1800 202 8726
Ayushman Bharat scheme

Ayushman Bharat and — Biopsy Coverage

Ayushman Bharat does cover biopsy procedures for eligible patients — but only when the biopsy is part of a day-care or inpatient admission at an empanelled centre, not as a standalone outpatient visit.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • Day care is covered — A biopsy performed under a day-care admission at an empanelled hospital is covered under AB-PMJAY oncology packages.
  • OPD alone is not — A biopsy ordered as an outpatient test, with no day-care admission registered, falls outside the scheme.
  • Add-ons may be billed separately — IHC staining and molecular testing often sit outside the core biopsy package — ask before the test is run.
  • Three documents are the minimum — Your Ayushman card, Aadhaar and a current referral are what the Ayushman desk needs to begin pre-authorisation.
4.8 · 800+ Google reviews · 15,000+ patients treated
Limited Slots Today

Get an indicative cost estimate

₹950   Today: FREE  ·  Including free written second opinion

Reply within 2 working hours
Report reviewed by a senior oncologist
Confidential. No commitment to start treatment.
or
Call 1800 202 8726
17+
Cancer Specialists
on Panel
96.9%
Breast Cancer
Survival Rate*
15,000+
Patients
Treated
4.8★
Google Rating
(800+ reviews)

Ayushman Bharat PM-JAY covers biopsy procedures when performed as day care or inpatient at an empanelled centre, under oncology-linked health benefit packages. A standalone outpatient biopsy is not covered. If your centre is on the national empanelled list and you carry your Ayushman card, Aadhaar and a doctor's referral, you pay nothing for the covered procedure itself.

What Ayushman Bharat covers — and what it does not

ServiceAB-PMJAY coverageIndicative out-of-pocket (2026)
Core needle or incisional biopsy — day care or inpatient at empanelled centreCovered within applicable oncology packageNil for the procedure itself
Standard histopathology report (H&E staining)Generally included in the same package as the biopsyNil where included in package
Immunohistochemistry (IHC) panelMay be in the package or billed separately — varies by centre and package codeConfirm with billing before the test is run
Molecular and biomarker testing (PD-L1, MSI, FISH, NGS)Not typically covered under standard PM-JAY packagesVaries — discuss with your team before requesting
CT-guided or ultrasound-guided biopsyCovered where a matching image-guided package exists; pre-authorisation requiredNil if pre-authorised
Biopsy at a non-empanelled centreNot covered — regardless of card statusFull procedure cost out-of-pocket
Standalone OPD biopsy (no day-care admission registered)Not covered under PM-JAYFull cost out-of-pocket

How does the process actually work at an empanelled centre?

Your oncologist writes a referral specifying the biopsy type and site. Bring that referral — along with your Ayushman card and Aadhaar — to the empanelled hospital before your procedure date, not on the morning of the procedure where possible.

The hospital's Ayushman desk submits a pre-authorisation request on your behalf. You do not contact the scheme directly. For most day-care biopsies this takes a few hours on a working day; complex or image-guided cases may take one to two working days.

Once pre-authorisation is granted, the procedure goes ahead and the hospital bills the scheme directly. You sign a consent form and should not be asked to pay for the covered portion at discharge.

At CION centres, the Ayushman desk at each location can tell you before your visit whether your specific procedure is pre-authorisable under your card, and which supplementary tests — if any — would be billed separately.

Keep a copy of your discharge summary and the pre-authorisation reference number. These are your evidence if any billing question arises later.

What will this actually cost you?

Costs depend on the regimen, the number of cycles and your scheme eligibility. Send your reports and we will give you an itemised, indicative estimate.

Meet the Specialists

17+ senior cancer specialists. One panel for your case.

Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.

Dr. Naresh Gundu
Medical Oncologist

Dr. Naresh Gundu

MBBS, DNB (Internal Medicine), DM (Medical Oncology)

View Profile
Dr. C. Raghavendra Reddy
Medical Oncologist

Dr. C. Raghavendra Reddy

MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)

View Profile
Dr. Bharati Devi Gorantla
Medical Oncologist

Dr. Bharati Devi Gorantla

MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)

View Profile
Dr. Owais Mohammed
Medical Oncologist

Dr. Owais Mohammed

MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)

View Profile
Dr. T. Raghavender Reddy
Medical Oncologist

Dr. T. Raghavender Reddy

MBBS, DM (Medical Oncology), MD (Radiation Oncology)

View Profile
Dr. N. Kiranmayee
Medical Oncologist

Dr. N. Kiranmayee

MBBS, DM (Medical Oncology), MD (Internal Medicine)

View Profile
Dr. Muralidhar Muddusetty
Surgical Oncologist

Dr. Muralidhar Muddusetty

MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)

View Profile
Dr. Raghavendra Naik
Surgical Oncologist

Dr. Raghavendra Naik

MBBS, MS (General Surgery), M.Ch (Surgical Oncology)

View Profile
Dr. Mohammed  Imaduddin
Surgical Oncologist

Dr. Mohammed Imaduddin

M.B.B.S, MS (General Surgery), M.Ch (Surgical Oncology)

View Profile
Dr. Vinay Mamidala
Surgical Oncologist

Dr. Vinay Mamidala

MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)

View Profile
Dr. Paila Gowri Naidu
Surgical Oncologist

Dr. Paila Gowri Naidu

MBBS, MS (General Surgery), M.Ch (Surgical Oncology), FMAS

View Profile
Dr. Venkata Sushma P
Radiation Oncologist

Dr. Venkata Sushma P

MBBS, MD (Radiation Oncology)

View Profile
Dr. Kirti Ranjan Mohanty
Radiation Oncologist

Dr. Kirti Ranjan Mohanty

MBBS, MD (Radiation Oncology)

View Profile
Dr. Gangadhar Vajrala
Radiation Oncologist

Dr. Gangadhar Vajrala

MBBS, MD (Radiation Oncology), MPH

View Profile
Dr. Basudev Pokhrel
Hematologist

Dr. Basudev Pokhrel

MBBS, M.D (Immunohematology & Blood Transfusion)

View Profile
Dr. Mohammed Imran
Interventional Radiologist

Dr. Mohammed Imran

View Profile
Dr. Vajja Sandeep Kumar
Surgical Oncologist

Dr. Vajja Sandeep Kumar

MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology

View Profile
Dr. Sridhar Kamani
Surgical Oncologist

Dr. Sridhar Kamani

MBBS, MS (General Surgery), DrNB (Surgical Oncology)

View Profile

Want a specific doctor for your case? Mention them when booking.

Book Free Consultation

Know the cost before you commit

An itemised estimate, plus a check of which schemes you may qualify for.

Book Free Consultation Call 1800 202 8726

Documents to carry on the day

  • Ayushman Bharat card or e-card printout from the PM-JAY portal or Ayushman app
  • Aadhaar card — original and one photocopy
  • Ration card or family ID if family members are not yet listed on your Ayushman card
  • Treating oncologist's referral or prescription specifying the biopsy type and anatomical site
  • Any prior scans or pathology reports that led to this biopsy being recommended
  • A passport-size photograph — some centres ask for one at the time of registration
  • Your state scheme card as well, if you hold an Aarogyasri (Telangana) or Dr. YSR Aarogyasri (Andhra Pradesh) card

Did you know?

AB-PMJAY is the largest government-funded health assurance programme in the world by beneficiary count.

Its oncology day-care packages were designed so that cancer investigations — including diagnostic biopsies — do not require full inpatient admission, reducing both the financial barrier and the time between suspicion and diagnosis.

Source: National Health Authority, PM-JAY Programme Overview; Ministry of Health and Family Welfare

Explore 71 more Understanding Your Biopsy and Whether You Need One topics

HUB — Does a Biopsy Spread Cancer? Myths and Evidence

HUB — What Is a Biopsy? Everything You Need to Know

All Understanding Your Biopsy and Whether You Need One →

Next step

Still not sure what applies to you?

Send your reports across and a senior medical oncologist will go through what they mean, what is known, and what the options actually are.

Book Free Consultation Call 1800 202 8726
Common questions

Frequently asked questions

Can I use Ayushman Bharat for a biopsy done during an outpatient visit?

No. PM-JAY covers inpatient admissions and approved day-care procedures, not outpatient tests. If your biopsy is being done as an outpatient investigation — you arrive, have the procedure and go home without a formal day-care admission being registered — it falls outside the scheme. Ask your oncologist whether the same procedure qualifies for day-care admission, because that one change makes it eligible.

How long does pre-authorisation take, and do I have to arrange it myself?

The hospital's Ayushman desk manages pre-authorisation on your behalf — you do not contact the scheme directly. For most day-care biopsies, approval comes through within a few hours on working days. Complex or image-guided cases may take one to two working days. Arriving before your procedure date with all documents speeds this up; arriving on the morning of the procedure can cause delays if the desk is busy.

My biopsy sample needs IHC staining or molecular testing. Is that covered?

Standard histopathology — the basic tissue examination — is generally part of the biopsy package. IHC panels and molecular tests such as PD-L1, MSI, FISH or NGS are a separate question. They may fall under a different package code, or outside the scheme entirely, depending on the centre. Ask the Ayushman desk, before the additional test is run, to confirm in writing whether it is included. This is where unexpected charges most commonly arise, and asking early is the only way to avoid a surprise at discharge.

What if the centre I am going to is not empanelled with AB-PMJAY?

The scheme only covers procedures at empanelled facilities. If your centre is not on the list, the procedure is fully out-of-pocket regardless of your card status. You can check empanelment on the PM-JAY beneficiary portal using your registered mobile number. If the recommended centre is not empanelled, ask your oncologist whether an empanelled centre performs the same procedure — and factor in that delaying a biopsy has its own consequences.

I have both an Aarogyasri card and an Ayushman Bharat card. Which one applies?

Carry both. Telangana's Aarogyasri and AP's Dr. YSR Aarogyasri each operate alongside PM-JAY with their own package lists and empanelled centre networks. The hospital's desk will confirm which scheme has the relevant package for your procedure. Note the pre-authorisation reference number given to you and confirm which card was used — you will need this if any question arises about the claim.

The hospital asked me to pay for something I think the scheme should cover. What do I do?

Do not pay without a written explanation of why the item falls outside the package. Ask the billing team for that in writing, then ask to speak with the Ayushman grievance officer — every empanelled hospital is required to have one. You can also call the PM-JAY helpline number printed on your Ayushman card, or raise a complaint through the PM-JAY portal. Keep every receipt. You are entitled to a clear answer about what is and is not covered before you pay anything.

Full index

Browse all 701 biopsy topics

Every page in this section, grouped by the part of the journey it belongs to. Pick a group to see what is in it.

What Is a Biopsy?

What Is a Biopsy? Everything You Need to Know →

Types of Biopsy Compared

Which Biopsy Will You Have? Techniques Compared →

Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

After a Biopsy: Recovery, Aftercare and Warning Signs →

Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

How to Read a Biopsy Report: Terms Explained →

IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

Cytology & Prostate Scoring Systems Explained →

How Accurate Is a Biopsy?

How Accurate Is a Biopsy? Errors and Second Opinions →

If Your Result Is Benign

Your Biopsy Is Benign: What It Means and What Comes Next →

Call now Book free consultation