Central government employees and pensioners will now have a substantial improvement in their healthcare access. The government has declared the largest revision to the Central Government Health Scheme (CGHS) in 15 years. These changes will be effective from October 13, 2025, and are intended to address complaints over the years, about insufficient reimbursement and the lack of cashless treatment at empanelled hospitals.
Addressing Cashless Treatment Challenges
One of the key issues faced by employees and pensioners under CGHS was the rejection of empanelled hospitals to offer cashless treatment. Patients were frequently required to pay significant out-of-pocket expenses for medical care, only to experience long interruptions in reimbursement. This created financial complications and, at times, led to rejection of treatment, especially in case of emergencies.
These new reforms revise package rates for about 2,000 medical procedures, taking into account the Tier-I, Tier-II, and Tier-III cities, along with the hospital’s endorsement status (such as NABH). By regulating these rates, the government anticipated to make it easier for hospitals to offer cashless services, thereby reducing both extra payments and reimbursement delays.
Important Changes in CGHS Package Rates
• Tier-II cities: 19% lower package rates compare to the base rate.
• Tier-III cities: 20% lower rates to the base rate.
• NABH-accredited hospitals: Services will be given at only base rate.
• Non-NABH hospitals: Will have 15% lower rates.
• Super-specialty hospitals: Hospitals with more than 200 beds will have 15% higher rates.
These crucial changes are expected to restructure the healthcare process and procedures by reduce the financial burden on employees and pensioners, and minimizing further delays in repayments.
By integrating these comprehensive changes, CGHS targets to provide efficient and accessible healthcare to millions of central government employees and their families, thus ensuring better services and quicker reimbursement process.
Ankur Mishra is a journalist who covers an extensive range of news, from business, stock markets, IPOs to geopolitics, world affairs, international crises, and general news. With over a decade of experience in the business domain, Ankur has been associated with some of the reputed media brands. Through a sharp eye on global marketplaces along with deep insights and analysis of business strategies, Ankur brings simplicity to the complex economic matrix to decode market trends and empower people.
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