Maharashtra has expanded coverage for PET-CT scans under the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) and Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The decision is intended to reduce the financial burden on eligible cancer patients who need this advanced diagnostic test.
A Government Resolution (GR) issued by Maharashtra’s Public Health Department on 15 October 2026 adds PET-CT as an additional diagnostic procedure under 63 cancer treatment packages. It also permits the scan as a regular or primary diagnostic procedure for 13 selected cancer categories, subject to the scheme’s conditions. Previously, PET-CT was available as an add-on under 44 packages. Read the report from News On AIR.
For patients, the key point is that this is not an unconditional offer of a free scan to everyone with cancer. The scan must be medically necessary, the patient must meet the scheme’s eligibility and package requirements, and the hospital must follow the prescribed approval process.
What has changed under Maharashtra’s health schemes?
PET-CT combines positron emission tomography (PET) with computed tomography (CT). Doctors may use it to assess cancer activity, determine the extent of disease, evaluate treatment response and investigate possible recurrence.
The new coverage expands access in two ways:
| Change | What it means |
|---|---|
| PET-CT included in 63 treatment packages | Eligible patients undergoing covered cancer treatment may receive the scan as an additional diagnostic procedure when medically indicated |
| PET-CT approved for 13 selected cancer categories | The scan can be used as a regular or primary diagnostic procedure under the specified conditions |
| Government-approved scan rates | The GR sets rates for different scan types under the scheme |
| Specialist certification required | A specialist must certify that the scan is medically necessary |
| Prior approval required | The hospital must obtain the necessary approval before conducting the scan |
| Hospital infrastructure requirements | The empanelled hospital must meet the prescribed technical, staffing and in-house PET-CT facility conditions |
The decision follows recommendations from a study committee constituted after requests from patients and empanelled hospitals. The government expects the expansion to help eligible patients access necessary diagnostic investigations without having to pay the full cost themselves. See The Times of India’s report.
What are the approved PET-CT scan rates?
Reports on the Government Resolution list the following rates:
| Type of scan | Reported rate |
|---|---|
| Whole-body PET-CT | ₹20,400 |
| Brain PET-CT | ₹14,650 |
| Gallium-68 scan | ₹15,000 |
| Cardiac PET-CT | ₹9,400 |
These are reported scheme rates, not a promise that every patient can claim the amount as cash. Under the applicable cashless treatment arrangement, the scheme pays the empanelled hospital for an approved covered procedure according to its rules.
Eligible patients should not assume that they must pay these rates upfront and then seek reimbursement. Confirm the package, approval and payment arrangements with the hospital’s scheme desk before the scan.
Who can get a PET-CT scan under MJPJAY or Ayushman Bharat?
Coverage depends on the patient’s eligibility, the cancer-related treatment package, the medical indication and the hospital’s ability to provide the procedure under the scheme.
Before arranging a scan, check these points:
- Scheme eligibility: Confirm that the patient qualifies under MJPJAY, AB-PMJAY or the applicable integrated scheme arrangement.
- Medical necessity: The treating specialist must certify that the scan is needed.
- Package coverage: The relevant cancer treatment or diagnostic package must cover the scan under the new rules.
- Hospital eligibility: The hospital must be empanelled and satisfy the PET-CT facility requirements.
- Prior authorisation: The required approval and medical documentation must be submitted before the procedure.
The inclusion of PET-CT in 63 packages does not mean that every patient with any cancer automatically qualifies for every scan. Similarly, the 13 selected cancer categories refer to specified treatment or diagnostic categories under the scheme, not a blanket guarantee for all patients with those cancers.
How to get a PET-CT scan at an empanelled hospital
Follow these steps to reduce the risk of unexpected expenses or delays.
Step 1: Obtain a referral from your treating specialist
Ask your oncologist or the relevant specialist whether PET-CT is medically indicated and whether the planned scan fits the scheme’s coverage rules.
Keep the referral or clinical advice, recent reports, biopsy or pathology results where relevant, and previous imaging records available.
Do not arrange an expensive scan independently before checking whether the scheme requires a referral and prior authorisation.
Step 2: Confirm your scheme eligibility
Ask the hospital’s MJPJAY/PM-JAY help desk to verify the patient’s eligibility and required documents.
Depending on the scheme and the patient’s circumstances, the hospital may request identification, scheme or beneficiary details, medical records and other documents needed for authorisation.
Use official scheme channels if you are unsure whether the patient is covered.
Step 3: Find an empanelled hospital with PET-CT facilities
Not every empanelled hospital necessarily has its own PET-CT centre. The reported GR requires participating hospitals to have the necessary equipment, qualified staff and an in-house PET-CT facility.
Before travelling, call the hospital and ask:
- Is the hospital currently empanelled under the relevant scheme?
- Is PET-CT available at this facility?
- Can the hospital process the scan under the new coverage?
- What medical documents and beneficiary details are required?
- Does the hospital need to obtain prior authorisation?
Confirming these details in advance is particularly important for patients travelling from rural areas or smaller towns.
Step 4: Ask the hospital to obtain prior approval
The hospital must complete the prescribed authorisation process and submit the necessary medical documents before performing the scan.
Ask the scheme desk to explain whether the request has been submitted and whether approval has been received. Keep any reference or acknowledgement provided by the hospital.
Do not treat a doctor’s referral alone as confirmation that the scan has been approved for cashless coverage.
Step 5: Confirm the cashless arrangement before the scan
Once the hospital confirms approval, ask it to clarify what is covered under the authorised package and whether any item is excluded.
For an approved covered procedure, eligible patients should receive the benefit according to the scheme’s cashless rules. If the hospital asks for payment, request a written explanation of the charge and contact the scheme help desk before paying, where practical.
Retain copies of the authorisation, scan report, discharge or treatment documents, and any receipts.
Where can you find an empanelled hospital?
Start with the official scheme resources rather than relying on an old hospital list circulating on WhatsApp.
- MJPJAY official website: jeevandayee.gov.in
- Ayushman Bharat PM-JAY: pmjay.gov.in
- National Health Authority: nha.gov.in
Use the current hospital-search or empanelled-hospital information available through these official sites, or ask the scheme desk at a hospital to confirm its current status.
When calling a hospital, be specific: ask whether it is empanelled under the applicable scheme and whether it can perform and obtain approval for PET-CT under the newly covered packages. General empanelment does not necessarily mean that every diagnostic service is available at that location.
What if a hospital says PET-CT is not covered?
If a hospital refuses to process the scan under the scheme, ask for the reason. The issue may relate to patient eligibility, the relevant treatment package, the medical indication, the hospital’s facilities or a pending authorisation.
You can then:
- Ask the treating specialist to confirm the medical indication and relevant package.
- Request the hospital’s scheme desk to explain the applicable coverage rule.
- Check whether another currently empanelled hospital has the required PET-CT facility.
- Contact the official scheme help desk if you believe the request is being handled incorrectly.
- Keep records of the hospital’s response and any authorisation reference.
Do not assume that a refusal at one hospital means the scan is excluded everywhere. Equally, do not assume that the government announcement guarantees approval for every case.
Why is PET-CT important in cancer care?
PET-CT provides information about metabolic activity alongside anatomical imaging. Depending on the cancer and clinical situation, doctors may use it to:
- Help assess the extent or stage of a cancer.
- Investigate whether disease may have spread.
- Evaluate response to treatment.
- Investigate possible recurrence.
- Support treatment planning when the result is expected to influence clinical decisions.
PET-CT is not necessary for every cancer patient or at every stage of treatment. The treating specialist determines whether it is appropriate based on the diagnosis, previous investigations and clinical guidelines.
Frequently asked questions
Are PET-CT scans now free for all cancer patients in Maharashtra?
No. Eligible patients can receive approved scans under MJPJAY or AB-PMJAY when the relevant package and conditions apply. Specialist certification, hospital requirements and prior approval remain important.
What are the 63 treatment packages?
The government has added PET-CT as an additional diagnostic procedure under 63 cancer treatment packages. Patients should ask their treating specialist or the hospital scheme desk to verify the exact package applicable to their treatment.
What does coverage for 13 cancer categories mean?
For 13 selected cancer categories, PET-CT has been approved as a regular or primary diagnostic procedure under specified conditions. It does not automatically cover every scan for every patient with those cancers.
Do I need a doctor’s referral?
The reported GR requires the relevant specialist to certify medical necessity. Ask your treating specialist to document why the scan is required and let the hospital confirm the authorisation procedure.
Can I get the scan at any hospital that accepts MJPJAY?
Not necessarily. The hospital must meet the relevant empanelment and technical requirements, including the reported requirement for its own PET-CT facility and qualified staff. Confirm availability before travelling.
Will I have to pay ₹20,400 for a whole-body scan?
The reported scheme rate for a whole-body PET-CT is ₹20,400. For an eligible and approved covered procedure, the applicable scheme’s cashless arrangement should apply. Confirm the authorisation and any exclusions with the hospital before the scan.
What should I do if I cannot find a nearby hospital?
Check the official MJPJAY and PM-JAY resources, then call potential hospitals to confirm their current empanelment and PET-CT capability. Ask your treating specialist whether a referral to another participating centre is appropriate.
The bottom line
Maharashtra’s decision expands PET-CT coverage under MJPJAY and Ayushman Bharat to 63 cancer treatment packages, with the scan also approved as a primary diagnostic procedure for 13 selected cancer categories.
For patients, the safest route is to get a specialist referral, verify scheme eligibility, confirm that the hospital can provide PET-CT under the scheme, and obtain prior approval before the scan. The announcement can reduce out-of-pocket costs for eligible patients, but coverage still depends on the applicable package and authorisation rules.
This article provides general information, not medical advice. The treating specialist should decide whether PET-CT is clinically appropriate. Confirm current coverage and authorisation requirements with the scheme and hospital before making travel or payment arrangements.