**CGHS Rates Revised After 15 Years: How It Affects You**
*By Mudit Dube | Oct 06, 2025, 05:28 pm*
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 will come into effect from October 13, 2025. This new rate structure is designed based on multiple factors including accreditation status, hospital type, city classification, and ward entitlement.
### Scheme Revamp: Addressing Complaints from Beneficiaries and Hospitals
This revision comes amid growing concerns from CGHS beneficiaries who have frequently faced denial of cashless treatment at empanelled hospitals. Many patients had to pay out-of-pocket expenses and endure long waits for reimbursement.
On the other hand, hospitals argued that the government-set package rates have been outdated for over a decade and fail to reflect medical inflation since 2014. The updated, multi-dimensional rate structure aims to resolve these long-standing issues by balancing the interests of both patients and healthcare providers.
### New Rate Structure Based on Ward Entitlement
The revised framework applies to all CGHS cardholders, with package rates benchmarked against semi-private room entitlements. Here’s how the rates vary according to ward types:
– **General Ward:** Rates will be 5% lower than the base semi-private room rates.
– **Private Ward:** Rates will be 5% higher than the base rates.
Additionally, consultations at NABH (National Accreditation Board for Hospitals) or NABL (National Accreditation Board for Testing and Calibration Laboratories) accredited healthcare organizations (HCOs) will be charged at standard base rates. Non-accredited HCOs will offer rates that are 15% lower than those of accredited hospitals.
### Tier-Wise Rate Variations Introduced
To account for geographical variations, a new tier-based classification of cities has been introduced: Tier I, Tier II, and Tier III. The rates for medical procedures will vary accordingly:
– Procedures in **Tier II cities** will be priced 10% lower than those in Tier I cities.
– Procedures in **Tier III cities** will be priced 20% lower than those in Tier I cities.
However, rates for radiotherapy, investigations, day-care procedures, and minor treatments that do not require hospital admission will remain uniform across all wards and city tiers.
### Beneficiary Coverage and Implementation
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 in India.
The Union Health Ministry has directed all empanelled healthcare organizations to submit an undertaking confirming their acceptance of the new rate terms and conditions by October 13, 2025. Hospitals and clinics that fail to comply will be considered de-panelled and subsequently removed from the CGHS network.
### What This Means for You
If you are a CGHS beneficiary, expect changes in the cost structure of your medical treatments depending on your ward entitlement, the hospital’s accreditation status, and the city where the treatment is availed. The revision is intended to improve cashless treatment availability and reduce delays in reimbursement, making healthcare more accessible and affordable under the CGHS scheme.
Stay informed and ensure that your empanelled hospital adheres to the new rates to enjoy seamless treatment benefits.
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