NABH Entry Level Incentive:
10% Extra on PMJAY Claims

What is the NABH Entry Level PMJAY Incentive?

Under the Pradhan Mantri Jan Arogya Yojana (PMJAY) operational guidelines, hospitals empanelled under Ayushman Bharat are reimbursed at differentiated rates based on their accreditation status. Hospitals that hold a valid NABH Entry Level Certification (ELC) receive a 10% uplift on the base package rate for every claim processed under the scheme.

This incentive is not a one-time bonus — it applies to every approved PMJAY claim for the entire duration of the ELC validity period (2 years). The incentive is automatically applied once your State Health Agency (SHA) updates your hospital's tier following ELC grant.

Incentive Rates: ELC vs Full Accreditation vs None

Note: Exact uplift percentages may vary slightly by state and SHA. The 10% ELC / 15% Full Accreditation differential reflects the standard AB-PMJAY operational guideline rates. Always confirm current rates with your State Health Agency.

Eligibility for the PMJAY NABH Incentive

To qualify for the 10% PMJAY incentive via NABH Entry Level Certification, your hospital must meet all of the following criteria:

• ✓Active PMJAY empanelment — the hospital must be currently empanelled with the National Health Authority (NHA) or the State Health Agency. Hospitals not empanelled with PMJAY cannot claim the incentive, regardless of accreditation status.
• ✓Valid NABH ELC certificate — the certificate must be in force at the time of claim submission. Expired ELC certificates do not attract the incentive. Renewal applications must be submitted before expiry.
• ✓Minimum 50 beds (HCO ELC) — the standard NABH HCO Entry Level programme applies to hospitals with 50 or more beds. Smaller facilities (up to 50 beds) should apply under the NABH SHCO ELC pathway, which also qualifies for PMJAY incentives.
• ✓SHA tier updated — the State Health Agency must have updated your hospital's reimbursement tier on the PMJAY portal. This step requires you to submit your ELC certificate to your SHA after receiving it from NABH.
• ✓Claim compliance — the hospital must not be under suspension or show-cause proceedings by the SHA at the time of the claim.

How to Apply and Activate the Incentive

1. 1

   Achieve NABH Entry Level Certification

   Complete the NABH ELC process — gap assessment, SOP implementation, internal audits, NABH portal application, and on-site assessment. Refer to the full NABH ELC guide for a step-by-step walkthrough. Typical preparation time is 6–12 months.

2. 2

   Receive and Verify Your ELC Certificate

   NABH issues the ELC certificate digitally via the accreditation portal. Verify the certificate number, validity dates, and hospital details. Download a certified copy for submission to the SHA.

3. 3

   Submit Certificate to the State Health Agency

   Log in to your state's SHA empanelment portal and upload the NABH ELC certificate under your hospital's accreditation section. In some states this requires a physical application with an attested copy to the SHA district office — check your state's specific process.

4. 4

   SHA Updates Your Reimbursement Tier

   The SHA verifies the certificate and updates your hospital's tier on the PMJAY claims portal — typically within 15–30 working days. Once updated, all claims submitted after the effective date will automatically attract the 10% incentive.

5. 5

   Monitor and Reconcile Enhanced Claims

   After tier activation, verify that claims are being processed at the enhanced rate by checking reimbursement amounts against the base package rates. If claims are still being processed at the non-accredited rate, follow up with the SHA with your tier update confirmation.

6. 6

   Renew Before ELC Expiry

   NABH ELC is valid for 2 years. Submit the renewal application at least 3 months before expiry to avoid any gap in incentive eligibility. A lapse in ELC validity resets your tier to the base rate until a new certificate is issued.

Fee Structure for NABH Entry Level Certification

The ELC certification fee is a one-time cost covering the full 2-year cycle. Fees are set by NABH (w.e.f. June 2025) and are exclusive of 18% GST. See the complete NABH fee structure for all programmes including Full Accreditation and SHCO.

*Breakeven calculated at ₹15,000 average PMJAY package and 10% incentive, over the full 2-year ELC validity period. Actual breakeven varies by average package value and claim volume.

ELC vs Full Accreditation: Which is Right for You?

For most small and medium hospitals, ELC is the right starting point. The 10% PMJAY incentive funds the preparation cost and generates incremental revenue — while the hospital builds its quality systems toward Full Accreditation. See the detailed cost comparison for both pathways.

Frequently Asked Questions

What is the NABH Entry Level Certification PMJAY incentive?

Hospitals with NABH Entry Level Certification (ELC) receive a 10% higher reimbursement on all PMJAY/Ayushman Bharat package claims compared to non-accredited empanelled hospitals. This incentive is defined under the AB-PMJAY operational guidelines and is applicable across all states implementing the scheme.

Which hospitals are eligible for the PMJAY NABH incentive?

Any hospital empanelled under PMJAY/Ayushman Bharat that holds a valid NABH Entry Level Certification or NABH Full Accreditation is eligible. The hospital must be actively empanelled and in good standing with the State Health Agency (SHA). Read the full ELC eligibility guide.

How much extra can a hospital earn with the NABH incentive?

A hospital processing 200 PMJAY claims per month at an average package of ₹15,000 earns ₹3,00,000 in additional monthly revenue with the 10% ELC incentive. Over a 2-year ELC cycle, that is ₹72 lakh in incremental revenue — far exceeding the ELC certification cost even for the largest slab.

Is there a higher incentive for Full Accreditation vs Entry Level?

Yes. NABH Full Accreditation hospitals receive the highest PMJAY reimbursement rates — typically 15% above the base rate. NABH Entry Level Certification hospitals receive 10% above the base rate. Non-accredited hospitals receive only the base package rate.

How do I apply to claim the PMJAY NABH incentive?

After receiving your NABH ELC certificate, submit a copy to your State Health Agency (SHA) empanelment portal. The SHA will update your hospital's rate tier. Claims submitted after the tier update automatically attract the 10% incentive — no per-claim application is required.

What is the fee for NABH Entry Level Certification?

NABH ELC fees (w.e.f. June 2025, excluding 18% GST): Up to 5 beds — ₹21,000 | 6–20 beds — ₹30,000 | 21–50 beds — ₹48,000 | 51–100 beds — ₹96,000 | 101–300 beds — ₹1,20,000. The fee covers the full 2-year certification cycle with no annual surveillance fees. See the complete NABH accreditation cost breakdown.