CGHS Rates for Specialized Lab Tests (Genetic, Allergy, Cytogenetics)

The Central Government Health Scheme (CGHS) provides comprehensive medical care to its beneficiaries, which includes a wide array of diagnostic laboratory investigations. This page details the approved rates for a specific set of specialized and genetic tests that are crucial for diagnosing and managing complex health conditions. These tests go beyond routine blood work and delve into areas like cellular pathology, genetics, fertility, and allergic responses.

The procedures listed here, such as Cytogenetics, allergy screening panels, and advanced histopathology, often require sophisticated equipment and specialized expertise. The rates for these tests are fixed by the CGHS and are uniform across all empanelled healthcare facilities, including private hospitals and diagnostic centres. The final rate applied depends on the accreditation status of the hospital (NABH or non-NABH). This guide is designed to help beneficiaries understand the coverage for these specific tests and navigate the process at an empanelled facility.

CGHS Specialized & Genetic Laboratory Test Rates (effective 13 October 2025)

• Post Coital Smear Examination, Non-NABH — Rs 340
• Post Coital Smear Examination, NABH — Rs 400
• Semen Analysis (Automated/Manual), Non-NABH — Rs 213
• Semen Analysis (Automated/Manual), NABH — Rs 250
• Routine - H & E, Non-NABH — Rs 463
• Routine - H & E, NABH — Rs 545
• Special Stain, Non-NABH — Rs 170
• Special Stain, NABH — Rs 200
• Body Fluid for Malignant cells, Non-NABH — Rs 298
• Body Fluid for Malignant cells, NABH — Rs 350
• Imprint Smear from Endoscopy, Non-NABH — Rs 850
• Imprint Smear from Endoscopy, NABH — Rs 1,000
• Chromogranin A, Non-NABH — Rs 4,250
• Chromogranin A, NABH — Rs 5,000
• Faecal calprotectin, Non-NABH — Rs 2,321
• Faecal calprotectin, NABH — Rs 2,730
• Cytogenetics, Non-NABH — Rs 4,250
• Cytogenetics, NABH — Rs 5,000
• Allergic Bronchopulmonary Aspergillosis (ABPA) Panel, Non-NABH — Rs 2,465
• Allergic Bronchopulmonary Aspergillosis (ABPA) Panel, NABH — Rs 2,900
• Allergy Food Screening Panel, Non-NABH — Rs 5,100
• Allergy Food Screening Panel, NABH — Rs 6,000
• Beta-D-Glucan Assay, Non-NABH — Rs 12,750
• Beta-D-Glucan Assay, NABH — Rs 15,000
• Skin Prick Test for Allergy, Non-NABH — Rs 1,530
• Skin Prick Test for Allergy, NABH — Rs 1,800
• Comprehensive Allergy Panel, Non-NABH — Rs 5,950
• Comprehensive Allergy Panel, NABH — Rs 7,000
• DCP (DES Gamma-Carboxy- Prothrombin), Non-NABH — Rs 2,848
• DCP (DES Gamma-Carboxy- Prothrombin), NABH — Rs 3,350
• UGT1A1 Gene Analysis, Non-NABH — Rs 5,100
• UGT1A1 Gene Analysis, NABH — Rs 6,000

Rates shown are as per the CGHS approved package rates (Office Memorandum F.No.5-16/CGHS(HQ)/HEC/2024(PartI) dated 03.10.2025, effective 2025-10-13) (2025 (effective 13.10.2025)) and are subject to periodic revision. Always verify the latest approved rates on the official source.

Who This Covers

This rate guide is intended for CGHS beneficiaries who have been prescribed specific, non-routine laboratory tests by a qualified medical practitioner. The procedures covered on this page are relevant for patients undergoing investigation for a variety of conditions, including:

• Fertility Issues: Individuals or couples requiring tests like Semen Analysis (automated or manual) or a Post Coital Smear Examination to assess fertility parameters.

• Cancer and Cellular Diagnostics: Patients needing detailed tissue analysis, such as Routine H & E staining, Special Stains for specific cellular components, Body Fluid analysis for Malignant Cells, or Imprint Smears from endoscopic biopsies. Tests like Chromogranin A are also used as tumour markers.

• Allergic Conditions: Individuals experiencing symptoms of allergies who require diagnostic tests like a Skin Prick Test, Allergic Bronchopulmonary Aspergillosis (ABPA) Panel, a general Food Screening Panel, or a Comprehensive Allergy Panel.

• Gastrointestinal Disorders: Patients with suspected inflammatory bowel conditions may be prescribed a Faecal Calprotectin test.

• Genetic and Chromosomal Analysis: Individuals requiring Cytogenetics to study chromosomes for genetic disorders or UGT1A1 Gene Analysis, often used to assess drug metabolism or risk for certain inherited conditions.

• Fungal Infections: Patients for whom a Beta-D-Glucan Assay is recommended to detect invasive fungal infections.

What CGHS Covers vs. What You Pay Separately

The CGHS package rates listed in the table are for the procedure itself, as defined by the scheme. This typically includes the cost of performing the test, analysis by a pathologist or specialist, and the generation of the report. The rates are comprehensive for the investigation code mentioned.

However, for certain specialized tests, there may be associated costs for items not included in the package rate. These could include high-cost or imported consumables, specialized collection kits, or specific drugs required for the test (such as allergens for a skin prick test). These items may be billed separately to the patient at MRP.

It is important for beneficiaries to have a clear discussion with the hospital's billing department or the lab administration before proceeding with the test. Ask for a breakdown of any potential extra costs for consumables or other materials that are not part of the CGHS package rate to understand the full financial picture.

How to Use This at a CGHS-Empanelled Hospital

To avail of these tests at CGHS rates, beneficiaries should follow a standard procedure at any empanelled hospital or diagnostic laboratory.

1. Obtain a Valid Referral: You must have a prescription for the specific test from a government specialist or a CGHS medical officer. The prescription should clearly state the name of the test required.

2. Visit the Empanelled Facility: Go to a hospital or lab that is empanelled under CGHS. Carry your CGHS card, the doctor's prescription, and any other required identification.

3. Confirm Procedure Code and Rate: At the hospital's billing or registration desk, present your documents. It is advisable to confirm that the procedure code the hospital is using matches the one prescribed and listed in the CGHS schedule. This helps prevent any billing discrepancies.

4. Understand the Applicable Rate: The CGHS has different rates for NABH (National Accreditation Board for Hospitals & Healthcare Providers) accredited hospitals and non-NABH accredited hospitals. The rate that applies to your test is determined by the accreditation status of the hospital you are visiting, not by your personal choice. You can usually find a hospital's accreditation status on its website or by asking at the front desk.

Frequently Asked Questions

What is the difference between a routine H&E stain and a special stain in histopathology?

A routine Hematoxylin and Eosin (H&E) stain is the standard method used in pathology to view overall tissue structure. Special stains are additional dyes used to highlight specific structures, substances, or microorganisms (like fungi or bacteria) within a tissue sample that are not visible with an H&E stain, providing more detailed diagnostic information.

What is Cytogenetics and why is it prescribed?

Cytogenetics is the study of chromosomes to identify changes in their number or structure. It is prescribed to diagnose genetic disorders, birth defects, and certain types of cancer. The test requires a sample of blood, bone marrow, or other tissue.

Do I need to prepare in any special way for an allergy panel blood test?

For most allergy blood tests, no special preparation like fasting is required. However, if you are undergoing a Skin Prick Test, you may be asked to stop taking antihistamines for several days beforehand. Always follow the specific instructions provided by your doctor or the laboratory.

What is the purpose of a UGT1A1 Gene Analysis?

UGT1A1 Gene Analysis is a genetic test that checks for variations in the UGT1A1 gene. This gene is important for processing bilirubin and metabolizing certain medications, particularly some chemotherapy drugs. The test can help doctors determine the cause of high bilirubin levels (Gilbert's syndrome) or adjust drug dosages to avoid toxicity.

How do a Semen Analysis and a Post Coital Smear Examination differ?

A Semen Analysis directly evaluates a semen sample in a lab to check sperm count, motility, and morphology. A Post Coital Smear Examination is a test performed on a sample of cervical mucus taken from the female partner after intercourse to assess the interaction between sperm and the mucus. Both are used in fertility investigations but evaluate different aspects.

How can I find out if a hospital is NABH accredited?

You can check the hospital's official website, look for the NABH accreditation logo displayed at the facility, or inquire directly at the hospital's reception or billing counter. The applicable CGHS rate for your procedure will depend on this status.

Related

• How to apply for a CGHS card
• CGHS rate list for common procedures
• CGHS vs Ayushman Bharat: what's the difference

Medical Disclaimer

The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.