The Ministry of Health and Family Welfare (MoHFW) has revised the referral process for Central Government Health Scheme (CGHS) beneficiaries seeking consultations, investigations, and treatment. This Office Memorandum was issued on June 28, 2024.
The revised guidelines include AIIMS, Institutes of National Importance (INIs), North East Institutions, Tata Memorial Hospital, and other medical institutions under the purview of government hospitals.
The revised guidelines state that referral from a CGHS Wellness Centre Medical Officer (MO) is valid for three months. During this period, beneficiaries can consult up to three specialists on the referring doctor’s recommendation. A maximum of six consultations are allowed within the three-month validity.
Now, no further CGHS endorsement is required for routine listed investigations and minor procedures (without hospitalization) advised by specialists within the initial referral’s three-month validity.
Referral/endorsement from CGHS is mandatory for special investigations exceeding Rs. 3,000 (CT Scan, MRI Scan, PET Scan) and procedures requiring hospitalization. Both referrals are valid for three months.
Permission for unlisted investigations and treatment procedures will be granted based on delegated powers as per existing norms for pensioners and serving employees.
CGHS beneficiaries aged 70 and above can now avail consultations, investigations, and treatment procedures previously limited to those 75 and above. Moreover, teleconsultation through e-Sanjeevani remains an option.
Existing guidelines for emergency treatment and post-operative follow-up remain unchanged.
