**CGHS Rates Revised After 15 Years: How It Affects You**
*By Mudit Dube | Oct 06, 2025, 05:28 PM*
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The Union Health Ministry has announced a significant overhaul of the Central Government Health Services (CGHS) scheme for the first time since 2014. The revised rates for nearly 2,000 medical procedures are set to come into effect from October 13, 2025.
### Scheme Revamp: Addressing Complaints from Beneficiaries and Hospitals
The revision comes amid increasing complaints from CGHS beneficiaries who faced denial of cashless treatment by empanelled hospitals. Many patients had to pay out of pocket and endure long waits for reimbursement.
Hospitals, on the other hand, have argued that the government-set package rates have been outdated for years and no longer reflect the prevailing medical inflation since 2014. To resolve these issues, the government has introduced a new, multi-dimensional rate structure.
### New Rate Structure Based on Ward Entitlement and Hospital Accreditation
The revamped framework applies to all categories of CGHS cardholders, with semi-private rooms now serving as the base rate for medical procedures.
– Beneficiaries entitled to a **general ward** will see a **5% reduction** in rates.
– Those entitled to a **private ward** will have rates increased by **5%**.
Further, consultations and procedures at hospitals accredited by the National Accreditation Board for Hospitals & Healthcare Providers (NABH) or the National Accreditation Board for Testing and Calibration Laboratories (NABL) will be charged at the standard base rate.
Non-accredited healthcare organizations (HCOs) will have rates that are **15% lower** than those of accredited hospitals.
### Tier-wise Rate Variations Introduced for Different Cities
The revised scheme also factors in city classification, introducing tier-wise rate variations for CGHS-empanelled hospitals located in Tier I, II, and III cities.
– Procedures in **Tier II cities** will be priced **10% lower** than in Tier I cities.
– Procedures in **Tier III cities** will be **20% lower** than in Tier I cities.
However, rates for radiotherapy, investigations, day-care procedures, and minor procedures not requiring admission will remain consistent across all ward entitlements and city classifications.
### Wide Coverage: Over 4.26 Million Beneficiaries Affected
CGHS primarily serves central government employees, pensioners, and their dependent family members. As of October 5, 2025, the scheme covered approximately **4.26 million beneficiaries** across 80 cities nationwide.
The Union Health Ministry has directed all empanelled healthcare organizations to submit an undertaking confirming their acceptance of the new rates and terms by October 13. Failure to comply will result in hospitals being de-panelled from the CGHS scheme.
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This comprehensive revision aims to ensure fair compensation for hospitals while enhancing cashless treatment access and satisfaction for CGHS beneficiaries across India.
https://www.newsbytesapp.com/news/business/new-cghs-rate-structure-effective-from-october-13/story