Big news for over 10 million central government employees and pensioners! The central government has announced the biggest changes to the Central Government Health Scheme (CGHS) in 15 years.
New rates have been introduced for nearly 2,000 medical procedures, effective October 13, 2025.
These changes will make cashless treatment at private hospitals easier for CGHS cardholders.
Why These Changes Were Needed
For a long time, many hospitals hesitated to provide cashless treatment under CGHS due to old package rates and delays in payments.
Employees and pensioners often had to pay out of pocket and wait months for refunds.
In August 2025, the Central Government Employees Union (GENC) requested the government to improve the system.
There were even cases where emergency treatment was difficult to access.
What’s New in CGHS Rules
Rates for 2,000 procedures will now depend on the city category and hospital accreditation.
Tier-II cities: rates 19% lower than base rate.
Tier-III cities: rates 20% lower than base rate.
NABH-accredited hospitals: base rates apply.
Non-NABH hospitals: rates 15% lower than base rate.
Super-speciality hospitals (200+ beds): rates 15% higher than base rate.
Benefits for Employees and Hospitals
Easier cashless treatment.
Reduced out-of-pocket expenses for employees.
Faster refunds — employees won’t have to wait long.
More confidence for CGHS cardholders and hospitals.
Additional Changes Made
On September 16, 2025, rules under the CS(MA) Rules, 1944 were updated.
Now, transgender children and siblings who are financially dependent can also receive CGHS benefits if certified under the Transgender Persons (Protection of Rights) Act, 2019.
Improvements in the Past Year
CGHS online portal and mobile app improved.
More hospitals now provide cashless treatment.
New private hospitals added to CGHS.
Online referral system speeds up approvals.
Real-time tracking of medications introduced.
Special helpdesks created for senior citizens.
Who Is Eligible
All Central Government employees (except Railways and Delhi Administration) and their families.
Central Pensioners (except Railways and Armed Forces).
Must live in CGHS-covered cities (currently 80 cities).
How to Get a CGHS Card
Employees: submit the prescribed form and family photo to your department.
Pensioners: apply at the city’s Additional Director’s office or download the form from cghs.gov.in.
If a PPO is unavailable, a provisional CGHS card can be issued based on the Last Pay Certificate.
How to Check the New Rates and Procedure Codes
Visit the CGHS website and go to Circulars or Notifications.
Download the PDF containing all procedure codes and new package rates.
Rates differ between NABH and non-NABH hospitals.
Example: In 2024, Laparoscopic Cholecystectomy cost ₹33,000 at NABH hospitals and ₹8,050 at non-NABH hospitals.
