CGHS Fresh Empanelment 2025: New Guidelines for Private Hospitals Explained

On 22 December 2025, the Directorate General of CGHS issued an Office Memorandum (F.No. 5-34/CGHS/HEC(HQ)/2025) titled Fresh Empanelment of Private Hospitals under CGHS. It invites applications from new hospitals and asks every hospital that is already empanelled to apply afresh under a new Memorandum of Agreement (MoA) and the revised package rates notified on 03.10.2025.

CGHS covers around 42 lakh beneficiaries in 81 cities, including serving and retired central government employees and their families. For a private hospital, diagnostic centre or dialysis unit, a CGHS panel brings steady patient volume. This guide explains what the new OM says, who is eligible, what it costs and how the application works, in plain language.

Download the official OM (PDF): CGHS Fresh Empanelment OM dated 22.12.2025 (175 pages, 3 MB)

What the 22.12.2025 OM Changes

• Open to more cities: applications are open to Health Care Organisations (HCOs) in cities already covered under CGHS, and also to HCOs within the municipal limits of district headquarters across India.
• Fresh application for existing hospitals: every currently empanelled HCO must submit a fresh application with the prescribed fee, be approved by the Hospital Empanelment Committee (HEC) and sign the revised MoA.
• Deadline for existing hospitals: the OM set 31 March 2026 as the last date to execute the new MoA, and said hospitals that do not comply would be de-empanelled from 1 April 2026. This date was later reported to be extended to 30 April 2026. Both dates have now passed, so hospitals should confirm their current status with the CGHS office of their city.
• Online only: applications are made through the Hospital Engagement Module (HEM) portal of the National Health Authority.

How the New CGHS Rates Work

The OM links payment to accreditation, hospital type, city tier and the ward entitlement of the beneficiary:

• Accreditation: package rates for Non-NABH / Non-NABL HCOs are 15% lower than for NABH / NABL accredited HCOs.
• Super speciality hospitals: rates are 15% higher than NABH rates for the matching super specialities in the same city category.
• City tier: HCOs in Y (Tier II) cities get rates 10% lower than X (Tier I) cities, and Z (Tier III) cities get rates 20% lower. Y-tier rates also apply in the North-East, Jammu & Kashmir and Ladakh.
• Ward entitlement: rates are notified for the semi-private ward. General ward is 5% lower and private ward is 5% higher.
• Same across wards: consultations, radiotherapy, investigations, day-care procedures and minor non-admission procedures are paid the same in every ward.
• Cancer: existing rules and rates for cancer surgery continue. Revised rates apply to chemotherapy, investigations and radiotherapy.

The MoA also provides for a claim processing fee of 2% of the claim amount plus applicable taxes, deducted at the time of payment. Hospitals should factor this into their CGHS pricing review.

Eligibility: Beds, Accreditation and Turnover

Hospitals

Beds are counted as certified in the State Government registration certificate. For multi-speciality and single speciality hospitals, NABH, entry level NABH or, in their absence, a QCI recommendation is required to stay on the panel. Super speciality hospitals must hold NABH or an equivalent accreditation such as JCI or an ISQua-recognised body, must have NABL for in-house labs, and must offer CGHS empanelled facilities across a defined list of super specialities, including nephrology and urology with renal transplant, neurosurgery, cardiothoracic surgery, medical, surgical and radiation oncology, transplant facilities and endocrinology.

In Tier II, Tier III cities, the North-East and J&K, hospitals without accreditation or a QCI recommendation can be provisionally empanelled, on the condition that they obtain QCI recommendation or entry level NABH within the time allowed.

Eye, Dental, Dialysis, Chemotherapy and Diagnostic Centres

ABDM-compliant HCOs get a 20% discount on the Performance Bank Guarantee. Chemotherapy centres are empanelled in the Non-NABH category and must obtain a QCI recommendation within 6 months.

Performance Bank Guarantee (PBG)

A fresh PBG from a Scheduled Commercial Bank, in the format at Annexure D, must be submitted before empanelment. It must be valid for 42 months. For hospitals that are re-applying, the existing PBG is released only after the fresh bank guarantee is submitted.

Step-by-Step Application Process

1. Pay the application fee (non-refundable) on the Bharatkosh portal, then approach the office of the Additional Director, CGHS of your city with the receipt and a request on the letterhead signed by the head of the facility or CEO.
2. Attend the pre-empanelment briefing. It is mandatory. The head of facility and staff from reception, billing and finance who will deal with CGHS beneficiaries should attend. The HCO must accept all CGHS policies and MoA terms.
3. Register and apply. The CEO or head of facility registers on the User Management Portal (UMP), and the HCO applies on the HEM portal with all documents.
4. Document scrutiny. The committee examines applications every quarter and may return them if anything is missing.
5. Physical inspection. Inspection is mandatory for all newly empanelled HCOs, including accredited ones. For existing NABH HCOs it may be done within 6 months.
6. Sign the MoA within 15 days of approval and submit the MoA, PBG and the Hospital Policy for CGHS beneficiaries to the Additional Director office. Upload the signed copies on HEM within 24 hours.
7. Create system logins (TMS / MEDCO ID) within 2 working days, with help from the Additional Director office.
8. Empanelment notification is issued and published on the CGHS website, followed by NHA training on the TMS portal for registration, pre-authorisation, bill submission and reconciliation.

Documents and Compliances to Keep Ready

• Registration certificate showing bed strength, and NABH / NABL / QCI certificates (an existing QCI certificate should have at least 1 year of validity at the time of applying).
• Bharatkosh receipt of the application fee and the hospital undertaking.
• Fire clearance certificate and details of fire safety arrangements.
• PNDT, AERB and other approvals for equipment such as USG, CT, MRI, PET and radiotherapy.
• Registration for organ transplant and IVF / ART procedures, where applicable.
• Waste management and other statutory approvals.
• Details of all facilities, including outsourced ones, and a comparison of your rates with CGHS rates.
• Proof of registration as a Convergence Partner on consumerhelpline.gov.in within one month of signing, and registration on the IVFRT medical value travel portal.

Common Mistakes That Delay Empanelment

• Bed count in the application does not match the State registration certificate.
• Accreditation certificates close to expiry at the time of applying.
• Bank guarantee issued in the wrong format or with a validity shorter than 42 months.
• Billing and TPA staff skipping the pre-empanelment briefing, leading to claim rejections later.
• Not reviewing the 2% claim processing fee and ward-wise rate differences before signing the MoA.

How I&D Hospital Solution Can Help

I&D Hospital Solution helps hospitals, diagnostic centres and dialysis units across India with CGHS, ECHS and other panel empanelments. Our team can check your eligibility, prepare documents, guide you through the HEM portal and help you get ready for physical inspection. Call or WhatsApp us, or send an enquiry, and our team will review your case.