi,Ksheeradhara,
Pizhichil

12 Twak Vikara (Skin  Discolouration Vamana, Virechana, Nehapana, 8-28 Days

Diseases), Kitibha,  Itching Rakthamokshana-
Ekakushta,  Scaling (Jaloukavacharana, prachana,
Vicharchika,  Oozing siravedha/ siravyadha) ,
Gajacharma  Peeling
(Lichen Planus,  Burning Parisheka, Takradhara, Lepa,
sensation
5
 Psoriasis,  Numbness KashayaDhara,
Eczema..etc) KashayaVasthi,TailaVasthi,
Kshalana, Abhyanga,
NadeeSweda

13 Visarpa  Rashes Rakthamokshana, 14- 28

 Blisters Jalukavacharana, Days
(Cellulitis,  Itching
Erisepelus,  Oozing Vamana, virechana,
Necrotising  Burning
Cellulitis, sensation Kashaya Vasthi, Thaila Vasthi,
Impetigo,  Pain Kashaya Dhara, Thakra Dhara,
Pemphiguos  Growths
Abhyanga, lepa,
vulgaris…etc),
Grandhi,
Arbuda(Benign &
Malignant
growths, Hodgkins
disease..etc)),

14 Arsha,  Constipation Virechana, Avagaha, Upanaha, 1-7 DAYS

Bhagandara,  Pain in anal Lepa, Taila Vasthi-Mathravasthi,
Parikarthika region Kshalana, Thakrapana, Varthi,
(Haemorrhoid,  Itching around Ksharakarma,Ksharasoothra,
Fistula in ano, anus Agnikarma Varieties Like
 Burning
Fissure in Classical/ Infra Red Coagulation/
sensation
ano..etc), NADEE  Prolapse of High Frequency Coagulation/
VRANA mass from Radio Frequency coagulation
(Pilonoidal anus ..etc, suction aided ring ligation
sinus..etc)  Bleeding from procedure, Kshara Pathana,
anus Taila Daha, Dhoopana,
 Pus from anus Goshbanabandha,

15 Moothraghata,  Painful Snehapana, Nadee Sweda, 14-28

Moothrakruchra, micturition or Virechana, Avagaha, DAYS
Asmari (Renal Pain in scrotum
disfunction, and penis with Kashaya vasthi, Taila Vasthi,
decreased Abhyanga,Uthara Vasthi, Lepa,
Renal/Urinary
urine output Dhara-Sthanika
Calculi, Urinary  Presence of
Disfunction/
6
 Obstruction...etc) blood with
urine may be
present
16 Kashtarthava,  Severe pain with Vamana, virechana, 14- 28
Kruchrarthava, menstruation DAYS
Artava Dushti,  Very less Kashaya vasthi, Thaila Vasthi,
Yonee Roga , menstrual flow or
no Menstruation Nasya, snehapana, Uthara
Rakthapradara vasthi, Yoni Prakshalana,
 Irregular
(Amenorrhoea, Udwarthana, Dhanyamla Dhara,
menstruation
Dysmenorrhoea,  Abnormal Dhanyamla Pinda Sweda,
PCOD/ PCOS, menstruation Avagaha , Yonidhavana, Yoni
D.U.B..etc) Pichu, Yoni Poorana, Yoni
Dhoopana, Abhyanga,
Ksharakarma, Nadeesweda

17 Mamsagata  Weakness of Choorna Pindasweda, Pathra 14-28

Vikara, muscles Pinda Sweda, Swedana, DAYS
Mamsakshaya  Wastage of Shashtika Pinda Sweda, mamsa
(Muscular muscles Pinda Sweda, Annalepa,
Dystrophy...etc) Vesthanam, Pizhichil,
Udwarthana,

Upanaha, Matra Vasthi,

Kashaya Vasthi

18 Dristidosha-  Diminished Tharpana, aschothana, 7- 28

Asama Drishti, vision DAYS
Nethraja  Photophobia Nasya,
Rakthapitham,  Dyplopia
 Watering of Eye exercises, Anjana,
Jeerna Putapaka, Shashtika
eyes
Nethrabhishyanda Pindasweda- Sthanika, Kashaya
 Pus formation
m, in eyes Vasthi, Thaila Vasthi,
Sushkakshipakam  Itching of eyes Jaloukavacharana, Nethra
,  Strain & pain in Dhara/ Akshi Seka, Sirovasthi,
Adhimandam,Nak eyes Taila Dhara, Thakra Dhara,
ulandhyam,  Restricted field Pichu, Dhoomapana,
Puyalasa, of vision
Snehapana, Virechana,Pindi,
Chathurtha  Headache
Vitalaka, Kshalana,
Patalagatha Sirolepa,Sirolepam,
Vikara Thalam,Eshana, Bhedana
(Refractive errors,
Chronic Allergic &
Inflamatory
diseases, Chronic
Conjunctivitis, Dry

7
 Eye
Syndrom,Retinitis
Pigmentosa, Night
Blindness,
Dacrocystitis,
A.R.M.D,
Retinopathy,
Blepharospasm..e
tc)

19 Sirasoola,  Severe Snehapana, Nadee Sweda, 7- 21

Sooryavartham, headache Nasya, Vamana, Virechana, DAYS
Ardhavabhedaka  Heaviness of Dhoomapana, Kabala,
m(Migraine, head Gandoosha, Thalam, Moordha
Headache…etc)  Nausea Taila, Pichu-Siropichu,
 Photophobia
Sirovasthi, Tailadhara,
Thakradhara

20 Khanja ,Pangu-  Dislocation of Veshtanam, Lepam, Dhara- 14-21

Abhigathaja, bone/ cartilage/ Sthanika, Kukkutanda Pinda DAYS
AbhighatajaVikara vertebrae Sweda, Jambeera Pindasweda,
(Restricted  Pain Shashtika Pinda Sweda,
movements due to  Swelling Annalepa, Choorna
 Restricted or
fracture/ Pindasweda, Pathra
painful
dislocation..etc) movements of Pindasweda, Pizhichil,
associated Dhanyamla Dhara, Pichu,
area/ nearby Abhyanga
muscles

3. Benchmark costing of Ayurvedic therapies/interventions-

Unit cost per therapy/intervention means cost of procedure including cost of
medicines used in the procedure as under.

Therapy/Intervention
No Treatment Name Unit Cost in Rupees
1 Abhyanga 1145
2 Abhyanga- Sthanika 570
3 Abhyanga + Sweda 1280
4 Avagaha 765
5 Anjana 340
6 Aanchana (Traction) 480
7 Annalepa/Njavaratheppu- Full body 1290
8
8 Annalepa/Njavaratheppu - Sthanikam 755
9 Aschothana 335
10 Agnikarma-Infra Red Coagulation (Package rate for full 10,000
Course of treatment)
11 Agnikarma- High frequency Coagulation (Package rate for 10,000
full course of treatment)
12 Agnikarma- Radio frequency Coagulation (Package rate for 10,000
full course of treatment)
13 Achasnehapana/day 440
14 Bhedana (of eye) 565
15 BhagnaBandhana (Fracture Bandage with Reduction 885
&Immobilisation)
16 ChoornaPindaSweda/Podikkizhi-Full Body 1210
17 ChoornaPindaSweda/Podikkizhi- Sthanika/Ekangam 715
18 DhanyaPindaswedam/Dhanyakkizhi/ Navadhanyakkizhi- 1245
Full body
19 Dhara/Sirodhara-Thaila 1420
20 Dhanyamladhara-Sthanika/Local -KateeDharaetc 705
21 Dhoopana 480
22 Dhoomapana 460
23 DhanyamlaPindaSweda/ Dhanyamlakkizhi/Kaatikkizhi-Full 1240
Body
24 Eshana 565
25 Greevavasthi 845
26 Gandoosha 390
27 Goshbanabandha 300
28 Jaloukavacharana 745
29 Jambeerapindasweda/ Narangakkizhi-Full Body 1190
30 Januvasthi 845
31 Kabala 390
32 Kateevasthi 845
33 Kashayavasthi (Niroohavasthi)-Different varieties 1030
34 KashayaDhara- Full Body 1045
35 KashayaDhara -Ekangam/ Local 635
36 KsheeraDhara(Medicated-different varities) -full body 1155
37 KsheeraDhooma 735
38 Kshara karma (Package rate for full course of treatment) 10,000
39 Ksharasoothra-Low level fistula (Package rate for full 10,000
course of treatment)
40 Ksharasoothra-Middle level fistula (Package rate for full 10,000
course of treatment)
41 Ksharasoothra- High level fistula (Package rate for full 10,000
course of treatment)
42 Kshalana 355
43 KsharaPathana(Package rate for full course of treatment) 10,000
44 Karnapoorana 350

9
45 Kuttanam 540
46 Lekhana 540
47 Lepa/Lepana-Local 390
48 Mathravasthi 350
49 MamsaPindaSweda/Mamsakkizhi-Full Body 1420
50 MamsaPindaSweda/Mamsakkizhi-Sthanikam/Ekangam 820
51 Mukhalepa 490
52 Moordhataila 315
53 Nadeesweda/Snigdhasweda - Full 580
54 Nadeesweda/Snigdhasweda - Ekangam/Local 450
55 Nethradhara/Akshiseka 595
56 Nasya 600
57 PathraPindaSweda/Ilakkizhi-Full 1220
58 PathraPindaSweda/Ilakkizhi-sthanika/Ekangam 720
59 Pizhichil/Kayaseka - Full Body 1995
60 Pizhichil - Sthanikam/Ekangam/Local 1105
61 Pichu 410
62 Prushtavasthi 845
63 Putapaka 850
64 Prachanna 590
65 Pindi 450
66 ShashtikapindaSweda/Navarakkizhi-full body 1320
67 ShashtikapindaSweda/ Navarakkizhi-Ekangam/Sthanikam 770
68 Sirovasthi 970
69 Snehapana/day 440
70 Sirolepa/Thalapothichil 1120
71 Siravyadha/Siravedha/Rakthamoksha 640
72 TailaVasthi 710
73 Thakradhara 1145
74 Thalam 410
75 Tharpana 735
76 Tailadaha (Package rate for full course of treatment) 10,000
77 Thakrapana 250
78 Utharavasthi 1100
79 Udwarthana 1095
80 Urovasthi 845
81 Upanaha/Upanahasweda 590
82 Vamana 745
83 Virechana 355
84 Valukasweda/Manalkkizhi- Full Body 1080
85 Vitalaka/Bitalaka 450
86 Yoniprakshalana 500
87 Yonidhavana 500
88 Yoni Pichu 460
89 Yoni Poorana 460
90 Yoni Dhoopana 335
10
91 Valukasweda/Manalkkizhi- Sthanikam 655
92 Ksheeradhara-Head 1095
93 Jambeerapindasweda/ Narangakkizhi-sthanika/Local 735
94 Dhanyapindasweda-Sthanika/Local 730
95 Dhanyamlapindasweda/ Katikkizhi-Sthanika 705
96 Veshtanam 330
97 Agnikarma (Classical with PanchalohaSalaka) 995

4. Determination of treatment expenditure for insurance coverage:

For the purpose of settlement of Ayurvedic treatment expenditure under health
insurance policy, following criteria may be applied-

a) Above-mentioned rates of therapies/interventions shall be benchmarks for

calculating treatment expenditure to settle insurance claim.

b) The above unit rates are inclusive of the cost implication of materials, medicines,
accessories, equipment maintenance and manpower (medical, paramedical and
nursing) used in imparting therapiesexcept room rent of the hospitalization.

c) Pre and post procedure cost will be chargeable @ Rs 75 per day.

d) 25% hike of the above rates shall be applicable for the treatment taken in NABH-
accredited hospital or any other hospital located in metropolitan city.

e) Room rent etc shall be chargeable as per norms of the insurance

company/insurance policy.

*****

11