CGHS Rule Change: Is Your ₹3,000 Test Covered?
CGHS has updated its reimbursement rules. Tests costing up to ₹3,000 must be done at the same facility. Tests above ₹3,000 need a prior CGHS referral. Consultations are now valid for 7 days within the same specialty.
A single MRI scan can cost ₹8,000–₹15,000 — skip the CGHS referral and you foot the entire bill yourself.
Tests above this amount now need prior CGHS referral — or you pay out of pocket
Key Takeaways
Before booking any diagnostic test above ₹3,000 — MRI, CT scan, or advanced blood panels — visit your CGHS wellness centre first and obtain a written referral slip.
Check that your follow-up tests below ₹3,000 are scheduled at the same hospital or diagnostic centre where your doctor's consultation took place to avoid reimbursement rejection.
Verify with your CGHS wellness centre which three eye examination procedures are now covered under the restructured eye consultation fee before paying for private eye tests.
CGHS has updated its reimbursement rules. Tests costing up to ₹3,000 must be done at the same facility. Tests above ₹3,000 need a prior CGHS referral. Consultations are now valid for 7 days within the same specialty.
Here's what happened: CGHS has updated rules stating all follow-up treatments and tests costing up to ₹3,000 must be conducted at the same facility where the initial consultation took place.. For medical investigations priced above ₹3,000, beneficiaries must obtain a prior referral from CGHS before undergoing the test to qualify for reimbursement.. CGHS consultations are now valid for seven days within the same medical specialty, and eye consultation fees have been restructured to include three defined examination procedures..
What you should do: Before booking any diagnostic test above ₹3,000 — MRI, CT scan, or advanced blood panels — visit your CGHS wellness centre first and obtain a written referral slip.. Check that your follow-up tests below ₹3,000 are scheduled at the same hospital or diagnostic centre where your doctor's consultation took place to avoid reimbursement rejection.. Verify with your CGHS wellness centre which three eye examination procedures are now covered under the restructured eye consultation fee before paying for private eye tests..
Keep a photo of every CGHS referral slip on your phone the moment you receive it — many reimbursement claims are rejected simply because the original paper slip was lost before submission.
For readers weighing their credit and loan options, our personal loan guide and CIBIL score resources put this update in context.
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- [1]“CGHS medical reimbursement rules clarified: What changes for tests up to Rs 3,000 and above” Wealth-Economic Times · 17 Aug 2026
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