NABH accreditation: a clear guide for hospitals in 2026

NABH accreditation is the hospital quality mark that India’s central government health schemes, CGHS and PM-JAY, use when they set package rates and approve hospitals, and several of its rules changed in 2025 and 2026. A new standards edition took effect, the entry-level route was rebuilt on a new portal, fees were revised and CGHS now pays non-NABH, non-NABL hospitals 15% less than NABH or NABL accredited ones for the same package.

For a hospital board, chief executive or quality head deciding whether and how to apply, the questions are practical: which programme fits the bed count, which NABH standards are in force, what NABH charges, how long each stage takes and what the badge is worth in reimbursement. This guide answers each from NABH’s own notices and programme pages, the CGHS office memorandum of October 2025 and National Health Authority guidelines, as of November 2026.

What NABH accreditation is and who runs it

The National Accreditation Board for Hospitals and Healthcare Providers (NABH) describes itself as a constituent board of the Quality Council of India (QCI). It has operated since its inception in 2005, and NABH describes its hospital accreditation programme, started the same year, as its flagship. NABH also says it is “accredited by ISQua for its Hospital Accreditation Standards”, which gives the NABH standards an international reference point.

NABH’s website reports “over 29,000 healthcare facilities accredited or certified” across more than 30 programmes, and QCI’s home page gives “30,000+ Hospitals Accredited & Certified”. Neither page dates its count or separates NABH accredited hospitals from entry-level certificates and other programmes, so neither is a count of hospitals holding full NABH accreditation. NABH does not publish that split on the pages reviewed for this guide.

NABH’s hospital FAQ says NABH accreditation is increasingly accepted as a quality requirement for government healthcare schemes, insurers and corporate health programmes. The sections below show where that acceptance turns into money.

Which route fits: full NABH accreditation, SHCO or entry level

NABH runs separate programmes by size and level. Full NABH accreditation under the Hospital Accreditation Programme (HCO) is for “Hospitals with more than 50 sanctioned beds”, public or private. The NABH standards must apply across the whole institution rather than selected departments, and applicants must already meet legal, statutory and regulatory requirements. A notice of 20 January 2026 (NABH/Gen/2026/00410) relaxed the earlier 30% average occupancy requirement: a hospital must have operated for at least six months, implemented the NABH standards for at least three months, and show average bed occupancy of at least 20% for the final assessment, 25% for surveillance and 30% for renewal.

Smaller facilities, which NABH lists as “Hospitals, Day Care Centres, Super/Specialty Centres with ≤50 sanctioned beds”, use the Small Healthcare Organisation (SHCO) programme. It runs on the 3rd edition SHCO standards of August 2022 and states that “Accreditation is valid for 4 years.”

The third route is certification rather than NABH accreditation. The Entry-Level Certification Programme (2nd Edition) is, in NABH’s words, “a unified quality framework” for SHCOs of up to 50 beds and hospitals of 51 beds and above. It is open to allopathic hospitals functional for at least six months, with “Minimum 20% occupancy during the last 3 months” before the final assessment, rising to 25% at the first renewal and 30% at the second. Certification is priced for two years.

Feature	Hospital accreditation (HCO)	SHCO accreditation	Entry-level certification
Who it is for	More than 50 sanctioned beds	Up to 50 sanctioned beds	Up to 50 beds and 51 beds and above, allopathic only
NABH standards	6th edition, effective 1 January 2025	3rd edition, August 2022	2nd edition, new portal from 16 February 2026
Cycle	Surveillance in year 2, reapply in year 4	Valid 4 years	Two years
Published fees	Application plus annual fee by beds	Rs 25,000 application, Rs 1,50,000 annual	Rs 21,000 to Rs 2,00,000 for two years

Hospitals above 300 beds

The entry-level route now has a ceiling. A notice of 21 April 2025 (NABH/Gen/2025/3798) urged hospitals with more than 300 beds to move to full NABH accreditation from 1 October 2026, after which “no fresh or renewal applications” under the HOPE entry-level programme would be accepted for them. Such hospitals could still apply until 30 September 2026, for a certificate valid two years. After that date the notice lists two exceptions: a new hospital commissioned on or after 1 October 2026, for one cycle, and “All government-owned hospitals, regardless of their date of commissioning”.

The NABH standards in force: the 6th edition

The NABH standards for hospitals are in their 6th edition. The implementation notice of 10 September 2024 (NABH/Gen/2024/6413) said the edition “will be released on September 17, 2024” and that “The new edition will be effective from January 01, 2025.” The 6th edition standards document carries “Effective 1 Jan, 2025” on its title page.

The 6th edition has 10 chapters, 100 standards and 639 objective elements, of which 105 are core, 457 commitment, 60 achievement and 17 excellence. The chapters are access, assessment and continuity of care (AAC); care of patients (COP); management of medication (MOM); patient rights and education (PRE); infection prevention and control (IPC); patient safety and quality improvement (PSQ); responsibility of management (ROM); facility management and safety (FMS); human resource management (HRM); and information management system (IMS).

The categories set the pace of the four-year NABH accreditation cycle. Core elements are “mandatorily assessed during each assessment” and must score at least 4 on NABH’s five-point scale. Commitment elements are assessed at the final assessment, achievement elements at surveillance and excellence elements at reaccreditation. NABH states that “The basis for scoring shall be implementation”, and inadequate documentation can lower a score by one point.

The foreword lists what is new. It says the edition “has also added annexures on Medication errors, Risk Management, Patient Reported Outcome Measures”, among others, and describes “The integration of sustainable measures within these accreditation standards”. The summary of changes records a new standard, ROM.3, “added to address environmental, social and economic factors”. For a hospital whose policies were written for the earlier NABH standards, these are the topics with no 5th edition equivalent.

How the switch from the 5th edition worked

The changeover to the new NABH standards is complete. The September 2024 notice stated that “no fresh or renewal application will be accepted as per 5th Edition Standard after 31st December, 2024” and that “no surveillance assessment will be conducted as per 5th Edition standards after 31st March 2025.” Hospitals that had paid fees, finished a pre-assessment or applied for reaccreditation by 31 December 2024 could choose either edition. A notice of 28 March 2025 (NABH/GEN/2025/2962) opened the 6th edition portal to new applicants from 1 April 2025 and to renewal and surveillance cases from 4 April 2025.

How to get NABH accreditation in 8 steps

NABH’s hospital programme page sets out eight steps to NABH accreditation. They are listed below with the detail that NABH’s notices and timeline document add.

1. Download the NABH standards. NABH directs applicants to download the 6th edition hospital standards from its website.
2. Buy the guidebook. NABH sells a guidebook for “detailed guidance on implementation and compliance”; the 2024 notice made it available from 15 October 2024.
3. Implement for at least three months. NABH asks hospitals to “Implement the standards for at least 3 months to ensure readiness.” Its E-Mitra platform offers free sample policies, procedures and checklists, which NABH says are generic and must be adapted to each organisation.
4. Submit the application. The form, documents, self-assessment toolkit and fee go through the NABH portal. The timeline allows 30 days from activation of registration to complete the application.
5. Desktop assessment. NABH reviews the submitted documents. This stage applies to the HCO and SHCO programmes.
6. Onsite assessment. Trained assessors visit the hospital. A pre-assessment is optional, and NABH’s timeline places both the pre-assessment and the final assessment “Within 15 days of application”.
7. Accreditation decision. The hospital reports corrective action “Within 100 days of final assessment”, and the accreditation committee reviews the case “Within 30 days of Closure of CAPA of Final Assessment”. The committee can order a verification assessment.
8. Surveillance and renewal. NABH’s instruction is to “Undergo Surveillance in Year 2 and reapply in Year 4 for continued accreditation.” Renewal applications are due “Before 6 months of expiry of accreditation / certification”.

The entry-level process now differs in one respect. Under the notice of 13 February 2026 (NABH/GEN/2026/01369), “the Desktop Assessment process shall include a single cycle of nonconformity (NC) closure only”, meaning one consolidated set of observations with no second round, before onsite assessment and Certification Committee review.

NABH accreditation timelines, stage by stage

NABH publishes an accreditation and certification timeline, Issue No. 4 dated August 2025, which applies across its programmes. It sets a window for each stage rather than a total duration, so the elapsed time to NABH accreditation depends mainly on how quickly a hospital closes non-conformities. NABH labels the windows below an “Approx. time line”.

Stage	Approximate timeline stated by NABH
Application with fee, self-assessment toolkit and documents	30 days from activation of registration
Pre-assessment (optional)	Within 15 days of application
Final assessment	Within 15 days of application
Corrective action after final assessment	Within 100 days of final assessment
Accreditation committee review	Within 30 days of closure of corrective action
Surveillance assessment	24 months after award for a four-year cycle, 18 months for a three-year cycle
Corrective action after surveillance	60 days from the surveillance visit
Renewal application	At least six months before expiry

Where applications slip

NABH’s notices point to three avoidable problems. The first is payment. A notice of 4 January 2024 (NABH/Gen/Notice/2024/0049) said “In no case HCOs shall deposit cash/cheque/DD directly into any of the accounts of Quality Council of India.” Payments must go through the portal, details not updated there may not be credited, and the notice warned of a possible adverse decision. Since 1 July 2025, under a late fee notice (NABH/Gen/2025/6836), NABH charges 1% a month on outstanding invoices, and “Failure to pay the fee within 3 months of the due date of payment will result in suspension of accreditation/certification.”

The second is readiness: scoring under the NABH standards rests on implementation, not paperwork, and the programme requires three months of it before applying. The third is renewal timing. Full accreditation renewals are due at least six months before expiry. For entry-level hospitals moving from the old HOPE portal, the February 2026 notice allows a renewal application for up to six months after the certificate expires, and “Applications submitted beyond the stipulated six-month period shall be treated as fresh applications.” The 2024 fee notice adds “Fee once paid is non-refundable and non-transferable.”

NABH accreditation fees as published

NABH revised its annual accreditation fees from 1 April 2024 through a notice dated 5 March 2024 (NABH/Gen/2024/1840), which said “the application fees for all the categories shall remain the same.” The hospital programme page lists the schedule below. As of November 2026 the table is still headed “Hospitals Accreditation Programme (5th Edition April 2020)”, although the same page describes the 6th edition process; NABH does not explain the label.

Sanctioned beds	Application fee	Annual fee	Virtual assessment	Focus assessment	Certificate reissue
Up to 100	Rs 40,000	Rs 2,00,000	Rs 3,000	Rs 15,000	Rs 6,000
101 to 300	Rs 75,000	Rs 3,00,000	Rs 5,000	Rs 15,000	Rs 6,000
301 to 500	Rs 1,00,000	Rs 4,00,000	Rs 10,000	Rs 15,000	Rs 6,000
501 and above	Rs 1,50,000	Rs 5,00,000	Rs 15,000	Rs 15,000	Rs 6,000

NABH adds “18% GST applicable extra.” The 2024 revision raised the annual fee for hospitals of up to 100 beds from Rs 1,65,000 to Rs 2,00,000, for 101 to 300 beds from Rs 2,50,000 to Rs 3,00,000, for 301 to 500 beds from Rs 3,60,000 to Rs 4,00,000 and for 501 beds and above from Rs 4,40,000 to Rs 5,00,000. For SHCOs the annual fee rose from Rs 1,10,000 to Rs 1,50,000, with an application fee of Rs 25,000.

Entry-level certification is priced for two years: Rs 21,000 for up to 5 beds, Rs 40,000 for 6 to 20, Rs 80,000 for 21 to 50, Rs 1,60,000 for 51 to 100 and Rs 2,00,000 for 101 to 300, plus GST. These rates took effect on 1 June 2025 under the April 2025 fee notice, which also offered rebates of 25% and 40% on fresh and renewal applications “until September 30, 2026”. As of 1 November 2026, NABH’s entry-level page lists the full fees without the rebate, and its list of notices shows no extension of the rebates.

Assessor travel is a further cost. Under a notice of 27 July 2026, QCI has booked travel and hotels for NABH assessors for all assessments planned on or after 1 August 2026 and bills the hospital “on an actual-cost basis”. Hotel limits are Rs 10,000 a night plus taxes in Mumbai, Delhi, Kolkata, Chennai, Bengaluru and Hyderabad, Rs 8,000 in state capitals and other identified towns and Rs 6,000 elsewhere, and the hospital still arranges local transport. The published fees exclude consultancy, staff training and building works, and NABH does not publish an all-in cost of preparing for NABH accreditation.

How NABH accreditation affects CGHS, PM-JAY and insurer rates

CGHS: a 15% gap in package rates

The clearest financial effect sits in the Central Government Health Scheme. An office memorandum of 3 October 2025 (F.No. 5-16/CGHS(HQ)/HEC/2024(PartI)) revised CGHS rates with effect from 13 October 2025 and set the rule as “Non-NABH and Non-NABL HCOs: 15% lower than NABH/NABL accredited HCOs.” CGHS’s own website could not be opened for this guide, so the copy linked here is the memorandum as published by the Raman Research Institute, not a copy from CGHS. Business Standard reported that the revision covered “nearly 2,000 medical procedures”.

The same memorandum sets super speciality rates “15% higher than those applicable to NABH-accredited hospitals” and makes rates in Y (Tier II) and Z (Tier III) cities “10% and 20% respectively lower” than in X (Tier I) cities. Rates are for a semi-private ward, 5% less for general ward and 5% more for private ward.

On classification, NABH’s summary of a later CGHS memorandum, dated 22 December 2025, says hospitals accredited by NABH are considered under the NABH category, while Tier 1 hospitals without NABH accreditation “may apply under the Non-NABH category; however, Entry-Level NABH Certification or NABH-QCI recommendation is mandatory”. A hospital with only entry-level certification therefore applies in the non-NABH category.

CGHS empanelment is a separate step. NABH says it assesses hospitals for CGHS under a memorandum of understanding and that “NABH-QCI submits its recommendations to CGHS”. Its CGHS empanelment page sets minimum sanctioned beds of 50 in metro cities and 30 elsewhere, with fees of Rs 30,000 below 100 beds, Rs 35,000 above and Rs 25,000 for diagnostic, eye and dental centres, plus GST.

Those figures date from before the December 2025 memorandum. A NABH notice of 17 February 2026 (NABH/Gen/2026/01624) says hospitals already NABH accredited or certified now apply to CGHS directly, and that super speciality empanelment requires full NABH accreditation, at least 200 beds in Tier 1 cities or 100 elsewhere, and NABL accreditation for in-house laboratories. In Tier 2 and Tier 3 cities, the north-eastern states, Jammu and Kashmir and Ladakh, hospitals without NABH accreditation, certification or a QCI recommendation may be provisionally empanelled but must obtain one within six months. A NABH-QCI recommendation is valid for three years.

PM-JAY: up to 15% more per package

Under Ayushman Bharat PM-JAY, NABH status affects both entry and price. The National Health Authority’s hospital empanelment guidelines say applicants that are “PM-JAY Bronze Certified/NABH accredited/NABH certified/CGHS empaneled/ECHS empaneled will be auto-approved” if they have applied on the portal and meet the minimum criteria, and NABH hospitals are excepted from the physical verification that other fast-tracked hospitals must undergo within three months. Empanelment renews “once every 3 years or till the expiry of validity of PM-JAY Bronze/NABH certification whichever is earlier”.

On price, the AB PM-JAY Quality Certification, launched in 2019 by the National Health Authority and QCI according to NABH, “Offers incentives (5% Bronze, 10% Silver, 15% Gold)”. Silver is for empanelled hospitals with NABH entry-level certification and Gold for those with NABH accreditation or NQAS, each granted on desktop assessment for Rs 2,000 plus GST. A Lok Sabha answer of 23 July 2021 by Dr Bharati Pravin Pawar, then Minister of State for Health, described the same 10% and 15% structure.

Private insurers

Insurers and third-party administrators set their own network terms. In July 2018 the insurance regulator IRDAI issued modified guidelines on standards for hospitals in the provider network (a copy hosted on the qps.nhsrcindia.org portal, not on IRDAI’s own site), telling existing network hospitals to “Obtain either Pre-entry level Certificate (or higher level of certificate)” from NABH, or a state-level NQAS certificate, within twelve months.

That rule has since changed. Business Standard reported on 20 July 2022 that a new IRDAI circular allowed insurers to empanel network providers “that meet the standards and benchmarks criteria as specified by their respective boards”, and asked them to publish those criteria. No insurer-wide rate rule comparable to the CGHS gap was found for this guide. For context, see our report IRDAI chief estimates at most 15 per cent have effective insurance cover and our Policy and payers section.

What changed in 2025 and 2026

• 1 January 2025: the 6th edition NABH standards for hospitals took effect.
• 31 March 2025: the last date for surveillance assessments under the 5th edition.
• 1 and 4 April 2025: the 6th edition portal opened to new applicants, then to renewal and surveillance cases.
• 1 June 2025: rationalised entry-level (HOPE) fees took effect, with rebates until 30 September 2026.
• 1 July 2025: a late fee of 1% a month on overdue NABH invoices took effect, with suspension after three months unpaid.
• August 2025: NABH issued Issue No. 4 of its accreditation and certification timeline.
• 13 October 2025: revised CGHS rates took effect, with rates for non-NABH and non-NABL hospitals set 15% below those for accredited ones.
• 22 December 2025: a CGHS memorandum set new empanelment criteria, which NABH summarised on 17 February 2026, including compulsory NABH accreditation for super speciality hospitals.
• 20 January 2026: NABH set revised minimum occupancy of 20%, 25% and 30% for final, surveillance and renewal assessments.
• 16 February 2026: applications under the 2nd edition entry-level standards moved to a new portal. The HOPE portal was to “continue to operate until 28th February 2026”, and fees paid on or after 1 March 2026 fall under the 2nd edition.
• 1 August 2026: QCI took over travel and hotel bookings for NABH assessors, billed to the hospital at actual cost.
• 1 October 2026: the date from which, under the April 2025 notice, fresh or renewal HOPE applications from hospitals above 300 beds were no longer to be accepted, subject to the exceptions above.

The February 2026 notice also set the assessment pattern for entry-level hospitals of 51 beds and above: core and commitment elements at the first assessment, adding excellence elements from the first renewal.

What it means for operators, suppliers and investors

Operators. The commercial case can now be set out in figures. A 200-bed hospital pays NABH a Rs 75,000 application fee and Rs 3,00,000 a year, plus GST. Against that, CGHS pays unaccredited hospitals 15% less than NABH accredited ones on the same package, and PM-JAY quality certification pays 15% for Gold against 10% for Silver. NABH does not publish a return calculation; the answer depends on each hospital’s CGHS and PM-JAY volumes.

For private hospitals above 300 beds commissioned before October 2026, entry-level certification is no longer available unless an exception applies, which leaves full NABH accreditation. Hospitals seeking full accreditation now prepare against the 6th edition NABH standards, with their new annexures and the ROM.3 sustainability standard, and super speciality hospitals need that accreditation to be empanelled by CGHS at all. Coverage of hospital groups runs in our Providers section.

Suppliers. The information management system chapter, the medication error and risk management annexures and patient reported outcome measures all create documentation and data requirements. NABH also runs digital health standards and lists NABH certified healthcare software on its site. Documentation consultancies now compete with free official templates on E-Mitra, which NABH says must be customised and do not guarantee NABH accreditation.

Investors and lenders. Status can be checked on NABH’s search for accredited organisations, and the cycle position matters: a hospital approaching surveillance at 24 months or renewal carries assessment risk that a recently NABH accredited one does not. A lapse in NABH accreditation would move a hospital to CGHS rates 15% below the accredited rate. Our Listed 100 hospital profiles and Deals and capital coverage follow the operators involved.

What to watch next

• A 6th edition fee table. Whether NABH relabels or revises the hospital fee schedule that is still headed with the 5th edition; its list of notices showed no 6th edition fee schedule as of 1 November 2026.
• Entry-level pricing after the rebate. The April 2025 rebates ran “until September 30, 2026” and no extension had been published by 1 November 2026. The notice says “The Policy shall be reviewed two years from the effective date”, which points to mid-2027.
• Large hospital migration. How many hospitals above 300 beds move from entry-level certification to full NABH accreditation after 1 October 2026; NABH has not published a count.
• CGHS empanelment. How many hospitals CGHS empanels under the December 2025 criteria, and how many provisionally empanelled hospitals in Tier 2 and Tier 3 cities obtain NABH certification or a QCI recommendation within six months.
• PM-JAY incentives. Any change by the National Health Authority to the 5%, 10% and 15% quality incentives, which would shift the value of each NABH tier.

The Healthcare Daily will log new NABH notices and scheme rate changes on the Tracker as they are published.