1, services: registration fees, out-of-hospital consultation fees, medical records, such as the cost of books; clinic fees, checking and treatment of expedited fees, surcharges on the operation of the name, high quality and premium fees, special nurses, such as the special needs of the medical services. The medical service fee for the special needs of the patients is the same as that of the medical service fee.
2, non-disease treatment programs: a variety of beauty, fitness programs and non-functional plastic surgery, orthopedic surgery, etc.; a variety of weight loss, weight gain, height projects; a variety of health checkups; a variety of preventive, health care diagnostic and treatment programs; a variety of medical consulting, medical appraisal.
3, diagnostic and therapeutic equipment and medical materials: the application of positron emission tomography (PET), electron-beam CT, ophthalmic excimer laser therapy and other large-scale medical equipment for the examination and treatment programs. Provincial price department regulations can not be charged separately for disposable medical materials.
4, medical project category: all kinds of organ or tissue transplantation of organ or tissue source; in addition to kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation of other organs or tissues; myopic orthopedics; qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other auxiliary treatment projects.
5. Others: all kinds of infertility (pregnancy), sexual dysfunction diagnosis and treatment programs; all kinds of scientific research, clinical verification of diagnosis and treatment programs. In addition, the basic medical insurance does not pay for the following expenses: transportation fees for consultation (referral), emergency ambulance; air-conditioning, television, telephone, baby warming box, electric stove, refrigerator, and compensation for damage to public property; escort fee, nurse fee, cleaning fee, outpatient decoction fee, meal fee; recreational activities and other special needs of the cost of living activities.
The installation of pacemakers falls into the first of two categories paid for by basic medical insurance.
The two categories paid by the basic medical insurance are:
The first category: the application of X-ray computerized tomography (CT), stereotactic radiography (gamma knife, X-knife), cardiac and angiography X-ray machine (including subtraction equipment), nuclear magnetic **** vibration imaging device (MRI), single-photon emission computer scanning device (SPECT), color Doppler, medical linear accelerator and so on. Examination and treatment programs performed by large-scale medical equipment such as nuclear magnetic*** vibration imaging device (MRI), single-photon emission computerized scanning device (SPECT), color Doppler, medical linear gas pedal, etc. Extracorporeal shock wave lithotripsy and hyperbaric oxygen therapy. Artificial organs and materials for in vivo replacement such as pacemakers, artificial joints, artificial crystals and vascular stents. Provincial price departments to provide a separate charge for disposable medical materials.
The second category: hemodialysis, peritoneal dialysis; kidney, heart, valves, cornea, skin, blood vessels, bone, bone marrow transplantation; cardiac laser perforation, anti-tumor cellular immunotherapy and fast neutron therapy projects. In addition, the cost of inpatient beds and outpatient (emergency) observation beds, and the cost of expensive medical instruments and equipment for examination, treatment and medical materials as stipulated by the labor security departments of the provinces can also be partially paid for by the medical insurance.
Specific regulations are set out in the "Notice on the Issuance of "Answers to Relevant Issues of Beijing Municipal Basic Medical Insurance (VII)" issued by the Municipal Bureau of Labor and Social Security -
which stipulates that pacemakers are paid for as artificial organs and should be reimbursed in accordance with the relevant provisions of the Beijing Municipal Basic Medical Insurance Regulations. reimbursement.
Beijing Medical Insurance Zi [2000] No. 18 of the Beijing Municipal Bureau of Labor and Social Security
On the issuance of the "Beijing Municipal Basic Medical Insurance
Medical Expense Payment Scope and Standards" notice attached to the
"Beijing Municipal Basic Medical Insurance Medical Expense Payment Scope and Standards" Article 3 (Basic Medical Insurance Diagnostic and Therapeutic Items), that is, there is a clear provision that
Artificial organs installed in the body are subject to the following maximum reimbursement standards:
(1) Cardiac pacemakers: 14,000 yuan per set for single-chamber ones, 18,000 yuan per set for double-chamber ones, and 6,000 yuan per set for temporary pacemakers.
(2) heart valves: 7,000 yuan per set for biological membranes and 8,000 yuan per set for mechanical membranes;
(3) artificial crystals at 668 yuan each;
(4) artificial joints: 4,500 yuan per set for artificial hip joints, 5,000 yuan per set for artificial knee joints, and 3,300 yuan per set for artificial bone and femur heads;
(5) the maximum cost of placing other artificial organs in the body is 18,000 yuan. The maximum cost standard for the placement of other internal artificial organs is 18,000 yuan.
Specific policies and regulations can be found at the following link:
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