CGHS Rates Revised For ECHS Beneficiaries: Healthcare Treatment At New Rates From December 15

The revised Central Government Health Scheme (CGHS) rates for the Ex-Servicemen Contributory Health Scheme (ECHS) will take effect on December 15, 2025. According to the circular issued by the Department of Ex-Servicemen Welfare (DoESW) on December 5, 2025, the new rate will be applicable to ECHS empanelled healthcare organisations (HCOs), medical reimbursement of claims for beneficiaries, and cashless treatment for pensioners and other eligible ECHS beneficiaries. The claims would be reimbursed according to the existing guidelines for reimbursement.  

However, if a beneficiary avails of services from a non-empanelled hospital, say a private HCO, the non-NABH (National Accreditation Board for Hospitals for Healthcare) providers’ rates of the concerned city would be applicable.

• For example, a cardiac CT scan rates in a Tier I city in a semi-private ward are Rs 6,500 at NABH and super speciality HCO, and Rs 5,525 at Non-NABH HCO

• In a Tier II city, the rates at both NABH and super-speciality HCOs are Rs 5,850, and at a non-NABH centre, Rs 4,973

• For Tier III cities, the NABH and super speciality HCO rates for the same CT scan are Rs 5,200, and for non-NABH HCOs, it is Rs 4,420

Rates Rationalisation

The rates will now depend on the type of hospital, accreditation status, city, and ward entitlement.

The rates for the general ward will be 5 per cent less than the semi-private ward. For a private ward, it will be 5 per cent more than the semi-private ward.

The revised rates for non-NABH and non-NABL (National Accreditation Board for Testing and Calibration Laboratories) would be 15 per cent lower than NABH or NABL-accredited HCOs. For super-speciality hospitals, the rates will be 15 per cent higher than those of NABH-accredited hospitals in the same city and category.

For cancer surgeries, the existing CGHS rules and rates will apply, but for chemotherapy, radiotherapy, and investigations, the revised rate will become applicable.

In the North-East region and the Union Territories of Jammu & Kashmir and Ladakh, the Tier II rate will apply.

In addition to this, the rates for consultations, daycare procedures, and other minor procedures which don’t require admission to the hospital will remain the same for all.

Undertaking Submission By HCOs

Before the revised rates apply, the HCOs need to renew their empanelment through the empanelment module. The old Memorandum of Association (MoA) will not be valid effective December 15, 2025. Thus, the HCOs are required to submit their undertaking before December 15, 2025, to confirm their acceptance of the terms and conditions, and execute the MoA within 90 days from December 15, 2025. Failing to do so would result in their de-empanelment.