India’s new hospital building rules could change healthcare expansion in big cities. Here’s why

India’s hospital sector may see more high-rise healthcare facilities after the government notified the National Building Construction Standards (NBCS) 2026, easing long-standing height restrictions for hospitals and permitting Intensive Care Units (ICUs) above 45 metres subject to enhanced fire safety provisions.

The move comes as hospital operators face rising land costs, limited bed capacity and challenges in expanding healthcare infrastructure in densely populated urban centres, where acquiring large land parcels for hospital projects has become increasingly expensive.

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The notification comes at a time when several private hospital chains are expanding capacity in metro cities amid rising demand for tertiary care, while also trying to manage high real estate and construction costs in urban markets.

Health industry has said restrictive building norms had prevented hospitals from optimising infrastructure, often resulting in fewer beds than required to meet growing demand.

The revised standards are expected to allow hospitals to expand vertically and make better use of existing infrastructure while maintaining patient safety norms. The changes could also reduce dependence on new greenfield projects, which are capital-intensive and time-consuming, by enabling expansion within existing facilities.

Dr Sangita Reddy, group managing director of Apollo Hospitals Enterprise and president of NATHEALTH, said the revised rules mark a “significant and timely step towards enabling future-ready healthcare infrastructure in India”.

“This is a progressive reform for in the larger public good. By unlocking much-needed capacity across the healthcare ecosystem, it will enable hospitals to operate more efficiently and optimise costs — benefits that can ultimately be passed on to patients, while maintaining the highest standards of safety,” she said.

The changes are expected to particularly benefit hospitals in densely populated cities where expanding existing facilities is often faster than setting up entirely new hospitals.

Varun Khanna, group managing director of Quality Care India, said the reform could help hospitals expand capacity without proportionate increases in capital expenditure by leveraging existing infrastructure more efficiently. Khanna is also the vice president of NATHEALTH. 

“Strengthening healthcare infrastructure is not just a sectoral priority it is an economic imperative. The ability to deliver timely, high-quality care at scale has a direct bearing on health outcomes, workforce productivity, and the broader resilience of the economy,” he said.

Hospital operators say land and construction costs remain among the biggest investments in building healthcare facilities, especially in urban markets where demand for tertiary and critical care services continues to rise.

Dr Ashutosh Raghuvanshi, managing director and chief executive officer of Fortis Healthcare, said the ability to expand vertically would help hospitals address capacity gaps in high-density urban centres while avoiding long gestation periods linked to new hospital projects.

“The ability to expand vertically and make better use of existing facilities is therefore a critical enabler. This will help address capacity gaps in high-density urban centres while avoiding the long gestation periods associated with new hospital developments,” he said.