CGHS Revises Ceiling Rates and Guidelines for Cochlear Implantation and Rehabilitation Under CGHS and CS(MA) Rules, 1944

F. No. S-367/2026/CGHSHQ/R&H/EHS(8410942)/I/3913657/2026

Government of India

Ministry of Health & Family Welfare

(EHS Section)

Kartavya Bhavan-1, New Delhi

Dated: 09-11-2026

OFFICE MEMORANDUM

Subject:Revised ceiling rates and guidelines for cochlear implantation and rehabilitation under CGHS and CS(MA) Rules, 1944.

The undersigned is directed to refer to OM No. 6-469/2003-CGHS/R&H dated 12 June 2009 and to convey the following revised guidelines, based on the Technical Committee’s recommendations. These apply to eligible CGHS beneficiaries and Central Government employees and dependent family members covered under the Central Services (Medical Attendance) Rules, 1944, subject to their respective entitlements.

1. Eligibility Criteria:

A. Prelingual deafness:

i. Children aged 9 months to 7 years with severe to profound bilateral sensorineural hearing loss.

ii. Trial of hearing aids for 3-6 months with no appreciable benefit. In case of Meningitis/ossification of cochlea, surgery may be considered on urgent basis.

iii. There shall be no intellectual disability, active middle-ear cleft disease, cochlear aplasia, cochlear nerve agenesis, retrocochlear lesion or central deafness.

iv. Any tympanic membrane perforation shall have been closed at least three months earlier.

v. Adequate family support and commitment to rehabilitation are essential.

B. Postlingual deafness:

i. All cases of severe to profound bilateral sensory neural hearing loss irrespective of age.

ii. Treatment of chronic ear disease.

iii. Exclusion of retrocochlear pathology and central auditory disorders.

iv. In case of Meningitis cochlear surgery may be considered on urgent basis.

Meningitis or cochlear ossification cases shall receive expedited consideration; urgent implantation may be considered on specialist advice, with expedited Local Technical Committee (LTC) processing wherever approval is required.

2. Implant system and treatment centres

(A) Multichannel cochlear implant approved by the Central Drugs Standard Control Organisation (CDSCO) is admissible for eligible beneficiaries of all ages.

(B) Surgery may be undertaken at Government hospitals, AIIMS, Institutions of National Importance (INIs), autonomous Government hospitals or CGHS-empanelled/CS(MA)-recognised hospitals, as applicable, with appropriate implant facilities, trained speech therapists and arrangements for mapping and prescribed auditory-verbal or other speech and auditory rehabilitation.

3. Assessment and specialist recommendations

A. Applications shall include clinical details, hearing-aid assessment, proposed implant and side, rehabilitation plan and itemised estimate. Unilateral or bilateral surgery shall be decided on case-to-case basis.

B. Pre-op investigations include:

i. Pure-tone/speech and impedance audiometry,

ii. Otoacoustic emissions (OAE)

iii. Brain stem evoked response audiometry (BERA)

iv. Auditory steady-state response (ASSR)

v. High-resolution temporal-bone CT for the bony cochlea and middle ear (HRCT)

vi. 3D MRI for the membranous cochlea, cochlear nerve/neural bundle and brain

vii. IQ/psychiatric evaluation for prelingual deafness.

The requisite medical advice shall be obtained from an ENT specialist working in a Government medical institution, such as AIIMS, an Institute of National Importance (INI), Tata Memorial Hospital, or any other Central/State Government medical institution. In cases where such advice is not available, recommendations from two ENT specialists of two different CGHS-empanelled hospitals shall be obtained, in accordance with paragraph 3(b) of OM No. 56-1/2026-27/CGHS/MSD dated 01.09.2026. All recommendations must be duly signed and dated, specific to the beneficiary concerned, and supported by adequate clinical justification.

4. Approval and submission

A. As cochlear implant surgery is planned procedure prior approval of the competent authority has to be obtained before the surgery. In case of both Serving and Pensioners the concerned Additional Directors zone/cities shall give permission as per the Decentralised STC approval OM dated 01.09.2026 listed under category-2.

B. Initially permission shall be given for unilateral cochlear implant and further permission for cochlear implant surgery on another side shall be considered after 01 year with proper justification and assessment of the first surgery.

C. Applications requiring permission shall be routed through the Wellness centres to the concerned Additional Directors Zones/Cities in case of CGHS beneficiaries.

D. CS(MA) beneficiaries through their Ministry/Department/Office to DGHS.

5. Package Cost:

Payment for unilateral implantation shall be limited to package cost or actual admissible expenditure whichever is lower.

Category	Package ceiling
For Pre-lingual deafness	Rs. 7,00,000 inclusive of GST
For Post-lingual deafness	Rs. 6,00,000 inclusive of GST

Package cost includes Assessment and investigations, the complete implant system, including internal implant/electrode array, external speech processor, microphone, transmitting coil, standard accessories, battery/rechargeable power arrangement and charger where applicable, warranty and first-year consumables; surgery and hospital care, including surgeon, anaesthesia, theatre, admissible stay, nursing, medicines, surgical consumables, investigations and postoperative care; activation, programming, mapping and follow-up; and prescribed auditory/speech therapy and counselling according to clinical need.

6. Warranty and replacement

i) The invoices shall clearly mention the warranty period for the internal implant, speech processor, microphone and other wearable components for all ages.

ii) Upgradation or replacement of eligible wearable components, such as the external/internal component, due to wear and tear may be allowed after three years, excluding rods and batteries, subject to warranty scrutiny. Reimbursement shall be limited to fifty percent of the package cost or actual expenditure whichever is lower. Such cases shall follow LTC/decentralised approval and CS(MA) cases the applicable competent-authority procedure.

7. Rehabilitation and settlement of claims

i) The implant centre shall ensure activation, mapping and prescribed rehabilitation through qualified professionals holding valid Central Rehabilitation Register numbers wherever applicable, and maintain mapping, therapy-session and progress records.

ii) CGHS pensioners shall claim reimbursement through the Wellness Centre to the concerned Additional Director; serving CGHS and CS(MA) beneficiaries through their Ministry/Department/Office; and autonomous-body beneficiaries through their respective bodies. Admissible cashless/credit bills shall follow the CGHS billing mechanism.

8. Effective date

These instructions take effect from the date of issue and supersede earlier orders on cochlear implantation and related reimbursement under CGHS and CS(MA) Rules, 1944.

Existing sanctions shall remain governed by their terms unless revised by the competent authority.

This issues with the approval of the competent authority and IFD concurrence vide CD No. 2680 dated 04.11.2026.

(Sonika Khattar)

Deputy Secretary to the Government of India

Tel. No. 011-24013215

To:

All Ministries/Departments; Director, CGHS; DGHS; All Additional Directors, CGHS; Concerned Pay and Accounts Offices; All HCOs/centres under CGHS/CS(MA).

Copy to:

CGHS/Ministry websites for publication; Office Order file.

 

CGHS Cochlear Implant Guidelines 2026, Cochlear Implant CGHS, CGHS Revised Rates, CS MA Rules 1944, Cochlear Implant Package Cost, CGHS Medical Reimbursement, Prelingual Deafness, Postlingual Deafness, Hearing Loss Treatment, Ministry of Health and Family Welfare, CGHS Beneficiaries, Cochlear Implant Surgery, CGHS Package Ceiling, ENT Specialist Recommendation, CDSCO Approved Implant, CGHS Circular 2026, Medical Attendance Rules, Sonika Khattar, Health Ministry OM, CGHS Rehabilitation Guidelines