North India Statesman
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New Delhi: The central government has announced significant reforms under the Central Government Health Scheme (CGHS) after the increase in dearness allowance (DA) for its employees and pensioners. The revised rates for around 2,000 medical procedures were announced on October 3, 2025, which would be applicable from October 13, 2025. This is the largest amendment in CGHS rates in the last 15 years.
Rate modification requirement:
The main complaint of central government employees and pensioners was that CGHS -affiliated hospitals often refused to provide cashless treatment. Patients had to spend huge amount from their pockets for treatment and they had to wait to return the money for months. Hospitals argued that the package rates fixed by the government were old and low. In addition, due to non -payment on time, hospitals were shy away from providing cashless services to CGHS card holders. In August 2025, the issue was raised by the National Confederation of Central Government Employees (GENC) and submitted a petition to the government. It was said that due to lack of cashless services, employees and pensioners are facing financial crisis. Treatment is also being denied in emergency situations.
Description of new rates:
The central government has fixed new rates for about 2,000 medical procedures. These rates are determined on the basis of city classification (Tier-I, Tier-II, Tier-III) and hospital quality (eg NABH recognition): Tier-II cities have package rates of 19% lower than base rate.
Tier-III cities are 20% lower than the base rate.
NABH-recognized hospitals provide services at base rates.
15% lower rate for non-NABH-recognized hospitals.
15% higher rate for super-specialty hospitals with more than 200 beds.
Benefits for Employees:
Cashless treatment will be easy: Since the revised rates are realistic to hospitals, hospitals will no longer hesitate to provide cashless services to CGHS card holders.
Low pressure on spending from pocket: No need to pay large amount in advance.
Reduction in repayment problems: The problem of waiting for months for repayment will be reduced.
Better Health Services: CGHS card holders can get treatment with confidence in affiliated hospitals.
The healthcare industry has welcomed this reform. NATAHLHTH President Amira Shah said, “This step reflects the government’s commitment to strengthen health services. It will solve the long -standing problems.” The Association of Healthcare Providers of India (AHPI) described it as a “long -awaited step”. They believe that this improvement will improve the financial condition of hospitals and ensure timely treatment to the beneficiaries.
Earlier, ICU, room rental and counseling fee rates were partially modified in April 2023. The rates of neuro-implants and some surgical processes were also revised in 2024. However, this is the first time that such a comprehensive and detailed rate amendment has been implemented.
CGHS is not just a treatment program, but a health protection shield for millions of government employees and their families. The scheme has been surrounded by complaints and challenges for a long time. The implementation of new rates is expected to ensure cashless and reliable healthcare for employees and pensioners along with ensuring payment on time and at reasonable rates. This reform is an important milestone in providing healthcare for central government employees.
