Health industry bodies welcome CGHS’ move to revise rates after 15 years

New Delhi, Oct 4 Health industry bodies have welcomed the central government's decision to revise the package rates for nearly 2,000 medical procedures under the Central Govt Health Scheme (CGHS).

The revised rates, announced on Oct 3, will come into effect from Oct 13.

“This reform, along with the earlier GST relief, reflects the government’s commitment to strengthening healthcare delivery and addressing long-standing concerns of the sector,” said Ameera Shah, President, NATHEALTH, in a statement.

CGHS is a vital programme for millions of beneficiaries, and the revised rates will improve access to safe and effective healthcare while enhancing system efficiency.

Earlier, the Association of Healthcare Providers of India (AHPI) called the revision “a long-awaited step”.

The last package was fixed in 2014, with only a minor update in 2024. This left hospitals and patients struggling for more than a decade with a gap between actual treatment costs and prescribed package rates.

The new policy would directly benefit both healthcare providers and CGHS beneficiaries, the AHPI said.

The revised framework applies to the CGHS cardholders in all categories, with semi-private rooms defined as two to four patients forming the base for package rates, and general wards accommodating up to 10 patients.

The rates will also vary based on city tiers, with tier-I cities applying the base rate, tier-II cities -- including Chandigarh, Jalandhar and Ludhiana -- set at a 19 per cent lower rate, and Tier 3 cities set at a 20 per cent lower rate.

Further, accreditation status will also determine rates, with non-NABH hospitals receiving a 15 per cent lower rate than NABH hospitals, while the super-speciality hospitals with over 200 beds will be entitled to 15 per cent higher rates than the NABH hospitals.

Building on the momentum, NATHEALTH suggested that CGHS and other government-sponsored schemes be periodically benchmarked to the Consumer Price Index (CPI).

“This will ensure predictability, sustainability, and a win-win value proposition for patients, providers, and policymakers,” Shah said.

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