Abstract. The total real hospital costs for Social Health Insurance (BPJS) Kesehatanpatients undergoing cesarean section are much higher than the collectible costs using the Indonesia Case-Based Groups (INA-CBGs) package as the basis of their payment policy. The purpose of this study was to determine the effect of using clinical pathways as a means of controlling the total real hospital costs of BPJS Kesehatan patients undergoing cesarean section.This research used action research. The clinical pathway was applied to BPJS Kesehatan patients undergoing cesarean section from January 1 to March 31, 2014, and compared the real hospital costs between that period and BPJS Kesehatan patients undergoing cesarean section from October 1 to December31, 2013. From the 126 study groups, 65 clinical pathway forms (51, 58%) were complete. The average real hospital cost was significantly higher after the implementation of CP with p = 0.019. The average length of stay, service costs, and hospital costs were significantly lower in the complete CP form group with p = 0.012, p = 0.013, and p = 0.012 respectively.This study demonstrated that implementing the clinical pathway can reduce the actual length of stay and hospital costs in C-section patients, and demonstrated that using the clinical pathway can make services more efficient.