CGHS reforms 2025: After 10 years, the central government has made a major revision in the rates of the Central Government Health Scheme (CGHS), which will come into effect from October 13. This will provide relief to about 46 lakh employees and pensioners. The new rates will now be decided on the basis of hospital category, city category and ward type.
This will also benefit private hospitals, as the rates have been increased by an average of 25–30%. The government has directed all hospitals to accept the new rates, otherwise they will be delisted. This move is expected to both improve the facility of cashless treatment and increase the income of the hospitals.
Why was the change necessary?
For several years, government employees and pensioners have complained that CGHS-affiliated hospitals refuse to provide cashless treatment. Patients were initially required to pay for their treatment themselves and then receive refunds months later. Private hospitals, on the other hand, argued that the old rates were too low and not in line with current medical expenses. It’s worth noting that the last major change to CGHS rates was in 2014. Since then, only minor improvements have been made, not comprehensive revisions.
In August of this year, the National Federation of Central Government Employees’ Unions submitted a memorandum to the government, stating that the lack of cashless access was causing financial hardship for employees and pensioners. Following this, the government took this important decision.
With the new rates, it is expected that hospitals will now offer cashless treatment to CGHS patients more easily. This will eliminate the need for employees and pensioners to spend out of pocket and eliminate the hassle of refunds.
What is included in the CGHS package?
CGHS package covers almost all the treatment related facilities-
Room and bed charges
Recruitment Fee
Anaesthesia, medicines and medical supplies
Doctor and specialist fees
ICU/ICCU expenses
Oxygen, ventilator, operation theatre charges
Physiotherapy, tests, blood transfusion etc.