Revised CGHS rates come into effect: What beneficiaries need to know

Terms for healthcare provided to central government employees and pensioners updated

The Central Government Health Scheme (CGHS) has implemented revised package rates for treatment at all empanelled healthcare organisations (HCOs) from October 13, 2025.

 

New rates apply to

 

All CGHS-empanelled hospitals and clinics

 

Medical reimbursement claims submitted by serving central government employees, pensioners, and other eligible beneficiaries

 

Cashless treatment continues for categories already entitled under existing CGHS rules

 

In certain exceptional cases, treatment availed from non-empanelled private hospitals may be reimbursed. However, reimbursement will be limited to Non-NABH rates applicable in the city where treatment was received.

 

Beneficiaries can access the full rate list in Annexure I on the official CGHS website.

 

 

Key highlights of the new rate structure

 

The revised framework considers multiple factors including hospital accreditation, type, city classification, and ward entitlement.

Accreditation-based rates

Non-NABH/NABL accredited hospitals will charge 15 oer cent lower than accredited institutions.

 

Super-specialty hospitals

 

These hospitals are entitled to 15 per cent higher rates than NABH-accredited hospitals in the same city.

 

City classification

 

Tier II cities (including Northeast India, Jammu & Kashmir, Ladakh): 10 per cent lower than Tier I

 

Tier-III cities: 20 per cent lower than Tier I

 

Ward entitlement 

Semi-private wards are included in the revised rates

 

General ward rates are reduced by 5 per cent, while private ward rates rise by 5 per cent

 

Uniformity across procedures

 

Consultation, investigations, day-care procedures, and radiotherapy rates remain the same, irrespective of ward type

 

Cancer surgeries follow existing CGHS rules, though chemotherapy, radiotherapy, and investigations will follow the new rates

 

New agreements with hospitals

The CGHS circular also directs all private empanelled hospitals to renew their Memoranda of Agreement (MoAs):

 

Existing MoAs cease to be valid from October 13, 12 am

 

Hospitals must seek fresh empanelment through the Hospital Engagement Module

 

Revised MoAs must be executed within 90 days of the new rates

 

Hospitals failing to submit an undertaking confirming acceptance of the new MoA will be de-panelled