ECHS Rule Change From December 15: Big Relief for Ex-Servicemen as Treatment Rates Updated

The Ex-Servicemen Contributory Health Scheme (ECHS) has announced a major update that will directly benefit millions of ex-servicemen and their families. The Ministry of Health has officially notified new treatment rates, which will now be aligned with the latest Central Government Health Scheme (CGHS) price list. These revised rates will come into effect from December 15, 2025, marking one of the most significant changes to the scheme in recent years.

According to the government, the new pricing structure is designed to make the healthcare system more transparent, uniform, and fair for beneficiaries, while also improving the overall quality of services across hospitals and diagnostic centers.

What Has Changed Under the New ECHS Rules?

Under the revised system, the cost of treatment across ECHS empanelled hospitals—including OPD services, inpatient care, medicines, and reimbursement—will now follow the updated CGHS rate list. This change will bring consistency in pricing nationwide and ensure that ex-servicemen receive healthcare services at fair and regulated costs.

Despite the changes, cashless treatment will continue just as before, ensuring no additional burden on beneficiaries at the time of hospitalization.

One of the biggest updates is that treatment charges will now vary depending on the hospital’s quality standards and the city category. This means the cost will reflect the hospital’s accreditation, facilities, and location.

Quality-Based Pricing for Hospitals

In an effort to improve healthcare standards, the government has introduced quality-linked rate adjustments:

• Hospitals without any quality accreditation will receive 15% less payment than the standard rate.

• Large, well-equipped, and accredited hospitals will be eligible for 15% higher rates.

This step aims to encourage hospitals to maintain higher quality benchmarks while ensuring fair value for the services provided.

City-Wise Pricing Structure Introduced

Treatment rates under ECHS will now differ based on the city category:

• Tier-1 Cities (Metros): Full CGHS rate

• Tier-2 Cities: 10% lower than standard

• Tier-3 Cities: 20% lower than standard

Additionally, regions such as Northeast India, Jammu & Kashmir, and Ladakh have been placed under the Tier-2 category.

As a result, treatment costs may vary between cities like Delhi, Guwahati, and small towns, depending on their classification.

Ward Category Will Also Impact Treatment Rates

Rates will now be calculated with the semi-private ward as the base benchmark.

• General Ward: 5% lower than standard

• Semi-Private Ward: Standard CGHS rate

• Private Ward: 5% higher than standard

This system will apply to most OPD services, diagnostic tests, day-care procedures, and hospitalizations. While cancer surgeries will continue at the older rates, procedures like chemotherapy and radiation will follow the updated pricing.

How Will Charges Be Calculated?

If the base treatment cost is represented as A, then the billing will be done as follows:

• General Ward: A – 5%

• Semi-Private Ward: A

• Private Ward: A + 5%

Hospitals will generate bills based on the ward category mentioned on the beneficiary’s ECHS card.

Why Was This Change Necessary?

ECHS provides healthcare support to millions of veterans and their dependents across military hospitals, polyclinics, and empanelled private hospitals. Over time, inconsistencies in pricing and variations in care standards created confusion and uneven cost structures.

With the new rules:

• Pricing becomes more transparent and predictable.

• Beneficiaries will know exactly how much treatment will cost in each type of city and hospital.

• Quality-linked incentives will help improve hospital standards.

• Billing becomes more consistent and error-free.

These revised rules are expected to make the ECHS system more streamlined, transparent, and beneficiary-friendly, ensuring that ex-servicemen and their families receive high-quality treatment without financial stress.