The bill now has to show the unit, the quantity, the price per unit, and the total. Once this reform is taken seriously, the standard of bills will automatically change.
Published Dec 20, 2025 | 7:00 AM ⚊ Updated Dec 20, 2025 | 7:00 AM
IS 19493:2025 lays down a common pan-India format for medical bills, mandating clear, itemised, and patient-friendly hospital billing formats in public and private healthcare facilities.
Synopsis: The new BIS guidelines brings several key changes. It mandates all healthcare providers, including hospitals, nursing homes, diagnostic centres, and outpatient clinics, follow a standardised billing format that enhances clarity, transparency, and accountability.
Deciphering a hospital bill is almost like attempting to decode a badly handwritten medical prescription.
Barring a few, the majority seldom know whether the bill amount is justifiable. They pay up and leave, mostly relieved of the ailment, though the thought of the hefty amount they have parted with remains rock-heavy in their hearts. For them, medical treatment had been of topmost priority, not money.
Hospitals are inevitable, and so are the bills. Instances of patients receiving inflated bills are not rare. Cases of families getting crushed financially after hospitalisation, too, have been reported.
Now, there is hope with the Bureau of Indian Standards (BIS) introducing a set of hospital billing guidelines, aimed at correcting the long-standing anomalies.
The new Indian Standard (IS) 19493:2025 has laid down a common pan-India format for medical bills, mandating clear, itemised, and patient-friendly hospital billing formats in public and private healthcare facilities.
The guidelines were drawn up after extensive consultation and citizen feedback.
The new set of BIS guidelines bring several key changes. It mandates all healthcare providers, including hospitals, nursing homes, diagnostic centres, and outpatient clinics, follow a standardised billing format that enhances clarity, transparency, and accountability.
Bills must include detailed information about the healthcare organisation, such as the full name, complete address, the 15-digit Goods and Services Tax Identification Number (GSTIN), phone number, email ID, registration and licence numbers, and accreditation details.
Each bill must also have a unique number and a timestamp of generation.
Patient information must be clearly captured, including the full name, age, gender, hospital-specific patient ID, Unique Health ID (UHID), address, contact information, emergency contact, date and time of admission and discharge, type of admission (inpatient, outpatient, or day-care), and GSTIN, if requested by the patient.
The standard also specifies detailed billing sections: summary of charges, itemised charges, net amount payable, payment details, and insurance coverage information.
Bills must use readable fonts (not smaller than 11 points), tabular layout, mention the amount in Indian rupees, use English or the local language, and be available in physical or digital format on A4 letterhead.
Recommended details should include payment modes, disclaimers, financial counselling status, and treating doctors’ names. Sample formats are provided to ensure consistency.
Speaking to South First, Vijay Gopal, Advocate and Founder of Forum Against Corruption, explained, “The bill now has to show the unit, the quantity, the price per unit, and the total. Once this reform is taken seriously, the standard of bills will automatically change.”
This effectively gives patients the right to question charges, and non-compliance by hospitals is now considered a violation, making accountability tangible rather than theoretical.
LocalCircles, a community platform helping citizens and small businesses to raise issues and shape government policies, played a crucial role in highlighting the gaps in hospital billing practices and bringing citizen voices to the forefront.
Through extensive surveys conducted across India, the platform collected nearly 23,000 responses from patients in 305 districts, capturing experiences across tier-1, tier-2, and rural areas. The data collected provided a clear picture of the widespread dissatisfaction with opaque hospital bills.
The surveys revealed that over half of the respondents did not receive fully itemised bills, with 43% receiving partial breakdowns and 10% receiving only package charges.
Such insights demonstrated the magnitude of the problem and the urgent need for a standardised approach to billing.
By presenting quantifiable evidence, LocalCircles validated the concerns of millions of citizens who had long struggled with unclear hospital charges.
The findings catalysed government action, emphasising the demand for a uniform, mandatory billing standard.
By documenting public opinion, the platform pushed for regulatory reform and helped ensure that policymakers recognised the public’s demand for transparency, accountability, and fairness in healthcare billing.
Beyond providing data, LocalCircles acted as a bridge between citizens and the government. Its reports informed discussions with policymakers and advocacy groups, contributing to the formulation of IS 19493:2025.
Gopal provided a simple example of hospitals overcharging patients. “For heart patients, stents are regulated at around ₹600 per piece, but hospitals charge anywhere between ₹20,000 and ₹25,000, and nobody is aware of it.”
With the new standard, bills must include detailed listings for every service, procedure, medicine, and consumable, making hidden charges or inflated package costs visible to patients and regulators.
The new standard covers room charges, consultation fees, procedures/surgeries including surgeon, anaesthesia, and operation theatre charges, investigation/diagnostic tests, pharmacy/medicine costs, medical consumables and disposables, package charges, and miscellaneous costs.
The total gross amount, discounts, taxes, net payable amount, mode of payment, and signatures of both the patient or next-of-kin and authorised signatory should be included in the bill.
“The bill now has to show the unit, the quantity, the price per unit, and the total. Once this reform is taken seriously, the standard of bills will automatically change,” Gopal said.
Beyond individual patient benefits, this transparency empowers insurers, employers, and government health schemes to verify claims, detect overbilling, and streamline reimbursements.
It helps establish accountability and reduces disputes between hospitals, patients, and insurers. “First, it helps patients establish that they have been exploited. Then it holds hospitals accountable,” Gopal added.
By providing a clear and itemised picture of all charges, the reform strengthens consumer protection, regulatory oversight, and overall trust in the healthcare system.
Patients are now armed with the information to question and report irregularities, fundamentally shifting the dynamics in favour of transparency and fairness.
While the new hospital billing guideline lays down comprehensive billing requirements, its effectiveness depends on active enforcement.
“The only challenge will be the will of the department to do random, regular checks. The moment something is not checked, it is forgotten,” Gopal said.
Without consistent monitoring, hospitals may fail to comply, undermining the intended transparency. Authorities must ensure routine inspections and enforce penalties for non-compliance across both public and private healthcare facilities.
This includes verifying the accuracy of itemised charges, monitoring adherence to regulated pricing, and auditing insurance-related claims. Only through systematic enforcement can the standard achieve its goal of creating genuinely accountable hospital billing.
Gopal emphasised the need for user-friendly mechanisms for citizens to report violations: “There is a need for mechanisms that ensure violators are reported, and citizens have a scope to bring the violations to their notice in a user-friendly manner.”
The combination of detailed billing and vigilant enforcement can transform hospital billing practices, making them transparent, fair, and trustworthy.
And it could save families too.
(Edited by Majnu Babu).
