Legal analysis: medical insurance treatment items are:
1, clinical diagnosis and treatment necessary, safe and effective, appropriate cost of treatment items;
2, by the designated medical institutions for the insured to provide the scope of the designated medical services of the diagnosis and treatment items;
3, by the pricing department has set the standard of the diagnosis and treatment items;
4, other diagnosis and treatment items Other medical treatment programs.
Legal basis: Article 28 of the Social Insurance Law of the People's Republic of China (PRC): Medical expenses that are in line with the basic medical insurance drug list, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency treatment and rescue, shall be paid out of the basic medical insurance fund in accordance with the state regulations.
Article 1 of the Circular on the Issuance of Opinions on the Management of Diagnostic and Treatment Items, Scope of Medical Service Facilities and Payment Standards of Basic Urban Workers' Medical Insurance
Basic medical insurance diagnostic and treatment items are diagnostic and therapeutic items that comply with the following conditions and are based on various kinds of medical technical labor items as well as on the use of medical instruments, equipments and materials for medical purposes:
(1) They are necessary for clinical diagnosis and treatment, (a) clinically necessary, safe, effective, and cost-appropriate diagnostic and treatment items;
(b) diagnostic and treatment items for which fees have been set by the price department;
(c) diagnostic and treatment items within the scope of the designated medical services provided by designated medical institutions for the insured.