CCTV News: According to the WeChat official account of the National Medical Insurance Administration, the National Medical Insurance Administration recently issued the "Guidelines for the Pricing of Oral Medical Services (Trial)" to integrate and standardize the price of oral medical service to help the healthy development of oral diagnosis and treatment.

Unified standardization of six types of price items

This time, the oral project approval guide is compiled, including six types of price items: oral comprehensiveness, orthodontics, restoration, dental pulp, oral surgery, and oral mucosa. In principle, projects are integrated and established according to different service outputs, and are not linked to specific technical details. They involve multiple surgeries. They can be combined according to clinical needs and charges are superimposed according to different surgeries.

For example, the "fixed restoration fee for restoration" was previously divided and established according to the diagnostic and treatment operation steps, and now the project was integrated according to the output of the provided diagnosis and treatment services, and the inspection, design, bonding, trial-fitting, blending, and reconstructing of the occlusal relationship were integrated into one; the project was previously established according to different restoration types, and now the crown, inlay, pile core root hat, pile crown repair, etc. are integrated into one. If there is a new repair technology, it can be directly compatible with the charges. At the same time, new technologies such as "oral respiration-free aspiration assisted treatment" will be added to the corresponding price items, and the fees will be charged according to regulations after the connection is implemented in various places.

Judging from the solicitation of opinions, medical institutions have a high degree of recognition of project standards. At the site of the last round of expert argumentation of the project price project guide for oral medical service prices, experts from Peking University Dental Hospital said, "For medical service charges, patients are afraid of too many patients, hospitals are afraid of leaks, and governments are afraid of chaos. This time, we have basically sorted out and balanced."

The boundaries for the charging of complex services are clearer

For example, the familiar "tooth extraction" was previously established based on different teeth such as baby teeth, anterior teeth, premolars, molars, wisdom teeth, etc., with one tooth position and one price. In fact, the difficulty of tooth extraction varies depending on the specific condition of the disease. For example, maxillary molars, if the root of the tooth penetrates into the maxillary sinus, it is very easy to have complications of oral maxillary sinus fistula.

For example, it is also a baby teeth, doctors generally report that it is difficult to remove the baby teeth in a solid body. For both impaired teeth, it is even more difficult to pull out medium and low-level impaired teeth, and the price "one-size-fits-all" cannot fully reflect the clinical value of complex situations. Therefore, the guide also sets complex additional price items for the extraction prices of the same tooth position according to technical difficulty and labor intensity. According to the professional consensus in the oral field, the application of complex prices will be clarified. Doctors and patients "have their work well and spend their money with confidence." Of course, due to the complex clinical diagnosis and treatment situations, it is difficult to distinguish between "routine" and "complex" situations one by one. Local governments still use the law of large numbers as the basic idea and cover various similar situations at a relatively appropriate price level.

Charge charges for personalized consumables return to the product attribute "on-price"

Medical institutions tailor their clothes to make personalized products such as oral appliances, retainers, and sports mouth guards for patients. The past habit was to subdivided into service charges according to the production steps, such as measurement fees, mold collection fees, design fees, cutting fees, processing fees, refining fees, debugging fees, etc. There are many names and poor consumption experience.

During the implementation of the special oral implant price special management activity in 2022, we took the lead in adjusting the charging method of dental crowns, from charging one by one according to the production steps to changing from "fixed price" according to the dental crown products. The cost of the medical institution producing or commissioning the processing of dental crowns by themselves is included in the "fixed price". What should be collected, what should be compensated, and the patient's payment is also refreshing and no longer dazzling. The guide expands the processing funds for crown prices to other personalized products in stomatology, and supports medical institutions to provide personalized services according to the individual needs of patients. After the policy adjustment, the environment for providing personalized products such as the price policy of medical institutions and third parties is more flexible and relaxed, especially to transform research results in the clinical practice of hospital doctors into new products to form benefits and become a new increment.

In addition, the oral project approval guide will provide tips for projects mainly based on cosmetic surgery, such as "dental bleaching fees", for reference when local medical insurance departments determine price management methods, support medical institutions to provide patients with diverse medical services, and medical institutions to obtain incremental income, meet patients' higher-level needs, and guide market prices to standardize.