The Central Government Health Scheme (CGHS) has notified revised package rates for treatment across all its empanelled healthcare organisations (HCOs) and a few other services. The new rates, issued by the Directorate General of CGHS, will be effective from October 13, 2025. The new rates will supersede all previous memoranda on the subject and aim to bring greater uniformity, transparency, and rationalisation in healthcare cost structures, as per a CGHS circular released on October 3, 2025.
The circular also says that in exceptional circumstances, where treatment has been availed from any nonempanelled private HCOs, reimbursement may be considered as per extant instructions, but the rate would be restricted to Non-NABH (National Accreditation Board for Hospital for Healthcare Providers) rates of the concerned city.
In the circular, the Ministry says that the revised rates effective from October 13, 2025, will apply to-
The updated rates will apply to all CGHS-empanelled healthcare organisations and to medical reimbursement claims submitted by serving employees, pensioners, and other eligible beneficiaries.
Under the revised framework, cashless (credit) treatment will continue for Central Government pensioners and other categories entitled under existing CGHS rules.
Beneficiaries can access the detailed rate list in Annexure I, which has been published on the official CGHS website.
The revised CGHS rates have been rationalised based on multiple factors such as hospital accreditation status, hospital type, city classification and ward entitlement. Below are the major highlights:
Hospitals without National Accreditation Board for Hospitals (NABH) / National Accreditation Board for Testing and Calibration of Laboratories (NABL) accreditation will have rates that are 15% lower than those applicable to accredited institutions.
These hospitals will be entitled to 15% higher rates than NABH-accredited hospitals within the same city category.
Rates will vary based on the city's tier. The applicable rates for different cities are-
HCO tariffs in Tier II (Y) and Tier III (Z) cities will be 10% and 20% lower than in Tier I (X). Y (Tier II) prices also apply to HCOs in the North-East region and Jammu & Kashmir and Ladakh.
The semi-private ward is covered under the new package rates listed. The rates for the general ward will drop by 5%, and the applicable admissible claim amount for the private ward entitlement will rise by 5%.
Rates for consultations, investigations, radiotherapy, and day care procedures will remain uniform, regardless of the ward entitlement.
Existing CGHS rules and rates for cancer surgeries remain unchanged. However, revised rates will apply to chemotherapy, investigations, and radiotherapy.
Renewal of MoA with empanelled hospitals
In its circular, the Health Ministry has also given instructions to HCOs. The instructions are-