I. Diagnostic and Treatment Items for which Basic Medical Insurance does not pay the fees Fan Zhou
(I) Service Item Category
1. Registration fee, out-of-hospital consultation fee, and cost of medical records.
2. Visiting fee, examination and treatment expediting fee, surcharge for named surgery, quality and premium fee, self-invited special nurse and other special medical services.
(2) non-disease metallurgical project category
1. A variety of beauty, fitness programs and non-functional cosmetic, orthopedic surgery.
2. All kinds of weight loss, weight gain, height increase programs.
3. All kinds of health checkups.
4. A variety of preventive and health care rash therapy programs.
5. All kinds of medical consultation and medical appraisal.
(C) diagnostic and therapeutic equipment and medical materials
1. The application of electron emission tomography (PET), electron beam CT, ophthalmic excimer laser therapy instrument and other large-scale medical equipment for examination and treatment programs.
2. Eyeglasses, dentures, eye prostheses, prosthetics, hearing aids and other rehabilitative devices.
3. A variety of self-use health care, massage, inspection and treatment equipment.
4. Provincial price departments can not be charged separately for disposable medical materials.
(D) treatment project category
1. Organ or tissue transplantation of all types of organ or tissue source.
2. In addition to kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation, other organs or tissue transplantation.
3. Orthopedic surgery for myopia.
4. Qigong therapy, music therapy, health care nutritional therapy, magnetic therapy and other complementary therapeutic programs.
(E) other
1. A variety of infertility (pregnancy), sexual dysfunction diagnosis and treatment programs.
2. A variety of scientific research, clinical verification of the treatment program.
Second, the basic medical insurance to pay part of the cost of the scope of treatment projects
(a) diagnostic equipment and medical materials
1. Application of X-ray computed tomography (CT), stereotactic radiography (Y knife, X knife), cardiac and angiographic X-ray machine (including digital subtraction equipment), magnetic *** vibration imaging device (MRI), single-photon emission computed computerized radiography (Y knife, X knife), cardiac and angiography X-ray machine (including digital subtraction equipment), magnetic resonance imaging (MRI) , single photon emission computer scanning device (SPECT), color Doppler, medical linear gas pedal and other large medical equipment for examination, treatment projects.
2. Extracorporeal shock wave lithotripsy and hyperbaric oxygen therapy.
3. Pacemakers, artificial joints, artificial crystals, vascular stents and other artificial organs replaced in the body, the body placed in the material.
4. Provincial price departments can be charged separately for disposable medical materials.
(B) treatment program category
1. Hemodialysis, peritoneal dialysis.
2. Kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation.
3. Cardiac laser perforation, anti-tumor cellular immunotherapy and fast neutron therapy programs.
(C) the provincial labor security departments to provide expensive medical instruments and equipment for inspection, treatment projects and medical materials.
Scope of life service items and service facilities not paid by the national basic medical insurance
I. The medical service facilities of basic medical insurance refer to the life service facilities provided by the designated medical institutions, which are necessary for the insured persons in the process of receiving diagnosis, treatment and care.
Second, the cost of basic medical insurance medical service facilities mainly includes inpatient beds and outpatient (emergency) beds. The basic medical insurance fund will not pay for the daily necessities, hospital transportation supplies, water and electricity, etc., which are already included in the inpatient bed charge or outpatient (emergency) observation bed charge, and the designated medical institutions will not charge the insured persons separately.
Third, the basic medical insurance fund does not pay the cost of living services and service facilities, mainly including:
(a) consultation (referral) transportation fees, emergency vehicle fees;
(b) air-conditioning fees, television fees, telephone fees, baby warming box fees, food warming box fees, electric stoves, refrigerators, and damages to public property indemnity fee;
(c) escorting (c) escort fee, caregiver fee, cleaning fee, outpatient decoction fee;
(d) meal fee;
(e) recreational activities and other special needs living service costs.
Whether other medical service facility items are included in the scope of payment of the basic medical insurance fund shall be stipulated by the labor security administrative departments of the provinces (autonomous regions and municipalities directly under the central government, hereinafter the same).
Fourth, the basic medical insurance inpatient bed fee payment standard, by the labor security administrative departments of the integrated regions in accordance with the provincial price department of the general inpatient ward bed fee standards. The standard of payment for hospital beds for patients in isolation and in critical condition shall be determined by the co-ordinating regions according to the actual situation.
The basic medical insurance outpatient (emergency) hospital bed fee payment standard is determined in accordance with the price department of the province's charges, but shall not exceed the basic medical insurance hospitalization bed fee payment standard.
Fifth, the fixed-point medical institutions to publicize the bed charges and basic medical insurance bed fee payment standards, in the arrangement of wards or outpatient (emergency) clinic beds, should be arranged to inform the participants or their families of the bed charges. The insured person may independently choose different grades of ward or outpatient (emergency) observation beds according to the recommendations of the designated medical institution. When the designated medical institution has to arrange the insured person to be in a ward that exceeds the standard due to the shortage of beds or other reasons, it shall first obtain the consent of the insured person or his/her family members.
VI. If the actual bed fee of the insured person is lower than the standard of payment for inpatient bed fee of basic medical insurance, the actual bed fee shall be paid according to the provisions of basic medical insurance; if the actual bed fee is higher than the standard of payment for inpatient bed fee of basic medical insurance, the fee within the payment standard shall be paid according to the provisions of basic medical insurance, and the part exceeding the standard shall be paid by the insured person himself/herself.