Do not delay emergency care
If immediate medical attention is required, seek appropriate emergency treatment. Routine referral procedures should not cause dangerous delay in genuine emergencies.
Empanelled hospital
If an empanelled hospital is available, show the current CGHS card/e-card and tell the hospital that the case is an emergency. Ask it to record the emergency status and preserve admission, clinical and billing documents.
Non-empanelled hospital
Emergency treatment may sometimes occur in a non-empanelled hospital because of urgency or availability. Reimbursement is not automatically equal to the full hospital bill; admissibility and rates are decided under CGHS rules.
Emergency investigations
The Ministry's referral simplification instructions state that where a listed investigation advised by an empanelled-hospital specialist is urgently required as a medical emergency and certified as such, it may be undertaken at that hospital.
Documents to preserve
Keep emergency/admission notes, discharge summary, prescriptions, investigation reports, itemised bills, receipts, payment proof, implant/device details where relevant, CGHS card details and any referral/permission available.
Get emergency certification/documentation
The medical record should clearly support why the case required urgent treatment. A later reimbursement claim is much harder if the emergency nature is not reflected in the hospital record.
Cashless versus reimbursement
Eligible cashless categories and planned-treatment rules are not identical to reimbursement after emergency expenditure. Verify the route applicable to the principal cardholder's category.
After discharge
Check whether any reimbursement claim is required, obtain all original/required documents before leaving the hospital, and submit through the current CGHS/departmental process applicable to the beneficiary.
If reimbursement is reduced or rejected
Ask for the reason or deficiency in writing. Compare the decision with hospital empanelment, CGHS admissible rates, emergency documentation and the documents actually submitted before filing a representation.
Related CGHS guides
CGHS Hub · Referral · Emergency Treatment · Medicines · Medical Reimbursement
Official sources
- MoHFW Annual Report 2025–26
- MoHFW CGHS referral simplification orders
- Official CGHS medical reimbursement claim form (serving employee)
Source review: 10 September 2026.