CGHS Clarification 2026: 7-Day Rule, ₹3,000 Test Limit & Referral Rules Explained
A simple guide to the latest CGHS clarification covering consultation validity, medical tests, referrals, eye consultation fees and reimbursement requirements.
📌 CGHS Clarification 2026 — In Brief
The UPSC Office Memorandum dated 11 August 2026 clarifies six important areas of the existing CGHS guidelines:
- 7-day validity for consultations of the same specialty.
- Tests costing up to ₹3,000 per individual test should normally be done at the same empanelled hospital.
- Tests at another CGHS-empanelled facility require CGHS referral/endorsement.
- CT, MRI, PET and other investigations costing above ₹3,000 require referral/endorsement.
- Eye consultation fees include refraction, tonometry and fundus examination.
- Unlisted investigations/procedures require prior Department/Office permission.
Visit the official UPSC website →
CGHS Rules Explained Step by Step
1 Consultation is valid for 7 days
Each consultation is considered valid for 7 days, provided the follow-up consultation relates to the same specialty.
2 What if the test costs ₹3,000 or less?
If a specialist at a CGHS-empanelled hospital prescribes an investigation costing up to ₹3,000 per individual test, the test should normally be undertaken at the same hospital/HCO where the primary consultation was taken.
3 Want to use another hospital?
If you want to get the prescribed test done at another CGHS-empanelled hospital, HCO or diagnostic centre, you need prior referral/endorsement from the CGHS Wellness Centre.
4 CT, MRI, PET & tests above ₹3,000
Referral/endorsement from CGHS is required for special investigations such as:
- CT Scan
- MRI Scan
- PET Scan
- Other investigations costing more than ₹3,000
5 What is included in eye consultation?
The eye consultation fee includes:
- Refraction – checking eye/glasses power
- Tonometry – checking eye pressure
- Fundus examination – examination of the back of the eye
These examinations are included as part of the eye consultation.
6 What about an unlisted investigation?
If a specialist at a CGHS-empanelled hospital advises an unlisted investigation or procedure, prior permission from the concerned Department/Office is mandatory.
📋 CGHS Rules at a Glance
| Situation | Requirement |
|---|---|
| Same-specialty follow-up | Consultation valid for 7 days |
| Test up to ₹3,000 per test | Normally same empanelled hospital |
| Test at another empanelled facility | CGHS referral/endorsement |
| CT / MRI / PET | CGHS referral/endorsement |
| Investigation above ₹3,000 | CGHS referral/endorsement |
| Unlisted investigation/procedure | Prior Department/Office permission |
✅ The Simple Rule to Remember
Before getting a prescribed investigation, ask:
“Am I getting this test at the same hospital where I consulted?”
If yes, a routine test costing up to ₹3,000 per individual test should normally be done there.
If you want to use another facility, check for the required CGHS Wellness Centre referral/endorsement.
For CT, MRI, PET, investigations above ₹3,000, or an unlisted procedure, make sure the required referral or permission is obtained before proceeding.
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📖 Official Reference
For the original government instructions and official reference, readers should refer to the Click here to download the OM.