For a long time, many hospitals under the CGHS were hesitant to offer cashless treatment. The reason was outdated package rates and delayed payments. In August 2025, the Central Government Employees Union demanded that the government address this issue.
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CGHS: Big news for central government employees and pensioners. Effective Monday, October 13, 2025, the biggest changes in the Central Government Health Scheme (CGHS) in 15 years have come into effect. New rates have been issued for nearly 2,000 medical packages. This will make cashless treatment in private hospitals easier than ever for CGHS cardholders.
Why were the changes necessary?
For a long time, many hospitals under the CGHS were hesitant to offer cashless treatment. The reason was the old package rates and delayed payments. This forced employees and pensioners to bear the cost of treatment themselves and wait months for refunds. In August 2025, the Central Government Employees Union (GENC) demanded reforms from the government on this issue. In many cases, even emergency treatment was not provided on time.
New CGHS Rates
Rates for approximately 2,000 medical procedures will now be determined based on the city and hospital category:
Rates in Tier-II cities will be 19% lower than the base rate.
Rates in Tier-III cities will be 20% lower.
The base rate will apply in NABH-accredited hospitals.
Rates in non-NABH hospitals will be 15% lower than the base rate.
Rates in super-specialty hospitals (200+ beds) will be 15% higher than the base rate.
Benefits for Employees and Hospitals
These new rates will make it easier for hospitals to provide cashless treatment. Employees will not have to bear large expenses directly. Refunds will be received faster and CGHS cardholders will gain confidence.
On September 16, 2025, the Ministry of Health updated the rules. Now, transgender children and siblings can also avail of CGHS benefits if they are financially dependent and certified under the Transgender Persons (Protection of Rights) Act, 2019.
Improvements in the Last Year
The CGHS online portal and mobile app have been improved.
Cashless treatment is available at more hospitals.
New private hospitals have joined CGHS.
The online referral system will make approvals faster and easier.
Real-time tracking of medicines began.
Special helpdesks were created for senior citizens.
Who is eligible?
All central government employees (except those in the Railways and the Delhi Administration) and their families.
Central pensioners (except those in the Railways and the Armed Forces).
Eligibility depends on living in CGHS-covered cities. Currently, the scheme is available in 80 cities.
How to get a CGHS card
Employees should submit the prescribed form and family photo to their department. Pensioners can apply at the city’s Additional Director’s office or download the form from the CGHS website, cghs.gov.in. If a PPO is not available, a provisional card will be issued based on the Last Pay Certificate.
How to check the new rates and codes
Download the PDF from the notification section of the CGHS website. This will contain all the procedure codes and new package rates.
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