Introduction

The Ministry of Health and Family Welfare has established a comprehensive Memorandum of Agreement (MoA) to govern the empanelment of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, and Siddha) Day Care Centers and Hospitals under the Central Government Health Scheme (CGHS). This initiative is a major step forward for Central Government Employees, pensioners, and their dependents, providing expanded access to recognized traditional medical treatments. The MoA standardizes treatment rates, eligibility criteria, and the referral process to ensure high-quality healthcare delivery.

Key Highlights of the Agreement

• Duration of Agreement: The empanelment is initially valid for a period of two years, with a possibility of a one-year extension based on satisfactory performance.
• Accreditation Mandatory: All empanelled centers must hold valid NABH (National Accreditation Board for Hospitals & Healthcare Providers) accreditation or certification.
• Standardized Pricing: Treatments are charged as per approved CGHS rates or the hospital's standard rates, whichever is lower.
• Digital Integration: Hospitals must register with the Ayushman Bharat Digital Mission (ABDM) and maintain electronic medical records.

Detailed Summary of Rules & Benefits

1. Eligibility for Treatment & Payment Rules

The MoA clearly outlines the payment structure for different categories of CGHS beneficiaries. Pensioners, Ex-Members of Parliament, Freedom Fighters, and serving employees of the Ministry of Health & Family Welfare (MoHFW) or Director General of Health Services (DGHS) are entitled to cashless medical treatment (credit facility). Conversely, Serving Central Government Employees must pay for their treatments upfront and later claim reimbursement from their respective departments using the approved CGHS rates.

2. The Referral Process

To avail of these services, beneficiaries must follow strict referral protocols. A referral must be issued by a CGHS AYUSH Doctor of the concerned medical stream. If an AYUSH doctor is unavailable, a CGHS Medical Officer (CMO) can generate the referral. Important Note: A referral is only valid for 30 days from the date of issue.

3. Treatment Duration and Procedures

Under the day-care system, treatment procedures are normally sanctioned for a maximum of 14 days (two weeks). If a patient requires an extension beyond this period, prior approval must be obtained from a CGHS/Government Doctor or the competent authority. Only approved AYUSH procedures detailed in the CGHS guidelines are permissible for treatment and billing.

Important Points at a Glance

• Room Rent Restrictions: Room rent is generally not admissible for routine day-care therapy centers.
• Package Limits: The maximum combined daily ceiling for Yoga and Naturopathy treatments is capped at Rs. 1000 per day.
• Medicines: Routine medicines must generally be obtained from the CGHS AYUSH Wellness Centers. For cashless patients, if medicines are prescribed by the hospital, the hospital must provide them and claim reimbursement.
• Hospital Infrastructure: Empanelled centers must possess specific infrastructure, including separate therapy rooms for male and female patients, proper waiting areas, and a dedicated nodal officer to assist CGHS beneficiaries.
• Zero Advance Payment: Empanelled centers are strictly prohibited from asking for advance payments from pensioners who are eligible for cashless facilities.

Download Official CGHS PDF

Conclusion

The formalization of the AYUSH empanelment via this MoA greatly enhances the healthcare options available to Central Government Employees and CGHS beneficiaries. By integrating traditional Indian medicine systems with strict quality controls (NABH) and transparent pricing, the government ensures that employees have access to holistic, safe, and heavily subsidized (or cashless) healthcare. Ensure you maintain a valid CGHS card and follow the appropriate referral process before beginning any AYUSH treatment protocol.