渭南将面瘫、中风病等5个病纳入中医门诊医保支付范围
<section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); text-indent: 2em; line-height: 1.75em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(255, 0, 0); visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">从</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">12</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">月</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">20</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">日起</span></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">，我市将面瘫、中风病、腰痛</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">(</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">限气滞血瘀证</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">)</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">、颈椎病、肩周炎等</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">5</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">个中医病种纳入中医门诊医保支付范围，在我市</span></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(255, 0, 0); visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">具备开展中医适宜技术且具有相关资质的一级及以上定点医疗机构</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">(</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">含社区卫生服务中心、乡镇卫生院</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">)</span></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">门诊采取中医适宜技术治疗的</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(255, 0, 0); visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">我市参保</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">患者可以按比例报销。</span></span></section><p></p><section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); text-indent: 2em; line-height: 1.75em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">把中医病种纳入中医门诊医保支付工作是一项利民便民政策，是贯彻落实《中华人民共和国中医药法》和《陕西省中医药条例》“我为群众办实事”的具体举措。参加我市城乡居民基本医疗保险或职工基本医疗保险的人员持本人身份证件、社保卡或医保卡到定点医疗机构就诊，经确诊为中医门诊病种的，享受相关待遇。具体为，参加我市职工基本医疗保险的人员基本医疗保险负担 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">70%</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">，个人承担 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">30%;</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">参加我市城乡居民基本医疗保险的人员基本医疗保险负担</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">60%</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">，个人承担</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">40%</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">。不设起付线，设置年度医保最高支付限额，单次支付不超过年度最高限额的 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">50%</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">，超过限额部分由参保人承担。</span></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(255, 0, 0); visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">颈椎病、中风病、肩周炎、面瘫病、腰痛病</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">(</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">气滞血瘀症型</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">)</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">的年度支付限额依次为</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">2200</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">元、 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">2100 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">元、</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">1600</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">元、</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">1400 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">元、</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">560</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">元。中医门诊病种医保支付金额纳入年度统筹基金支付限额。</span></span></span></section><section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); text-indent: 2em; line-height: 1.75em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">中医门诊病种患者在定点医疗机构发生的诊疗费用实行即时结算，定点医疗机构垫付的费用由医保经办机构与定点医疗机构进行结算。</span></section><p></p><p>来源：渭南医保局</p><link rel="stylesheet" href="//www.dafuping.cn/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_SkQ" id="wcn_editor_css"/>
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