Health Ministry Clarifies OPD Charges for CGHS Beneficiaries

The Ministry of Health and Welfare has clarified the Outpatient Department (OPD) consultation charges under the Central Government Health Scheme (CGHS) following numerous inquiries from beneficiaries. This clarification aims to address confusion regarding the application of the revised consultation fees, specifically the amounts of ₹350 and ₹700, and under what circumstances these fees are applicable.

CGHS serves as a pivotal healthcare service provider for central government employees and pensioners, catering to over 10 million beneficiaries across India. The recent statement from the Ministry highlights the specific conditions under which the OPD consultation rates apply, focusing on the qualifications of the consulting medical professionals.

Clarification on OPD Charges

According to the Ministry’s announcement, the OPD consultation charges of ₹350 and ₹700 will only be applicable when consultations are provided by super specialists holding recognized Doctor of Medicine (DM) or Master of Chirurgiae (MCh) qualifications. These rates are exclusive to consultations in relevant super-specialty disciplines performed in hospitals empanelled under CGHS. Any consultation that does not meet these criteria will not qualify for the ₹700 rate.

The CGHS rate list issued in October 2025 indicates that a ₹350 consultation fee is applicable for both outpatient consultations and inpatient consultations. The Ministry has also reiterated existing norms regarding inpatient treatment, stating that a maximum of two consultations per day per specialist will be allowed under CGHS regulations.

FAQs on CGHS Procedures and Contributions

Beneficiaries have raised several questions regarding the process of obtaining a CGHS card. Pensioners can acquire a CGHS card from the office of the Additional Director in their city of residence. The necessary forms can be downloaded from the official CGHS website, with the link provided at cghs.gov.in. Serving employees are required to submit the completed form along with photographs of eligible family members to their respective Ministry, Department, or Office.

The contributions for CGHS services vary based on the employee’s pay level under the 7th Pay Commission. The following deductions are applicable:

– Levels 1-5: ₹250
– Level 6: ₹450
– Levels 7-11: ₹650
– Level 12 and above: ₹1,000

Pensioners may choose to make contributions either annually or as a one-time payment for a duration of ten years.

Additionally, the Ministry has outlined the criteria for hospital ward entitlement for CGHS beneficiaries in empanelled hospitals. The entitlement is as follows:

– General Ward: Basic pay up to ₹36,500
– Semi-Private Ward: Basic pay between ₹36,501 and ₹50,500
– Private Ward: Basic pay above ₹50,501

This information aims to provide clarity and assist beneficiaries in understanding their rights and entitlements under the CGHS, ensuring they can access the healthcare services they need. For detailed inquiries, beneficiaries are encouraged to refer to the official CGHS website or contact the relevant authorities.