CGHS rate revision

[Helping Hands For Veterans]

✅ What’s changed with the CGHS Rate Revision

• The government has released a new CGHS rate list, adopted by ECHS on 5 Dec 2025. (echs.gov.in    https://www.echs.gov.in/assets/policy/CGHS%20rates%20list%20adoption%20Final%20policy%20letter%2005%20Dec%2025%20with%20covering%20letter.pdf  ) 

• Under the new policy, ~2,000 medical procedures/tests now have updated package rates — the first comprehensive overhaul since 2014. (mint)

• The new rate structure is more differentiated than before: rates now depend on

  • the type of hospital (e.g. “super-specialty hospitals”) (mint),

  • whether the hospital is accredited by National Accreditation Board for Hospitals & Healthcare Providers (NABH) or not (Express Healthcare),

  • the city-classification (Tier I / II / III) where the hospital is located (mint), and

  • the beneficiary’s ward entitlement (semiprivate / general / private) (Central Govt Employees News).

• For general-ward entitlement, the payable rate is 5% less than the semiprivate-ward package; for private-ward entitlement — 5% more. (Central Govt Employees News)

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📅 When does this apply — and who does it affect

Scheme / Beneficiaries	Effective date of new rates
CGHS (central government employees/pensioners)	13 October 2025 (mint)
ECHS beneficiaries (ex-servicemen, dependents)	15 December 2025 (Central Govt Employees News)

• The new rates apply to all healthcare services at ECHS-empanelled hospitals, including cashless treatment and medical reimbursement claims. (Central Govt Employees News)

• The previously existing memoranda on package rates have been superseded. (Central Govt Employees News)

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🎯 Why the Revision — and What It Aims to Do

• This is the most comprehensive CGHS update in 15 years. (mint)

• The revision is intended to:

  • Bring rate equivalence closer to actual costs — many private hospitals had cited outdated CGHS rates as a reason for refusing cashless treatment. (The Economic Times)

  • Introduce fairer pricing: accreditation, hospital type, city cost-of-living, and ward entitlement are reflected in rates to avoid uniform “one-size” pricing that was unfair to some cases. (mint)

  • Improve access and quality of care for beneficiaries under both CGHS and ECHS. (Express Healthcare)

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📌 What to Keep in Mind (As a Beneficiary)

• If you’re hospitalised under CGHS or ECHS after the effective dates, final billing will follow the new package rates.

• Coverage (cashless or reimbursement) continues as before — but the amount admissible will vary depending on hospital-tier, accreditation, city classification and ward entitlement.

• For general-ward admissions: expect a slight reduction (-5%) compared to semiprivate-ward package; for private-ward, a +5% increase.

• Non-medical or “inadmissible” items (e.g. toiletries, attendant food, non-medical services) are not to be billed to CGHS — hospitals must issue separate bills for those. (Legality Simplified)

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• The Economic Times
• The Economic Times
• The Economic Times

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[Ravindra Waman Pathak]

Dear Sir 

No one tells but why are there few hospitals that pull out of CGHS or even Police Medical schemes 

I am a proud Hindu and I believe Ahimsa, essentially, is doing everything to stop Himsa. Ahimsa is not the absence of Himsa, but the use of Sam, Dam, Danda, and Bhed to achieve peace.

 People often ask me what we can do for the soldiers. The answer is "be an Indian who is worth fighting for. "See if you can be one"

Do I have enemies? Yes.Good. That means I’ve stood up for something, sometime in my life.

Cdr Ravindra Waman Pathak I.N. (Veteran)

Member Veterans Pension Group

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[Helping Hands For Veterans]

Dear Sir,

Delayed reimbursements, outdated and unrealistic package rates, and arbitrary, unexplained deductions have rendered participation in ECHS, CGHS, and similar government health schemes increasingly unviable for many hospitals. Healthcare providers are compelled to deliver services at rates that bear little relation to actual costs, while enduring prolonged and uncertain payment cycles that severely strain cash flows and operational sustainability. Recurrent claim rejections and unilateral deductions, frequently imposed without reasoned orders, transparency, or any meaningful grievance redressal mechanism, further erode confidence in these schemes. 

It is also pertinent to mention that officials entrusted with the statutory and fiduciary responsibility of safeguarding the interests of beneficiaries have demonstrably failed to discharge their duties honestly, fairly, and in accordance with established rules and procedures. Such administrative apathy and dereliction have directly contributed to the withdrawal or curtailment of services by reputed hospitals, thereby denying beneficiaries timely and adequate medical care and fundamentally defeating the stated objectives of these welfare programmes.

Regards