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

 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.
2. • 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):

“Dear User, use OTP 507978 to proceed with verification, ifyou have understood the Aadhaar consent. Note: this OTP is set to expire in 10 minutes. NHA”

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.

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     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