Centre Revises CGHS Rates for Nearly 2,000 Medical Procedures

In a long-awaited overhaul, the Union health ministry has announced a comprehensive revision of medical procedure rates under the Central Government Health Services (CGHS) scheme, the first such major update since 2014. 

The new pricing framework, which becomes effective October 13, 2025, will apply to nearly 2,000 procedures and introduce a multi-dimensional rate system for the country’s 4.26 million CGHS beneficiaries across 80 cities.

Multi-Factor Rate Overhaul

Unlike the earlier system, which distinguished hospitals primarily by their accreditation status, the revamped structure now considers four key parameters — hospital accreditation, type of healthcare organisation, city classification, and ward entitlement. The base rate will correspond to semi-private rooms, with adjustments made for other categories.

According to the ministry’s October 5 memorandum, rates for general wards will be 5% lower, while those for private wards will increase by 5% over the base price. Hospitals accredited by the National Accreditation Board for Hospitals (NABH) or National Accreditation Board for Testing and Calibration Laboratories (NABL) will have standard base rates, while non-accredited facilities will see a 15% reduction. In contrast, super-specialty hospitals will be allowed a 15% higher rate.

The ministry has also classified cities into three tiers: Tier-I facilities will follow standard rates, Tier-II hospitals will charge 10% less, and Tier-III centres will charge 20% less. For instance, a procedure priced at ₹1,000 in a Tier-I NABH hospital would cost ₹900 in a Tier-II facility and ₹800 in a Tier-III one.

Balancing Complaints from Patients and Hospitals

The overhaul comes after years of friction between CGHS beneficiaries and private hospitals. Central government employees and pensioners had long complained that empanelled hospitals were refusing cashless treatment, forcing them to pay upfront and wait months for reimbursement.

Hospitals, meanwhile, argued that outdated package rates had failed to account for medical inflation since 2014, making treatments economically unviable. The new framework, officials said, aims to address both concerns by introducing a fair, flexible pricing model that reflects costs across different regions and healthcare standards.

Rates for radiotherapy, investigations, day-care services, and minor non-admission procedures will, however, remain uniform, unaffected by ward or city category differences.

Implementation and Fresh Empanelment Rules

All healthcare organisations (HCOs) under CGHS have been instructed to submit undertakings confirming acceptance of the new rate terms by October 13, 2025. Those that fail to comply will be automatically de-panelled, and all existing Memoranda of Agreement (MoAs) will cease to be valid from that date.

Hospitals seeking to remain part of the scheme must apply afresh via the revised Hospital Engagement Module on the CGHS portal. The health ministry said the new system will ensure transparency, uniformity, and accountability among empanelled hospitals.

Read More: PM Modi Unveils ₹62,000 Crore in New Initiatives to Empower Youth!

Conclusion

The revision of CGHS package rates marks a turning point in India’s public healthcare reimbursement framework. By aligning procedure costs with accreditation, geography, and patient category, the government aims to make the scheme more equitable and efficient for both hospitals and patients. For millions of central government employees and pensioners, the update promises faster access to cashless treatment — a long-pending relief 11 years in the making.

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