More than one crore central government employees, pensioners, and their families are ready to benefit from the government’s biggest improvement in the Central Government Health Scheme (CGHS) in the last 15 years. The Union Health Ministry has revised the package rates for about 2,000 medical procedures, a step that directly addresses complaints from hospitals and beneficiaries.

Changes, which will be implemented from October 13, 2025, are designed to make healthcare more economical, accessible and inclusive.

Over the years, CGHS patients have faced difficulties in obtaining cashless treatment as hospitals cited old package rates and delayed reimbursement. This forced many employees and pensioners to pay huge amount and wait for months for refund.

Expanding eligibility and inclusion under the latest reform scheme promises to reduce these challenges.

Why was CGHS reforms required?

Hospitals under CGHS often refused to provide cashless services, which was not revised in 15 years, pointing to the old package rates. Delay in reimbursement discouraged hospitals by treating patients. In August 2025, the Central Government Employees Union (GENC) highlighted these issues, emphasizing that many employees faced financial stress or even denied emergency care. Government’s reforms are direct feedback to these demands.

CGHS package rates major changes

The Ministry of Health has revised the rates for about 2,000 medical procedures. Rates are now based on the type of hospital and city category:

• Tier-II city: 19% less than base rate
• Tier-III city: 20% less than base rate
• NABH-recognized hospital: base rate
• Non-NABH Hospital: 15% less than base rate
• Super-Specialty Hospitals (200+ Bed): 15% more than base rate

This new system ensures appropriate and viable rates for hospitals, reduces disputes and makes cashless treatment easier.

Major benefits for employees and pensioners

Reforms are expected to take relief for millions of beneficiaries:

• Reduce cashless treatment
• Reduce out-off-pocket expenditure for employees and pensioners
• Ensure rapid reimbursement, cut in waiting time
• Improvement in confidence and access in CGHS network

In a major step towards inclusion, the Ministry of Health has expanded CGHS coverage for the siblings of transgender children and central government employees and pensioners. This applies regardless of their age, provided they are financially dependent and certification under the Transgender Persons (Rights of Rights) Act, 2019. This change ensures that more families gain equal healthcare rights.

Other updates in CGHS in the last one year

Apart from modifying the package rates, the government has also modernized the CGHS framework:

• CGHS online portal and mobile app for easy access
• New private hospitals added to imperialist list
• An online referral system introduced for rapid approval
• Real -time tracking of drug availability enabled
• Establish special assistance for senior citizens

How to apply for eligibility and CGHS card

• Qualified group: Central government employees (except railway and Delhi administration) and pensioners (except armed forces and railways), along with their families, they live in CGHS-Cover areas.
• CGHS coverage: Available in 80 notified cities across India.
• how to apply,
  • Employees can apply through their department with the prescribed forms and family photographs.
  • Pensioners can apply online in the office of the additional director of the city or on cghs.gov.in. If the pension payment order (PPO) is not ready, an provisional CGHS card can be issued using the final pay certificate.

How to check the latest cGHS rates

Beneficiaries can download the updated rate list from the circular/information section of the CGHS website. The new list has process code and revised package rates.

Rates vary to NABH and non-NABH hospitals. For example, in the 2024 amendment, NABH hospitals cost a laparoscopic cholecystactomy to Rs 33,000, while non-NABH hospitals have Rs 8,050.

With these reforms, the government aims to restore confidence in CGHS and ensure that employees, pensioners and their families get timely, cheap and inclusive healthcare.

The amendment of package rates and expansion of eligibility are expected to bring a long -awaited relief to the beneficiaries in India.