Advisory to CGHS Beneficiaries – Instructions to Pensioner beneficiaries who are eligible for Credit – Revised Rates implementation

Advisory to CGHS Beneficiaries – Instructions to Pensioner beneficiaries who are eligible for Credit – Migration to TMS 2.0 and implementation of Revised CGHS Rates (effective 00:00 hrs, 13.10.2025)

Government of India
Ministry of Health & Family Welfare
Central Government Health Scheme (CGHS)

Public Notice / Advisory to CGHS Beneficiaries

Date:12th October 2025

Subject: Migration to TMS 2.0 and implementation of Revised CGHS Rates (effective 00:00 hrs, 13.10.2025)-Instructions to Pensioner beneficiaries who are eligible for Credit.

Reference: CGHS Office Memoranda on (i) on-boarding to NHA IT platforms dated 19.08.2025 and (ii) Revised CGHS Rates issued vide O.M. dated 03.10.2025.

The Central Government Health Scheme (CGHS) is migrating to the NHA platforms (TMS 2.0/UMP/HEM 2.0) and implementing Revised CGHS Rates with effect from 00:00 hrs (midnight) of 13.10.2025. To ensure a smooth, safe, and transparent experience, all CGHS Pensioner beneficiaries who are eligible for credit to follow the instructions below.

A. Access to Care & Identification

1. Care will not be denied due to referral issue date. All empanelled Health-Care Organisations (HCOs) have been instructed to provide treatment to eligible CGHS beneficiaries even for valid referrals issued before 13/10/2025.
2. Use of Digital CGHS Card is valid. If physical CGHS card (Both plastic and paper cards are acceptable, provided the card’s validity is clearly indicated.) is not available beneficiary may share a downloaded e-card from:

• • the CGHS website (cghs.mohfw.gov.in),
  • the My CGHS 2.0 mobile app, or
  • DigiLocker

A clear soft copy is acceptable at HCOs.

B. Mobile Number, OTP Verification & Consent

1. OTP verification on beneficiary’s registered mobile number is mandatory in TMS 2.0 for claim submission. Accordingly, beneficiaries are requested to share the same with the HCO upon request.

• • Please ensure mobile number is updated in the CGHS database. If beneficiary’s number is missing on the TMS 2.0 portal, beneficiary will be requested to provide the correct contact number so the HCO can proceed with registration. To update mobile number, contact the nearest CGHS Wellness Centre (WC).
  • If an error occurs on the TMS portal because of missing beneficiary’s photograph/ward entitlement, beneficiary may contact the Office of concerned Additional Director (AD) City where the card is registered and have the photo uploaded and ward entitlement updated

Sample OTP SMS (for awareness):

2. Under exceptional circumstances, the attendant’s mobile number may be used for OTР verification. HCOs will record this in the TMS 2.0 portal along with the relation of the attendant.

C. Geotagging, Feedback & Transparency

1. Geotagged photo: HCOs have been issued guidelines for geotagging at the point of care. Beneficiaries are requested to co-operate when the HCO captures a geotagged photograph.
2. Mandatory feedback at discharge: As part of quality monitoring, please fill the CGHS feedback form at discharge. This form will be uploaded by the HCO with the claim. Beneficiary/Patient’s Attendant must clearly state if any amount was collected during admission. (Annexure 1)

D. Billing Rules Beneficiaries Must Know

1. Revised vs Old Rates (date-wise):

• Services on/after 13.10.2025 (00:00 hrs) → Revised CGHS Rates apply.
• Services up to 12.10.2025 (23:59 hrs) → Old CGHS Rates apply.

2. Separate bill for inadmissible items:

• If the HCO charges the beneficiary for inadmissible items (items not payable under CGHS rules), the HCO must issue a separate bill/receipt. (Annexure 2)
• Such inadmissible items must not be included in the final bill to be claimed from CGHS.
• No draft/temporary/running bills are acceptable. The HCO will upload a copy of any such separate inadmissible-items bill with the claim.
• Beneficiary should collect and retain proper bills/receipts for any payments made.

E. Grievance Redressal & Misuse Prevention

1. Hospital-level grievance desk: Every empanelled HCO is required to maintain a grievance redressal mechanism. If needed, please approach the Nodal officer at the HCO (details to be displayed at the facility).
2. Report any suspicious intimation: If any beneficiary receives an SMS/any intimation for a service which was not availed from HCO, inform office of the respective AD City where card is registered immediately for verification and action.

Any misuse of the CGHS card—by a beneficiary or an empanelled HCO—constitutes an offence and will attract action under applicable rules and law.

These measures protect beneficiaries, improve service quality, and prevent misuse of the CGHS scheme.

This advisory takes effect immediately and shall remain in force along with the referenced Office Memoranda till further orders.

For assistance with mobile updates, e-card downloads, or complaints, please contact CGHS Wellness Centre or Office of the Additional Director where the card is registered.

Sd/-
Director,
CGHS

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Annexure 1: CGHS Beneficiary Feedback Form (लाभार्थी प्रतिक्रिया प्रपत्र)

Name (नाम):… …. …. … … … … … … … CGHS Card No. (कार्ड संख्या): … …. …. … … … … … … …
Hospital (अस्पताल): … …. …. … … … … … … …  Admission (भर्ती): … …. …. … … … … … … …
Discharge (छुट्टी): …/…/……. Mobile (मोबाइल): …………………

1.Are you satisfied with the treatmentyou received at the hospital? (क्या आप अस्पताल में मिले इलाज से संतुष्ट हैं?)
□ Yes / हाँ □ No / नहीं
If No (यदि नहीं), please specify: … …. …. … … … … … … …

2. Did the hospital provide you with necessary information and assistance during your hospitalization? (क्या अस्पताल ने भर्ती के दौरान आवश्यक जानकारी और सहायता दी?)
□ Yes / हाँ □ No / नहीं
If No (यदि नहीं), specify issues:
Admission (भर्ती): … …. …. … Treatment (इलाज): … …. …. … Discharge (छुट्टी):… …. …. …

3.Were the hospital doctors, nurses and staff cooperative and courteous during your stay? (क्या डॉक्टर नर्सस्टाफ सहयोगी व शिष्ट थे?)
□ Yes / हाँ □ No / नहीं
If No (यदि नहीं), please specify: … …. …. … … … … … … …

4. Did you pay any money from your pocket for services/tests/implants etc.? (क्या आपने इलाज टेस्ट इम्प्लांट आदि के लिए अपनी जेब से पैसा दिया?)
□ Yes / हाँ □ No / नहीं
If Yes (यदि हाँ), please give details: … …. …. … … … … … … …  □ Only partial credit was offered (केवल आंशिक क्रेडिट दिया गया)

5.Did any doctor/hospital refuse to treat you under CGHS? (क्या किसी डॉक्टर/अस्पताल ने CGHS के तहत इलाज से मनाकिया?)
□ Yes / हाँ □ No / नहीं
If Yes (यदि हाँ), please mention details: … …. …. … … … … … … …

6.Was quality food provided during your hospital stay? (क्या अस्पताल ने भर्ती के दौरान गुणवत्तापूर्ण भोजन दिया?)
□ Yes / हाँ □ No / नहीं

7. Were prescribed medicines provided to you at the time of discharge? (क्या छुट्टी के बाद आपको दवाइयाँ दी गई?)
□ Yes / हाँ □ No / नहीं

8.Any other feedback (अन्य प्रतिक्रिया): … …. …. … … … … … … …

Date (तिथि): __/__/____

Signature (हस्ताक्षर): … …. …. … … … …

Annexure 2: Admissible and Non-Admissible Items