CGHS: Big news for over 10 million central government employees and pensioners. The central government has announced the biggest changes to the Central Government Health Scheme (CGHS) in 15 years. New rates have been released for nearly 2,000 medical packages.
Big news for over 10 million central government employees and pensioners. The central government has announced the biggest changes to the Central Government Health Scheme (CGHS) in 15 years. New rates have been released for nearly 2,000 medical packages. The new rates will be effective October 13, 2025. This will make cashless treatment at private hospitals easier than ever for CGHS cardholders.
Why were these changes necessary?
For a long time, many hospitals under the CGHS have been reluctant to offer cashless treatment. The reasons cited were outdated package rates and payment delays. This forced employees and pensioners to bear out-of-pocket expenses and wait months for refunds. In August 2025, the Central Government Employees Union (GENC) demanded that the government address this issue. In many cases, even emergency treatment was denied.
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These are the new CGHS rules
Rates for around 2,000 medical procedures will now be determined based on the category of the city and the accreditation of the hospital.
Rates in Tier-II cities will be 19 per cent lower than the base rate.
Rates will be 20 percent lower in Tier-III cities.
Base rate will be applicable in NABH-accredited hospitals.
Rates in non-NABH hospitals will be 15 per cent lower than the base rate.
In super-speciality hospitals (200+ beds), the rates will be 15 per cent higher than the base rate.
Benefits for employees and hospitals
Cashless treatment will be easier. The new rates will make it easier for hospitals to provide cashless treatment. This will reduce the burden on their pockets. Employees will not have to bear large expenses directly. Fast refunds will also be available, and employees will not have to wait long for their refunds. CGHS cardholders will gain confidence.
These changes were made
On September 16, 2025, the Ministry of Health updated the rules under the CS(MA) Rules, 1944. Now, transgender children and siblings can also receive CGHS benefits if they are financially dependent and certified under the Transgender Persons (Protection of Rights) Act, 2019.
Changes in the past year
The CGHS online portal and mobile app have been strengthened. Cashless treatment will now be available at more hospitals. New private hospitals have been added to the CGHS. An online referral system will make approvals quicker and easier. Real-time tracking of medications has been introduced. Special helpdesks have been created for senior citizens.
Who is eligible
All Central Government employees except those of Railways and Delhi Administration and their families.
Central Pensioners (except Railways and Armed Forces).
Eligibility depends on living in CGHS-covered cities. The scheme is currently available in 80 cities.
How to get CGHS card
Employees should submit the prescribed form and family photo to their department. Pensioners should apply at the city’s Additional Director’s office or download the form from the CGHS website, cghs.gov.in. If a PPO is not available, a provisional CGHS card can be issued based on the Last Pay Certificate.
How to see the new rates and codes
Visit the CGHS website and open the Circulars or Notifications section. You can download a PDF here containing all procedure codes and new package rates. Rates vary between NABH and non-NABH hospitals. For example, in 2024, the rate for Laparoscopic Cholecystectomy was ₹33,000 at NABH hospitals and ₹8,050 at non-NABH hospitals.
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