CGHS rates applicable for treatment at healthcare organisations located at X, Y and Z cities: CGHS O.M F.No.5-16/CGHS(HQ)/HEC/2024(PartI) dated 03.10.2025
F.No.5-16/CGHS(HQ)/HEC/2024(PartI)
(Comp No. – 8365027)
भारत सरकार
स्वास्थ्य एवं परवार कल्याण मंत्रालय
केन्द्रीय सरकार स्वाथ्य योजना महानिदेशालय
के.स.स्वा.यो. भवन, दिल्ली
दिनांक- 03.10.2025
कार्यालय ज्ञापन/OFFICE MEMORANDUM
Subject: CGHS rates applicable for treatment at healthcare organisation
In reference to subject above, and in supersession of all previous memoranda on the subject, the CGHS rates package rates are hereby notified.
1. Implementation of Revised CGHS Rates
These rates will be effective from 13.10.2025 and shall apply to:
a) All healthcare services availed at CGHS-empanelled Healthcare Organisations (HCOs)
b) Medical Reimbursement Claims of individuals (in r/o Serving, Pensioners and other eligible categories of CGHS beneficiaries).
c) CGHS, cashless (credit) treatment shall be extended to Central Government pensioners and other specified categories of beneficiaries as per extant rules.
The revised rates as per Annexure-I are for the semiprivate ward entitlement. and are also available on the CGHS website: https://cghs.mohfw.gov.in.
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.
2. Structure of Differential Rates
Revised rates have been rationalised based on accreditation status, hospital type, city classification and ward entitlement:
a) Non-NABH and Non-NABL HCOs: 15% lower than NABH/NABL accredited HCOs. (NABL – National Accreditation Board for Testing and Calibration of Laboratories)
b) Rates for super speciality hospitals shall be 15% higher than those applicable to NABH-accredited hospitals for the corresponding Super specialities within the same city category.
c) HCO located in Y (Tier II) cities and Z (Tier III) cities rates shall be 10% and 20% respectively lower than those located in X (Tier I) Cities. Y (Tier II) rates also apply to the HCO located in North-East region and Union Territories of Jammu & Kashmir and Ladakh. 1 5-16/CGHS(HQ)/HEC/2024(PartI) I/3807087/2025
d) The new package rates mentioned in are for semi-private ward. For general ward there will be a decrease of 5% in the rates, and for the private ward entitlement, there will be an increase of 5% on the applicable admissible claim amount.
e) Rates for consultations, radiotherapy, investigations, day care procedures, and minor procedures not requiring admission shall remain uniform, irrespective of the ward entitlement.
f) For cancer surgeries, existing CGHS rules and rates continue. However, revised rates apply to chemotherapy, investigations and radiotherapy.
3. Supporting Guidelines and Definitions
Key definitions and guidelines are provided in Annexures II–VII, including:
a) CGHS Package Rate structure and inclusions.
b) Description of Ward Categories.
c) ICU and Nursing Care Charges.
d) Equipment Charges.
e) Admissible vs. Non-Admissible Items.
f) Definition and Criteria for Super Speciality Hospitals.
g) Relevant Office Memoranda issued by the Directorate General of CGHS.
4. Renewal of MoA with Empanelled Hospitals
a. All existing Memoranda of Agreement (MoAs) executed with private empanelled hospitals shall cease to be valid with effect from 13.10.2025 12 AM.
b. All Health Care Organisations (HCOs) are required to seek fresh empanelment through the revised Hospital Engagement Module.
c. The revised MoAs must be executed afresh within 90 days from the date of implementation of the revised rates.
d. However, in order to continue to avail the benefit of the revised rate, each HCO shall be required to submit an undertaking, on or before 13.10.2025, confirming its acceptance of the terms and conditions of the newly notified MoA.
e. In case, the HCO fails to submit the undertaking shall be deemed to be de-panelled.
This issues with the approval of the Competent Authority.
Digitally signed by
Dr Satheesh Y H
Date: 03-10-2025
12:25:06
(Dr. Satheesh Y. H.)
Director (CGHS)
Annexure I (CGHS Rate List)
CGHS rates for Tier I (X City)
CGHS rates for Tier II (Y City)
CGHS rates for Tier III (Z City)
COMMENTS