India has moved to ease restrictions on hospital construction, paving the way for taller healthcare facilities and more flexible placement of critical care units, including ICUs.
The Bureau of Indian Standards (BIS) has removed the long-standing 45-metre height cap for hospitals under the National Building Construction Standards (NBCS) 2026. The revision follows sustained demands from healthcare industry groups and major hospital chains seeking greater flexibility in expansion.
Previously, under the National Building Code (NBC) 2016, hospitals were limited to a height of 45 metres roughly 12 to 15 floors and ICUs were required to be located within 30 metres. The updated norms now only “prefer” that critical care units remain within 45 metres, without enforcing a strict cap on either building height or ICU placement.
Industry stakeholders say the change could reduce hospital expansion costs by 20–25 per cent, as it allows operators to add floors to existing facilities instead of investing in new land. With land and construction costs forming a major part of hospital investments, the move is expected to significantly improve capital efficiency. Ashutosh Raghuvanshi, CEO of Fortis Healthcare, noted that land remains a key cost driver in hospital development.
The revised standards take into account evolving factors such as shrinking per capita land availability, growing infrastructure demands, and technological advancements. Varun Khanna of Nathealth said the reform will help hospitals scale capacity by optimising existing infrastructure while adhering to safety norms.
Healthcare associations, including Nathealth, had earlier flagged the issue with the Directorate General of Health Services, urging removal of vertical restrictions. Experts believe earlier norms often limited hospital capacity, resulting in fewer beds despite rising healthcare demand.
Dr. Sangita Reddy of Apollo Hospitals Group said the reform could unlock additional capacity across the healthcare system, enabling better efficiency and potential cost benefits for patients.
The move is particularly significant for densely populated urban areas, where setting up new hospitals is expensive and time-consuming. By allowing vertical expansion, hospitals can bridge capacity gaps without long gestation periods associated with greenfield projects.
At the same time, the updated code strengthens fire and life safety requirements. Hospitals with patient care areas above 45 metres must include features such as progressive horizontal evacuation systems and refuge terraces on alternate floors. These terraces are designed to temporarily support critical patients during emergencies, including access to medical gases to ensure continuity of care.
While building regulations remain under the jurisdiction of state and local authorities, the new standards reflect a shift toward a more performance-based framework, offering greater flexibility while maintaining safety compliance.