India to modify CGHS rates from October 13: What can change for hospitals and beneficiaries

The government has approved a comprehensive amendment of rates under the Central Government Health Scheme (CGHS), which is the first major overhaul in about 15 years. Update pricing, covering around 2,000 medical procedures, will be applicable on 13 October.

CGHS provides cashless medical treatment For central government employees, pensioners and their dependents.

The revised structure introduces a multidimensional pricing structure, which now has rates associated with accreditation status, feature type, city classification and ward entitlement in the hospital.

Under the new system, the National Accident Board for Hospitals (NABH) or the National Acridation Board for Testing and Calibration Laboratories (NABL) -Credited Hospital will serve as benchmarks for base rates. Non-recognized hospitals will receive 15% less reimbursement. Super-Spaceual Hospitals will be eligible for 15% high rates, while facilities in Tier-2 and Tier-3 cities will be compensated 10-20% below metro-level pricing.

Hospitals had been demanding amendment upwards for several years, arguing that the package rates had failed to keep pace with medical inflation by 2014.

In many examples, healthcare providers delayed or rejected cashless CGHS treatment due to viability concerns.

Analysts estimate that the revised schedule translates to an average increase of 25–30% in high-vantage processes, with super-specific centers receive additional 15% premium at standard NABH-Linked Rates.

Listed healthcare chains such as Max Healthcare, Narayan Health, Yathrtha Hospitals, and Fortis are among high -risk people for CGHS patients and are therefore expected to see financial benefits.

Experts in the sector say that the move is likely to strengthen cash flow for Tier -1 and super -secularity hospitals, although timely disposal of the outstanding amount will be significant as the revised structure is rolled.