The Ministry of Health proposes that health insurance cover radiological imaging techniques regardless of the imaging time.

The Ministry of Health requests the Ministry of Finance to pay attention and direct the Social Insurance agency to conduct assessment and payment in accordance with the law, especially not to use the time parameter in the technical procedure guidelines for the Radiology chapter.

The Ministry of Health has sent a document to the Ministry of Finance providing guidance on the application of the professional document "Guidelines for Technical Procedures on Diagnostic Imaging and Interventional Radiology" under the Radiology chapter.

According to a document signed by Deputy Minister of Health Tran Van Thuan, issued on August 29, 2025, the Ministry of Health issued Decision No. 2775/QD-BYT on the promulgation of the professional document "Guidelines for technical procedures on diagnostic imaging under the chapter on Radiology - Volume 1" (including 322 technical procedures);

Decision No. 2776/QD-BYT on the promulgation of the professional document "Guidelines for technical procedures on interventional radiology under the chapter on Radiology – Volume 1" (including 233 technical procedures).

The aforementioned documents were developed to standardize professional practices, improve the quality of healthcare services, and ensure patient safety in the fields of diagnostic imaging and interventional radiology.

The Ministry of Health requests the Ministry of Finance to pay attention and direct the Social Insurance agency to conduct assessment and payment in accordance with the law, especially not to use the time parameter in the technical procedure guidelines for the Radiology chapter to assess and pay for health insurance medical examination and treatment costs...

During the implementation process, the Ministry of Health received feedback from some localities and medical examination and treatment facilities regarding the use by social insurance agencies of the time stipulated in the guidance documents accompanying Decision No. 2775/QD-BYT and 2776/QD-BYT as a basis for refusing payment of health insurance medical examination and treatment costs, in cases where the time taken does not meet the time requirements specified in the procedures (for example: X-ray less than 6 minutes, echocardiogram less than 30 minutes according to some specific procedures).

To ensure consistent implementation, compliance with the law, alignment with professional practices, and protection of the legitimate rights of health insurance participants and healthcare facilities, the Ministry of Health offers the following opinion:

Regarding the meaning and interpretation of time parameters in technical procedure guidelines, according to the Ministry of Health, the time parameters stipulated in the technical procedure guidelines issued with Decision No. 2775/QD-BYT and 2776/QD-BYT are reference average times, built on the basis of common professional practices at medical examination and treatment facilities, aiming to standardize technical practices, ensure patient safety and professional quality.

The time parameters mentioned above are for professional guidance purposes only and are not intended to establish mandatory legal conditions or rigid quantitative criteria as the sole basis for assessing and paying for health insurance medical examination and treatment costs.

The time recorded on technical systems such as PACS, DICOM files, or equipment logs only reflects a part of the technical process, mainly the equipment operating time (time for radiation emission, scanning, or direct ultrasound), and does not fully reflect the entire time spent performing the technical procedure (confirming the correct patient, instructing on posture, taking a medical history, comparing with existing results, explaining, advising, reading and interpreting results... and transferring results to the system).

Using the time parameters recorded from the device in isolation for comparison with the time parameters in the technical procedure guidelines and as a basis for refusing payment of medical examination and treatment costs under health insurance is not in accordance with the technical procedure.

The actual time required for technical services can vary depending on the patient's clinical condition, specific professional requirements, personnel qualifications, facilities, and the level of automation of equipment at each medical facility.

Regarding the principles for assessing and paying health insurance costs for medical examinations and treatments under the Radiology program, the Ministry of Health stated that the assessment and payment of health insurance costs for these technical services are not based on the time parameters stipulated in the technical procedure guidelines issued with Decision No. 2775/QD-BYT and 2776/QD-BYT.

The assessment and payment process is based on a comprehensive evaluation of the patient's medical records and the actual provision of services, taking into account: the appropriateness of the technical service indication to the patient's clinical condition; compliance with the main professional steps of the technical procedure; the usability and clinical significance of the technical results in diagnosis and treatment; and the actual conditions regarding human resources, equipment, and organizational implementation at the medical examination and treatment facility as prescribed by law.

Currently, the payment and settlement of certain technical services such as: conventional X-ray, digital X-ray, CT scanner up to 32 slices, ultrasound, magnetic resonance imaging (MRI), between the social insurance agency and medical examination and treatment facilities are regulated in Clause 6, Article 4d of Circular No. 35/2016/TT-BYT dated September 28, 2016, issued by the Minister of Health, promulgating the List and rates and conditions for payment of medical technical services within the scope of benefits for health insurance participants, as amended and supplemented by Circular No. 50/2017/TT-BYT dated December 29, 2017, Circular No. 13/2020/TT-BYT and Circular No. 39/2024/TT-BYT dated November 17, 2024, of the Minister of Health.

In cases where unusually high increases or abuse of technical services are detected, the social insurance agency will coordinate with medical examination and treatment facilities and local state management agencies in the field of health to conduct inspections and verifications in accordance with their authority and legal procedures.

The Ministry of Health requests the Ministry of Finance to pay attention to and direct the Social Insurance agency to conduct assessment and payment in accordance with the law, especially not using the time parameter in the technical procedure guidelines for the Radiology chapter to assess and pay for medical examination and treatment costs under health insurance, ensuring the rights of medical examination and treatment facilities and the rights of health insurance participants.

During the implementation process, if any difficulties or obstacles arise, please report them in writing to the Ministry of Health for consideration and resolution .

Source: https://suckhoedoisong.vn/bo-y-te-de-nghi-thanh-toan-bhyt-ky-thuat-dien-quang-khong-phu-thuoc-vao-thoi-gian-chup-chieu-169260211102238561.htm