CGHS package rate revision: Healthcare sector welcomes key reforms for improved access

New Delhi: Health industry bodies have welcomed the central government’s decision to revise package rates for nearly 2,000 medical procedures under the Central Government Health Scheme (CGHS). The revised rates, announced on October 3, will come into effect from October 13.

“This reform, along with the earlier GST relief, reflects the government’s commitment to strengthening healthcare delivery and addressing long-standing sector concerns,” said Ameera Shah, President of NATHEALTH, in a statement. She added that 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) described the revision as “a long-awaited step.” The last package rates were fixed in 2014, with only minor updates in 2024, leaving hospitals and patients struggling for over a decade due to a gap between actual treatment costs and prescribed package rates. The AHPI said the new policy would directly benefit both healthcare providers and CGHS beneficiaries.

The revised framework applies to all CGHS cardholders. Package rates are based on semi-private rooms (two to four patients) and general wards (up to 10 patients). Rates will also vary according to city tiers: Tier-I cities will apply the base rate, Tier-II cities such as Chandigarh, Jalandhar, and Ludhiana will have rates 19 per cent lower, and Tier-III cities will be 20 per cent lower.

Accreditation status will further influence rates. Non-NABH hospitals will receive 15 per cent lower rates than NABH-accredited hospitals, while super-speciality hospitals with over 200 beds will be entitled to 15 per cent higher rates than NABH facilities.

Building on this 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.

IANS