According to the relevant provisions of the Notice on Including Some Medical Rehabilitation Projects in the Scope of Basic Medical Security, Zhejiang Province has included 25 medical rehabilitation projects, including comprehensive training of hemiplegic limbs, in the scope of basic medical security, and from 20 1 1 year 1 month, they have been included in the basic medical insurance for urban workers, the basic medical insurance for urban residents and the new rural cooperative medical system respectively.
Not only some rehabilitation projects are included in the scope of medical insurance, but also the scope of payment is limited. Taking the comprehensive training of hemiplegic limbs as an example, although it is included in the scope of medical insurance, the comprehensive training of hemiplegic limbs mainly pays no more than 3 months 1 disease process. With exercise therapy, only 1 item is required.
Some are still limited to children, such as comprehensive physical training for cerebral palsy, which is limited to children. Especially before the age of 3, the annual payment does not exceed 6 months; After the age of 3, the annual payment shall not exceed 3 months. The total payment period is no more than 5 years, and only 1 item is paid when it is used together with exercise therapy. In other words, this kind of disease can only be reimbursed to children before the age of 3.
Extended data:
Taking Zhejiang Province as an example, Zhejiang has included 13 medical rehabilitation items such as unarmed balance function examination into the payment scope of basic medical insurance, and adjusted the limited payment scope of 9 medical rehabilitation items such as speech ability assessment (general aphasia examination) paid by basic medical insurance.
The notice also stipulates that the payment for rehabilitation treatment of a disease process should not exceed 90 days in principle (the rehabilitation treatment of mental disorders should not exceed 90 days per year, and cerebral palsy should be implemented according to the limited payment provisions of this project). For patients who have exceeded the prescribed payment period, the payment period may be appropriately extended after evaluation by medical institutions with rehabilitation medical diagnosis and treatment qualifications and approval by medical insurance agencies.
The extension of the payment period shall not exceed 3 months in principle (cerebral palsy shall be paid according to the prescribed payment period).
Zhejiang government affairs service network-on the inclusion of some medical rehabilitation projects in the scope of basic medical security