Taiyuan, Sept 7, 2026 — The Shanxi Provincial Medical Security Bureau has issued a formal interpretation of its medical service pricing policy (Notice No. 9 of 2026), setting out detailed billing rules for public medical institutions across ten areas—from price-item design and “service output” definitions to surcharge stacking, pricing units and the separation of consumables from clinical services.
Policy Snapshot
| Attribute | Detail |
|---|---|
| Document | Interpretation of Price Policy for Medical Service Projects |
| Reference | Shanxi Medical Security Bureau Notice No. 9 of 2026 |
| Issuing body | Shanxi Provincial Medical Security Bureau |
| Date | Sept 7, 2026 (proactively disclosed) |
| Scope | Billing and price-item application across public medical institutions in Shanxi |
| Core principle | Price items anchored to “service output,” not to devices or consumables |
| Key reforms | Separation of technology and consumables (“技耗分离”); separation of drugs and consumables (“药耗分离”) |
Policy Context
The interpretation clarifies how hospitals should apply China’s new project-establishment guidelines for medical service prices. Under the framework, price items are created only where a distinct clinical service output exists: identical outputs from different techniques or pathways must map to a single item, complete procedures cannot be unbilled into steps, and no item may be established around a device or consumable—for instance, arrhythmia ablation is priced as one item regardless of whether radiofrequency, cryo, chemical or pulsed-field energy is used.
The document defines service output across four dimensions—core clinical outcomes, tangible auxiliary outputs such as test reports, patient-experience outputs, and auxiliary operations billed under an “A+B” (procedure plus add-on) model—and lays out anti-duplication rules with concrete examples: CT plain and enhanced scans may stack only when both are actually performed; ICU nursing fees already embed oral and perineal care; manual release cannot be billed alongside same-site traditional Chinese medicine tuina massage.
On pricing units, the bureau details per-session, per-site and progressive-base calculations—ambulance transport charges a base fare covering 4 kilometers plus 3 yuan per additional kilometer, while nerve-block anesthesia bills a two-hour base of 379 yuan plus 149 yuan per additional hour. Surcharge items within the same sequence cannot stack, though cross-sequence surcharges (for example, chief-physician and pediatric add-ons) may combine. The pediatric surcharge applies strictly through age six—until the day before a child’s seventh birthday—and “newborn” items are limited to the first 28 days of life.
Market Impact Analysis
The interpretation operationalizes one of the most consequential shifts in China’s healthcare payment system: the “separation of technology and consumables” principle, which purifies service prices to reflect clinical labor value while making consumable prices explicit and independently managed. By decoupling medical consumables from service items, the policy ends the legacy rule that “no service item, no consumable charge,” laying groundwork for a provincial medical insurance consumables catalog and extending drug-pricing tools—volume-based procurement and catalog management—to devices and disposables.
For hospitals, the document functions as a compliance manual: it resolves recurring billing ambiguities (whether examination fees may be layered onto consultation fees, how mapping items fold into price composition, when re-performed procedures may be billed again) that directly affect revenue integrity under medical insurance audits. The explicit anti-duplication and “basic material consumption” rules—where inclusive but non-analogical interpretation bars separate billing for items like soda lime while allowing distinct high-value devices such as pulse lavage systems—signal tighter scrutiny of unbundling practices.
Provincial-level guidance of this granularity is also a bellwether: as national project-establishment guidelines roll out across China, other provinces are expected to publish similar interpretations, making Shanxi’s framework a reference point for hospital billing systems, medical insurance enforcement and health-economics planning nationwide.
Forward-Looking Statement
Public medical institutions in Shanxi are expected to align billing systems, staff training and internal audit procedures with the interpretation immediately, as the document serves as the operational basis for price execution and insurance fund supervision. Market watchers will monitor whether the clarifications accelerate adoption of the standalone consumables pricing system and how the “service output” consolidation approach shapes future pricing of emerging technologies—including AI-assisted diagnostics and xenotransplantation, which the document already flags as non-separately-billable extensions of existing items. Similar interpretations from other provincial medical security bureaus are anticipated as the national pricing reform deepens toward mid-2027.-China Health Reform Pulse
Policy Source: https://ybj.shanxi.gov.cn/xxfb/xxgkml/202609/t20260907_10215759.html