New CGHS Rates Come into Effect from October 13: Major Revision After 15 Years to Impact Central Government Employees and Pensioners

New CGHS Rates Come into Effect from October 13: Major Revision After 15 Years to Impact Central Government Employees and Pensioners

NEW DELHI: Union Government has revised the treatment and diagnostic rates under the Central Government Health Scheme (CGHS) after nearly 15 years. The new rates officially come into effect from October 13, 2025, and will directly impact millions of serving and retired central government employees and their dependents across India.

According to the new order, rates for around 2,000 medical procedures and tests have been updated. The revised structure will apply to both CGHS-empanelled and non-empanelled hospitals. This is one of the most comprehensive updates in years, aligning medical reimbursement and cashless treatment charges with current healthcare costs.

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Under the new system, super specialty hospitals will now be entitled to charge 15% higher rates compared to NABH-accredited hospitals.

For example, if a procedure costs ₹1,00,000 at an NABH-accredited hospital, the same procedure will cost ₹1,15,000 at a super specialty hospital providing advanced services such as cardiology, oncology, neurosurgery, or nephrology.

National Accreditation Board for Hospitals (NABH) ensures hospitals maintain quality, safety, and ethical standards, while the National Accreditation Board for Testing and Calibration Laboratories (NABL) accredits diagnostic and testing facilities. Both function under the Quality Council of India (QCI).

The new rates will apply to:

• All CGHS-affiliated hospitals and healthcare organizations (HCOs)
• Medical reimbursement claims for serving employees and pensioners
• Cashless treatment facilities for CGHS pensioners and other eligible categories

The government has also classified rates based on city categories:

• Tier-1 cities will follow standard rates
• Tier-2 cities will have rates 10% lower
• Tier-3 cities will have rates 20% lower, including those in Jammu & Kashmir, Ladakh, and the North-Eastern states

Further, rates have been adjusted based on ward categories:

• Private ward rates increased by 5%
• Semi-private wards have newly revised rates
• General ward rates decreased by 5%
• Consultation, radiotherapy, and minor procedures will maintain uniform rates across all ward types

This update will be effective from October 13, 2025, is expected to reduce differences between healthcare costs and reimbursement rates, ensuring better benefits for central government employees and pensioners under the CGHS.