Tertiary designated medical institutions are reimbursed at a rate of 35% for the portion of less than 5,000 yuan, 40% for the portion of 5,000 yuan to 10,000 yuan, and 45% for the portion of more than 10,000 yuan.
The first-level designated medical institutions include town and street health centers and district-level specialized medical institutions, the second-level designated medical institutions include district-level general hospitals and municipal-level specialized medical institutions, and the third-level designated medical institutions include municipal-level and above-municipal general hospitals and above-municipal specialized medical institutions.
Legal basis:
The Social Insurance Law of the People's Republic of China
Article 29: The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administrative department and the medical institutions and pharmaceutical business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.
Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be carried out in accordance with state regulations.