CGHS New rules: In a significant update to healthcare provisions for central government employees, pensioners, and their dependents, the Union Ministry of Health and Family Welfare has announced a comprehensive revision of the Central Government Health Scheme (CGHS). It has revised package rates for nearly 2,000 medical procedures, effective from October 13, 2025.
According to an official release, the rates have been revised on the basis of accreditation status, hospital type, city classification and ward entitlement.
The move comes in response to growing concerns from both CGHS beneficiaries and empanelled hospitals. Patients have repeatedly reported being denied cashless treatment, often being forced to pay out of pocket and wait months for reimbursement.
What Is the new change?
The government has introduced a new pricing system. Hospital rates will now change depending on the city and hospital type:
- Tier-II cities- rates will be 19% lower than the standard rate
- Tier-III cities- rates will be 20% lower than the standard rate
- Hospitals with NABH accreditation will charge the standard rate
- Hospitals without NABH accreditation will charge 15% less than the standard rate
- Large super-specialty hospitals (200 beds) – 15% higher than base rate
Key benefits for employees & hospitals
- The major benefit is that it will be easier cashless treatment
- Reduced out-of-pocket payments
- Faster reimbursements
- Better healthcare access
Transgender dependents covered
On September 16, 2025, the Health Ministry changed the CGHS rules under the CS(MA) Rules, 1944. Now, dependent transgender children and siblings of central government employees and pensioners can get medical benefits, no matter how old they are. They need to be financially dependent and have a valid certificate under the Transgender Persons (Protection of Rights) Act, 2019. This change gives government families more inclusive healthcare.
What is CGHS?
The Central Government Health Scheme (CGHS) is run by the central government. It gives medical services at lower costs. The scheme pays for things like tests, doctor visits, and surgeries. CGHS has a fixed package rate that covers the full treatment, from admission to discharge. It mainly helps central government employees, pensioners, and their families. As of October 5, about 4.26 million people use CGHS in 80 cities in India, according to the official CGHS website.
