Overview

• The Union Health Ministry revised package rates for roughly 2,000 procedures in the first major update since 2014, with the changes taking effect on October 13.
• Non‑NABH/NABL hospitals will be paid 15% less than accredited facilities, super‑speciality hospitals get a 15% premium, Tier‑II and Tier‑III cities receive rates 10% and 20% below Tier‑I, and general/private ward entitlements adjust rates by −5%/+5% from a semi‑private base.
• The overhaul aims to restore easier cashless care for about 4.6 million beneficiaries after years of hospitals citing outdated rates and delayed reimbursements.
• Analysts see average uplifts of about 25–30% on many high‑volume procedures and hospital stocks rose up to roughly 5–6% after the announcement, though managements estimate overall CGHS receivables may rise a more modest 8–10% and are still reviewing line‑by‑line impacts.
• Empanelled providers that do not confirm acceptance by October 13 will be de‑empanelled, and all hospitals must sign a new Memorandum of Agreement within 90 days; some individual procedures show sharp increases under the new list, such as MRI mammography and complex tooth extraction.