SRINAGAR: The Jammu and Kashmir Government has amended the Jammu and Kashmir Civil Services (Medical Attendance and Allowance) Rules, 1990, by revising provisions governing eligible family members, reimbursement for medical treatment and ceiling rates for artificial appliances, cardiac devices, respiratory assistance equipment, hearing aids and prosthetic limbs.
The amendments have been notified by the Finance Department through Government Notification S.O. 276 dated October 23, 2026, signed by Shailendra Kumar, IAS, Financial Commissioner and Additional Chief Secretary, Finance Department.
The notification modifies Rule 3, Rule 5 and Rule 6-A of the 1990 rules and incorporates a revised schedule of maximum reimbursement ceilings for artificial appliances under Annexure ‘F’.
Under the amended Rule 3, the definition of family includes a government servant’s husband or wife, parents, sisters, widowed sisters, widowed daughters, minor brothers, children, stepchildren normally residing with and wholly dependent on the government servant, dependent brothers, dependent divorced or separated daughters, and stepmother.
The rules specify that family members shall be treated as wholly dependent on the government servant if they ordinarily reside with the employee and their total monthly income does not exceed Rs 9,000, plus dearness allowance, on the date of consideration. The notification also omits the note appearing below the explanation under clause (e) of the rule.
Rule 5 has been amended to explicitly include cardiac devices, intraocular lenses and CPAP, BiPAP and oxygen concentrator equipment within the provisions relating to artificial appliances and reimbursement. A new note specifies that the maximum reimbursement ceiling for artificial appliances shall be governed by Annexure ‘F’.
The revised schedule prescribes separate ceilings for different medical devices and procedures, including heart valve replacements, pacemakers, implantable cardioverter defibrillators, aortic stent grafts, eye lenses, respiratory support equipment, hearing aids and artificial limbs.
Under the schedule, the maximum ceiling for double valve replacement has been fixed at Rs 1,10,500, while mitral or aortic valve replacement has a ceiling of Rs 45,050.
For cardiac devices, the prescribed ceilings include Rs 34,840, plus GST, for a single-chamber pacemaker without rate response; Rs 44,928, plus GST, for a single-chamber pacemaker with rate response; Rs 83,200, plus GST, for a dual-chamber pacemaker; and Rs 1,95,000, plus GST, for a biventricular cardiac pacemaker.
The ceiling for a single-chamber implantable cardioverter defibrillator (ICD/AICD) has been fixed at Rs 1,75,786, plus GST, while a dual-chamber device carries a ceiling of Rs 3,75,000, plus GST. A combination cardiac resynchronisation therapy defibrillator (CRT-D) has a ceiling of Rs 4,90,000, plus GST.
The schedule also fixes the ceiling for an expandable, bifurcated aortic stent graft, including its delivery system, at Rs 4,40,960, plus GST. The ceiling for a rotablator with advancer is Rs 49,920, plus GST, while that for a rotablator burr is Rs 23,920, plus GST.
For intraocular lenses and related eye procedures, the schedule lists ceilings ranging from Rs 714 for small-incision cataract surgery with intraocular lens implantation to Rs 12,000 for cataract extraction with an intraocular lens and a Cionni’s capsular tension ring. The ceiling for extracapsular cataract extraction with intraocular lens implantation is Rs 5,000, while phacoemulsification with a foldable silicone, acrylic or PMMA intraocular lens carries a ceiling of Rs 9,375.
The listed ceilings also include Rs 10,000 for pars plana lensectomy with or without intraocular lens implantation, Rs 3,000 for penetrating keratoplasty with intraocular lens implantation and Rs 6,000 for secondary intraocular lens implantation, including anterior chamber, posterior chamber or sclera-fixated lenses.
For respiratory assistance equipment, the maximum ceiling has been fixed at Rs 45,000, plus GST, for an oxygen concentrator and Rs 45,000, plus GST, for a CPAP device. The ceiling for a bilevel CPAP device is Rs 68,000, plus GST, while a bilevel ventilatory system carries a ceiling of Rs 1,05,000, plus GST.
The schedule provides a ceiling of Rs 8,000 for digital behind-the-ear hearing aids and Rs 9,000 for digital in-the-canal or completely-in-canal hearing aids. The listed ceiling for a cochlear implant is Rs 5,35,000, subject to the conditions specified in the annexure.
The amendments also lay down reimbursement ceilings for artificial limbs and prosthetic devices, with rates varying according to the type of prosthesis, the limb involved, the patient’s age and the technology used.
For adults above 12 years, the listed ceilings for lower-limb prostheses include Rs 20,000 for a transtibial, or below-knee, prosthesis; Rs 37,000 for a transtibial prosthesis with a silicone or polyurethane liner; and Rs 45,500 for a prosthesis with such a liner and a shuttle-lock mechanism. A Symes prosthesis carries a ceiling of Rs 19,300, while a partial-foot prosthesis consisting of a shoe with filler has a ceiling of Rs 7,000.
The ceiling for a transfemoral, or above-knee, prosthesis for this age group is Rs 40,840 under the listed category. Higher ceilings have been specified for high-end prosthetic devices, including Rs 26,700 for a transtibial prosthesis, Rs 43,700 for a transtibial prosthesis with a silicone or polyurethane liner, and Rs 52,200 for one fitted with a liner and shuttle-lock mechanism.
For high-end above-knee prostheses for patients above 12 years, the ceilings include Rs 47,540 for a transfemoral prosthesis, Rs 51,340 for one with a suction valve, Rs 64,540 for one with a silicone or polyurethane liner, and Rs 73,040 for one with a liner and shuttle-lock mechanism. The ceiling for a high-end knee-disarticulation prosthesis is Rs 58,640.
Separate rates have been prescribed for children, with different ceilings for those aged up to six years and those aged seven to 12 years in specified categories. For instance, a transtibial prosthesis carries a ceiling of Rs 18,140 for children aged seven to 12 years and Rs 5,000 for those aged up to six years. A Symes prosthesis has corresponding ceilings of Rs 19,300 and Rs 5,000.
For children’s transfemoral prostheses, the schedule lists ceilings of Rs 49,980 for the seven-to-12-year age group and Rs 12,000 for children aged up to six years. A transfemoral prosthesis with a suction valve carries a ceiling of Rs 53,780 for the older child category, while specified versions with silicone or polyurethane liners and shuttle-lock mechanisms have ceilings of Rs 70,280 and Rs 78,780, respectively.
The schedule also covers hip and knee disarticulation prostheses, partial-foot devices, toe prostheses and upper-limb artificial appliances. The prescribed rates for these devices vary according to the type of prosthesis and age category.
For upper-limb prostheses, the listed ceilings include Rs 10,000 for a passive transradial, below-elbow or wrist-disarticulation prosthesis for patients above 12 years, Rs 20,000 for a passive transhumeral, above-elbow or elbow-disarticulation prosthesis, and Rs 30,000 for a passive shoulder-disarticulation prosthesis.
Body-powered devices carry separate ceilings, including Rs 17,000 for a transradial or below-elbow prosthesis and Rs 28,000 for a transhumeral or above-elbow prosthesis for patients above 12 years. The ceiling for an externally powered below-elbow or transradial prosthesis for adults is Rs 1,29,500, while an externally powered above-elbow or transhumeral prosthesis carries a ceiling of Rs 1,76,500.
The schedule further provides rates for silicone finger, thumb and partial-hand prostheses. A silicone finger prosthesis carries a ceiling of Rs 7,000 per finger for patients above 12 years and Rs 5,000 for those aged seven to 12 years. The corresponding ceilings for a silicone thumb prosthesis are Rs 8,000 and Rs 6,000. A silicone partial-hand prosthesis has ceilings of Rs 35,000 for patients above 12 years, Rs 25,000 for those aged seven to 12 years and Rs 10,000 for children aged up to six years.
Rule 6-A has also been amended to address reimbursement for treatment received at specified hospitals outside Jammu and Kashmir. The listed institutions include Apollo Group of Hospitals in Delhi, Chennai, Hyderabad, Bengaluru and Kolkata; Escort Heart Institute in Delhi; the Institute of Liver and Biliary Sciences Hospital in New Delhi; and Jaslok Hospital in Mumbai.
For treatment at these institutions, reimbursement is restricted to the amounts payable for the corresponding procedures at the All India Institute of Medical Sciences (AIIMS), New Delhi.
The notification thus establishes specified reimbursement ceilings for a range of medical appliances and procedures while revising the definition of eligible dependent family members under the Jammu and Kashmir Civil Services (Medical Attendance and Allowance) Rules, 1990.
The exact admissibility of individual claims, applicable conditions and the amount payable in a particular case will remain subject to the amended rules and the relevant provisions of the notification and its annexure.
