Instructions for implementing technical and testing service prices according to Circular 21/2023/TT-BYT in Vietnam

Instructions for implementing technical and testing service prices according to Circular 21/2023/TT-BYT in Vietnam (Internet image) 

Regarding this issue, LawNet would like to answer as follows:

On November 17, 2023, the Minister of Health issued Circular 21/2023/TT-BYT on the price framework for medical examination and treatment services in state medical examination and treatment establishments and guided the application of prices and payment of medical examination and treatment costs in some cases.

Instructions for implementing technical and testing service prices according to Circular 21/2023/TT-BYT in Vietnam

Specifically, Article 7 of Circular 21/2023/TT-BYT provides guidance on the implementation of technical and testing service prices as follows:

(1) Technical services are applied in the following order:

- For specific technical services whose prices have been regulated in the appendix issued with Circular 21/2023/TT-BYT, apply according to the prescribed price;

- Technical services whose prices have not been regulated in the appendix issued with Circular 21/2023/TT-BYT but have been classified as equivalent in terms of technique and implementation costs: applied according to the price of the service ranked equivalent in terms of technique and implementation cost by the Ministry of Health.

- In case there is overlap between different specialties, the price of the technical service performed in that specialty will apply to the technical service performed in that specialty.

(2) For technical services that have been authorized by competent authorities (Ministries and central agencies for centrally managed units, the Department of Health for locally managed units), approve the list of technical services (except for care services included in the cost of a treatment bed day and services that are part of a step that is included in the cost of another service), but the price has not yet been specified;

Technical services have been prescribed to be performed, but due to disease progression or the patient's physical condition, the specified technique cannot continue to be performed: Payment is made according to the actual quantity of drugs and supplies used for patients and the purchase price according to the provisions of the law.

(3) In case multiple interventions are performed in the same surgery: Payment is made according to the price of the most complex surgery with the highest price. Other technical services arising outside the technical procedure of the surgery mentioned above are paid as follows:

- Equal to 50% of the price of additional surgeries if that technique is still performed by a surgical team;

- Equal to 80% of the cost of the surgery incurred if that technique requires another surgical team to perform;

- In case the service is performed as a procedure, 80% of the price of the service will be paid.

(4) For the service "Changing wound dressings or surgical incisions ≤ 15 cm long":

- Payment for patients receiving inpatient treatment in the following cases: infected wounds or surgical incisions; Wounds are seeped with fluid and blood in skin peeling and open lesions with an area of over 6 cm2; The wound has been covered with gauze; Drainage tube wound drains a lot; multiple wounds or incisions; or after 1 surgery, two or more incisions must be performed;

- Does not apply to dressing changes in the following cases: laparoscopic surgery, wound dressing changes, common wounds, and newborn umbilical dressing changes.

(5) The service "Changing surgical wound dressings with a length of over 15 cm to 30 cm" in inpatient treatment only applies to the following cases:

- Infected surgical wound, gastrointestinal leak, bile leak, urine leak;

- Surgical wound infection after surgery (abdominal peritonitis, osteomyelitis, or abscess); surgical wound after surgery of the digestive tract, urinary system, biliary tract, or abdominal ascites;

- Incision after a surgery, but two or more abutments must be made;

- In case of cesarean section surgery: this price applies, but not more than 3 times.

(6) For immunocompatibility testing at 37°C and using antiglobulin serum (indirect Coombs test) in blood transfusion: payment according to the price of the service "Compatibility reaction using anti-human globulin" with serial number 1340 or 1341 specified in Appendix III issued with Circular 21/2023/TT-BYT.

(7) Technical services specializing in pediatrics but performed for adults or technical services performed for pediatric patients but having the same name as adults but without specific price regulations: Technical service prices are applied according to the list in Circular 21/2023/TT-BYT and equivalent decisions on techniques and implementation costs.

Technical services are only available at the pediatric department but are performed for patients over 16 years old: the same technical service price as the price prescribed at the pediatric department applies.

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