In a major relief for central government employees and pensioners, the Central Government Health Scheme (CGHS) has undergone its biggest update in 15 years, with new package rates coming into effect from October 13, 2025. This long-awaited revision covers nearly 2,000 medical procedures, making cashless treatment in private hospitals much smoother and more accessible.
For years, several empanelled private hospitals had been hesitant to provide cashless treatment under CGHS. The primary reasons were outdated package rates and delays in payments from the government. As a result, many beneficiaries were forced to pay out of pocket and wait months for reimbursement.
In August 2025, the Central Government Employees National Confederation (GENC) urged the government to revise rates and payment systems, highlighting frequent issues such as denial of emergency care due to administrative bottlenecks.
The Ministry of Health has restructured rates across hospitals based on city category and accreditation standards. The new structure ensures fair pricing for both hospitals and patients, promoting wider acceptance of cashless treatment.
Here’s how the updated rates are categorized:
Tier-II cities: 19% lower than the base rate
Tier-III cities: 20% lower than the base rate
NABH-accredited hospitals: Full base rate applicable
Non-NABH hospitals: 15% lower than the base rate
Super-specialty hospitals (200+ beds): 15% higher than the base rate
This structure incentivizes hospitals to maintain high standards while ensuring treatment affordability across regions.
The revised package rates aim to restore hospitals’ confidence in offering cashless facilities under CGHS. For beneficiaries, the impact will be immediate — no more heavy upfront payments, faster reimbursements, and improved service reliability.
Hospitals will also benefit from streamlined billing and faster settlements, creating a win-win situation for both healthcare providers and patients.
As per the Health Ministry’s September 16, 2025 update, the CGHS now extends coverage to transgender children and siblings who are financially dependent on the cardholder. This inclusion aligns with the Transgender Persons (Protection of Rights) Act, 2019, ensuring equal access to healthcare for all eligible family members.
Over the past year, CGHS has introduced multiple digital and operational upgrades:
A revamped online portal and mobile app for easier access.
Expansion of cashless treatment to more private hospitals.
New hospital empanelments across multiple cities.
Online referral system for faster and paperless approvals.
Real-time tracking of medicines to prevent shortages.
Dedicated helpdesks for senior citizens and pensioners.
These initiatives aim to make CGHS more transparent, efficient, and user-friendly.
The CGHS primarily covers:
All central government employees (excluding those under Railways and Delhi Administration).
Central government pensioners, excluding the armed forces and railways.
Family members who are financially dependent on the employee or pensioner.
Eligibility depends on residence within CGHS-covered cities, currently expanded to 80 urban centers across India.
For employees: Submit the prescribed form along with family photographs through your department.
For pensioners: Apply at the office of the Additional Director of CGHS or download the form from cghs.gov.in.
If the Pension Payment Order (PPO) is not yet issued, a provisional card can be obtained using the Last Pay Certificate.
The complete list of revised package rates and procedure codes is available in PDF format on the CGHS website’s notification section. Beneficiaries can download the document to verify applicable rates for different treatments and hospitals.
With the new rate structure effective from today, the CGHS is set to become more transparent, inclusive, and efficient. The revision not only addresses long-standing issues of payment delays and outdated rates but also ensures that cashless medical care becomes smoother for thousands of central employees and pensioners across India.
This update marks a major milestone in India’s government-backed healthcare ecosystem—making quality treatment more accessible, timely, and dignified for those who serve the nation.
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