Fresh Empanelment of Private Hospitals Under CGHS
The Ministry of Health and Family Welfare has released comprehensive new guidelines via Office Memorandum dated December 22, 2025, concerning the fresh empanelment of private Healthcare Organizations (HCOs). This initiative is designed to expand the network of healthcare providers and ensure high-quality medical services for all Central Government Health Scheme beneficiaries.
Key Deadlines & Eligibility
All currently empanelled hospitals must take note that this is a mandatory fresh cycle. To maintain their status, existing HCOs must submit new applications and sign a fresh Memorandum of Agreement (MoA) by March 31, 2026. Failure to meet this deadline will result in automatic de-empanelment effective April 1, 2026.
Multi-Specialty Hospitals
Requires a minimum of 50 beds in Tier I cities and 30 beds in Tier II/III cities.
Super-Specialty Hospitals
Must maintain a minimum of 200 beds and hold full NABH accreditation.
Eye & Dental Clinics
Specific requirements of 6 beds for Eye hospitals in Tier I and 5 beds in other regions.
Ward Entitlements & Rates
Treatment costs and room categories are strictly regulated based on the beneficiary's basic pay level as per the 7th Central Pay Commission:
- General Ward: Central Govt. employees with pay up to ₹36,500 (Level 1 to 5, as per 7th CPC) or equivalent pensioners. The daily rate is capped at ₹1,500.
- Semi-Private Ward: Pay range ₹36,501 to ₹ 50,500 (Level 6) or equivalent. The daily rate is capped at ₹3,000.
- Private Ward: Pay ₹50,501 and above (Level 7 and above) or equivalent. The daily rate is capped at ₹4,500.
- ICU Services: A uniform rate of ₹5,400 per day applies to all categories, inclusive of monitoring and nursing care.
Financial Commitments
Healthcare organizations are required to provide a Performance Bank Guarantee (PBG) to ensure adherence to service standards. Tier I Multi-specialty hospitals must provide ₹20 lakh, while Super-specialty hospitals are required to provide ₹25 lakh. Notably, hospitals that achieve ABDM M3 compliance are rewarded with a 20% reduction in the required PBG amount.
Digital Compliance & ABDM
In a move toward total digitization, all participating HCOs must register on the Health Facility Registry (HFR). The application process is entirely digital, handled through the HEM Portal. This ensures transparency in billing, referral tracking, and grievance redressal.
Ethical Standards and Penalties
The 2025 guidelines introduce strict disciplinary measures. Overcharging, refusing treatment in emergencies, or demanding advance payments from beneficiaries can lead to heavy financial penalties (up to five times the overcharged amount) and permanent de-empanelment.
Access Official Documentation
For the complete 175-page list of rates, terms, and conditions, download the official PDF below.
Download Official O.M. PDF
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