Indonesia's population is ranked 4th in the world after India and the United States, as well as the global Covid-19 pandemic, Indonesia is also recorded with the most cases of infections and deaths due to Covid-19 in ASEAN, therefore Hospitals in Indonesia has not been able to represent the need for beds and health services. Therefore, the hospital building construction project has become a driven demand for the fulfillment of health services for the Indonesian population. Estimation is one of the causes of the cost overrun. Implementation of Building Information Modeling Quantity take-off (BIM QTO) in hospital structural work can be done if the cost breakdown is ≤ 24%. Statistical analysis by using the Relative Importance Index (RII) has a result in 10 rankings of factors that influence the implementation of BIM QTO, namely drawing, completeness Bill of Quantity (BoQ), TOR & specifications, cost reduction, preparation of activities in the work breakdown structure, cost breakdown, 3D modeling details, Data Interoperability, Quantity Take Off, Subcont & Supplier pricing, and cost database. Study cases with the implementation of BIM QTO on hospital building structures work cost efficiency up to 6.18%.