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MINISTRY OF
HEALTH
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SOCIALIST
REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
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No: 24/2025/TT-BYT
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Hanoi, June 30,
2025
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CIRCULAR
AMENDMENTS
TO CERTAIN ARTICLES OF CIRCULAR NO. 04/2017/TT-BYT DATED APRIL 14, 2017 PROMULGATING
THE SCHEDULE, RATES AND CONDITIONS OF REIMBURSEMENT OF COSTS OF MEDICAL
SUPPLIES COVERED UNDER HEALTH INSURANCE SCHEME
Pursuant to the Law on Health Insurance 2008, as
amended in 2014 and 2024;
Pursuant to Government's Decree No.
146/2018/ND-CP dated October 17, 2018 elaborating and providing guidance on
measures to implement certain Articles of the Law on Health Insurance, as
amended by Government’s Decree No. 75/2023/ND-CP dated October 19, 2023;
Pursuant to Government’s Decree No. 42/2025/ND-CP
dated February 27, 2025 defining the functions, tasks, powers and
organizational structure of the Ministry of Health of Vietnam;
At the request of the Director of the Health
Insurance Department, Ministry of Health;
The Minister of Health hereby issues the
Circular on amendments to certain articles of Circular No. 04/2017/TT-BYT dated
April 14, 2017 promulgating the schedule, rates and conditions of reimbursement
of costs of medical supplies covered under health insurance scheme.
Article 1. Amendments to
certain articles of Circular No. 04/2017/TT-BYT dated April 14, 2017
promulgating the schedule, rates and conditions of reimbursement of costs of
medical supplies covered under health insurance scheme
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“Article 1. List of medical equipment covered
under health insurance scheme
The list of medical equipment covered under health
insurance scheme is specified in Appendix 01 issued with this Circular
and serves as the basis for the reimbursement of health insurance-covered
medical equipment costs from the health insurance fund in accordance with laws
on health insurance.”.
2. Clause 3 Article 2 is amended as follows:
“3. In the case where a private health facility does
not apply bidding laws to purchase medical equipment, such health facility
shall make a list of medical equipment exempt from the costs of medical
services, medical examination services, and hospital stay using Form No. 03
issued with this Circular and submit it to social insurance authorities.”.
3. Points b and Clause 2 Article 3 are amended as
follows:
a) Point b is amended as follows:
“b) The amount of reimbursement of total cost
of medical equipment in each use of medical service shall not exceed 45
months’ statutory pay rate.
This regulation shall not apply to medical
equipment for which rates of reimbursement are prescribed in the 5th column
of the Appendix 01 attached hereto:
Example 1: The amount of reimbursement of total
cost of medical equipment for a single use of medical services when the statutory pay rate is VND 2.340.000
shall be calculated as follows:
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- If the patient is a health insurance participant
entitled to 95% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is under 5 years: the
amount of reimbursement of total cost of medical equipment for a single use of
medical services by the patient shall be determined as 45 x 95% x 2.340.000 =
VND 100.035.000;
- If the patient is a health insurance participant
entitled to 95% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is more than 5 years:
+ In cases where the patient has not yet paid the
co-payment for medical care costs within a year till the date of use of medical
services: the amount of reimbursement of total cost of medical equipment for a
single use of medical services by the patient shall be determined as 45 x 95% x
2.340.000 = VND 100.035.000;
+ In cases where the patient has paid the
co-payment for medical care costs up incurred within a year till the date of
use of medical services of which the amount has reached the equivalent of 6
months' statutory pay rate: the amount of reimbursement of total cost of
medical equipment for a single use of medical services by the patient shall be
determined as 45 months’ statutory pay rate = VND 105.300.000;
- If the patient is a health insurance participant
entitled to 80% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is more than 5 years: the
amount of reimbursement of total cost of medical equipment for a single use of
medical services by the patient shall be determined as 45 x 80% x 2.340.000 =
VND 84.240.000;
- If the patient is a health insurance participant
entitled to 80% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is more than 5 years:
+ In cases where the patient has not yet paid the
co-payment for medical care costs within a year till the date of use of medical
services: the amount of reimbursement of total cost of medical equipment for a
single use of medical services by the patient shall be determined as (45 x 80%
x 2.340.000) + (45 x 20% - 6) x 2.340.000 = VND 91.260.000;
+ In cases where the patient has paid the
co-payment for medical care costs up incurred within a year till the date of
use of medical services of which the amount has reached the equivalent of 6
months' statutory pay rate: the amount of reimbursement of total cost of
medical equipment for a single use of medical services by the patient shall be
determined as 45 months’ statutory pay rate = VND 105.300.000.
Example 2: (In cases where the total cost of medical
equipment exceeds 45 month’s statutory pay rate): When the statutory pay rate
is VND 2.340.000, the patient is provided with 01 medical device A and 02
medical devices B in a single use of medical services. If the purchase
price of item A is VND 72,000,000, with the health insurance-covered cost
specified in the 5th column of Appendix 01 attached hereto is
VND 70.000.000; the purchase price of item B is VND 20.000.000, without any
health insurance-covered cost specified in the 5th column of
Appendix 01 attached hereto;
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Example 3: (In cases where the total cost of
medical equipment is less than 45 month’s statutory pay rate): The patient is
provided with 01 medical device A, 02 medical devices B and 03 medical devices
C in a single use of medical services.
If the purchase price of item A is VND 72,000,000,
with the health insurance-covered cost specified in the 5th column of
Appendix 01 attached hereto is VND 70.000.000; the purchase price of item B is
VND 10.000.000, without any health insurance-covered cost specified in the
5th column of Appendix 01 attached hereto; the purchase price of item C is
VND 4.000.000, without any health insurance-covered cost specified in the
5th column of Appendix 01 attached hereto;
the total cost of medical equipment for the patient
(where medical device A is calculated based on the specified health
insurance-covered cost specified in the 5th column of Appendix 01 attached
hereto, and medical device B is calculated based on the purchase price) for a
single use shall be determined as 70.000.000 x 1 + 10.000.000 x 2 + 4.000.000 x
3 = VND 102.000.000. As this cost is less than 45 months' statutory pay
rate (VND 105.300.000), the health insurance fund shall pay the total cost of
medical equipment for the patient as follows:
- If the patient is a health insurance participant
entitled to 100% coverage for of the medical care cost: the amount of reimbursement
of total cost of medical equipment for a single use of medical services by the
patient shall be determined as 102.000.000 x 100% = VND 102.000.000;
- If the patient is a health insurance participant
entitled to 95% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is more than 5 years: the
amount of reimbursement of total cost of medical equipment for a single use of
medical services by the patient shall be determined as 102.000.000 x 95% = VND
96.900.000;
- If the patient is a health insurance participant
entitled to 95% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is at least 5 years:
+ In cases where the patient has not yet paid the
co-payment for medical care costs within a year till the date of use of medical
services: the amount of reimbursement of total cost of medical equipment for a
single use of medical services by the patient shall be determined as
102.000.000 x 95% = VND 96.900.000;
+ In cases where the patient has paid the
co-payment for medical care costs up incurred within a year till the date of
use of medical services of which the amount has reached the equivalent of 6
months' statutory pay rate: the amount of reimbursement of total cost of
medical equipment for a single use of medical services by the patient shall be
determined as VND 102.000.000;
- If the patient is a health insurance participant
entitled to 80% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is more than 5 years: the
amount of reimbursement of total cost of medical equipment for a single use of
medical services by the patient shall be determined as 102.000.000 x 80% = VND
81.600.000;
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+ In cases where the patient has not yet paid the
co-payment for medical care costs within a year till the date of use of medical
services: the amount of reimbursement of total cost of medical equipment for a
single use of medical services by the patient shall be determined as
(102.000.000 x 80%) + (102.000.000 x 20% - 6 x 2.340.000) = VND 87.960.000;
+ In cases where the patient has paid the
co-payment for medical care costs up incurred within a year till the date of
use of medical services of which the amount has reached the equivalent of 6
months' statutory pay rate: the amount of reimbursement of total cost of
medical equipment for a single use of medical services by the patient shall be
determined as VND 102.000.000;
b) Point c is amended as follows:
“c) For medical service of drug-eluting stent
placement in the coronary artery that require the use of more than one stent,
the total cost of medical equipment includes the first stent and other medical
equipment for a single use of medical services (according to reimbursement
guidelines in point b Clause 2 of this Article), half (1/2) of the cost for the
second stent based on the purchase price of the health facility which does not
exceed VND 18.000.000, and one-third (1/3) of the cost for the third and fourth
stents based on the purchase price of the health facility which does not exceed
VND 12.000.000 for each stent.
Example: Drug-eluting stent A was purchased by a
health facility at the price of VND 40.000.000; the amount of reimbursement of
cost of a drug-eluting stent specified in the 5th column of
Appendix I attached hereto is VND 36.000.000. The patient was admitted to this
healthcare facility to be provided with the medical service of placing 05
drug-eluting stents A. The cost of other medical equipment excluding the
stents, which has not been included in the cost of medical service, medical
care service, hospital stay per day or episode of care (hereinafter referred to
as “other medical equipment”) is VND 50.000.000. The amount of reimbursement
for these other medical equipment costs are not specified in the 5th column
of Appendix I attached hereto.
- If the patient is a health insurance participant
entitled to 100% coverage for the medical care costs, the reimbursement for the
total cost of medical equipment for a single use of medical services by the
patient shall be determined as VND 105.300.000 according to Example 1 in point
b Clause 2 Article 3 hereof. The total cost of 01 drug-eluting stent A
calculated based on the amount of reimbursement specified in the 5th column
of Appendix I attached hereto and other medical equipment is 36.000.000 +
50.000.000 = VND 86.000.000; which is less than VND 105.300.000. The health
insurance fund shall reimburse the patient: (i) VND 86.000.000 for the first
stent and other medical supplies; (ii) VND 18.000.000 for the second stent;
(iii) VND 12.000.000 per stent for the third and fourth stents; (iv) and the
fifth stent shall not be reimbursed.
Therefore, the health insurance fund shall pay the
total cost of medical equipment for a single use of medical services by the
patient as: 86.000.000 + 1 x (1/2 x 36.000.000) + 2 x (1/3 x
36.000.000) = VND 128.000.000
- If the patient is a health insurance participant
entitled to 80% coverage for the medical care costs whose accumulated
consecutive period of health insurance participation is more than 5 years, the
reimbursement for the total cost of medical equipment for a single use of
medical services by the patient shall be determined as VND 84.240.000 according
to Example 1 in point b of this Clause. The total cost of 01 drug-eluting stent
A calculated based on the amount of reimbursement specified in the
5th column of Appendix I attached hereto and other medical equipment is
36.000.000 + 50.000.000 = VND 86.000.000; which is higher than VND 84.240.000.
Therefore, the health insurance fund shall
reimburse the total cost of medical equipment for a single use of
medical services by the patient as: 84.240.000 + 1 x (1/2 x 36.000.000) + 2 x
(1/3 x 36.000.000) = VND 126.240.000
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“4. In respect of medical equipment of which the
measurement unit is “set”, the health insurance fund shall make its
reimbursement as follows:
a) If all components of the “set” are entirely
used: full payment for the whole set shall be made;
b) If one or several components of the “set” are
used, the full payment for the whole set shall be made in the event that the
rest of components of the "set” is unusable. Health facilities shall take
an inventory of unusable components and notify this in writing to health insurance
authorities;
c) If one or several components of the “set” are
used and the rest of components of the "set” is usable, the reimbursement
for each used component at its predetermined price shall be made.”.
5. Some Clauses of Article 6 are amended as
follows:
a) Clause 1 is amended as follows:
“1. The Heath Insurance Department - Ministry of
Health shall:
a) Organize and supervise the implementation of
this Circular nationwide;
b) Lead and cooperate with relevant agencies to
address any issues arising during the implementation process; update the to
propose amendments to the list of medical equipment in Appendix 01 issued with
this Circular.”.
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“c) Promptly provide complete data and documents
related to the reimbursement of health insurance for medical costs to the
Ministry of Finance to develop and update the list of medical equipment.”;
c) Point c is added after point b Clause 3 as
follows:
“c) Direct health facilities in the area to
establish a list of medical equipment used at the facility in accordance with
this Circular and implementing solutions to ensure the timely and adequate
supply of medical equipment to ensure quality, meet treatment needs, and ensure
the rights of health insurance participants;”
d) Clause 6 is added after Clause 5 as
follows:
“6. Based on the actual operational needs, health
facilities, centralized procurement units, and price negotiation units shall
formulate the contractor selection plan and conduct bidding for procurement of
medical equipment as a set or components of a set to align with the usage at
the facility, avoiding wastage.”
6. Amendments to the list of medical equipment
covered under health insurance scheme specified in Appendix 01 issued
with Circular No. 04/2017/TT-BYT as follows:
a) Medical equipment No. 31, 153, 183, 195, 228,
279, 304, and 330 are amended as follows:
No.
Item code
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Unit of
Measurement
Note
(1)
(2)
(3)
(4)
(5)
31
N02.04.050
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Pad/bar/kit/ tube
153
N06.03.010
Artificial intraocular lens of various types
Piece
Reimbursement amount: VND 3,000,000 /1
intraocular lens
183
N07.01.090
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- Rotawire;
- Lubricant
rotaglide;
- Rotalink
burr;
- Rotalink rotablator advancer.
Set
195
N07.01.210
Extracorporeal membrane oxygenation (ECMO) of
various types and sizes
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N07.01.211
ECMO used in cardiac surgery (including:
- Breathing systems (including: reservoir,
air/gas mixing system, and heat exchanger);
- Circuit and air trapping component;
- Filter;
- Cannula connecting to blood vessels (arteries,
veins);
- Connectors, three-way connectors to the tubing)
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N07.01.212
ECMO used in emergency resuscitation, including:
- Breathing systems (including air/gas mixing
system, and heat exchanger);
- Circuit;
- Arterial cannula, venous cannula;
- Cannula connection to blood vessels (arteries,
veins);
- Reservoir;
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- Filter;
- Flow sensor.
Set
228
N07.02.050
Filters and conducting systems in continuous
molecular absorption technique
Set
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N07.06.030
Cement dispensers, including
- Needles
- Cement, mixing set, pressure pumps
- Balloon, balloon pumps
Set
Reimbursement amount: VND 40.000.000
304
N08.00.150
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Set, Piece
330
N08.00.460
Y-90 radioactive microspheres (with radiation
protection box, dose divider, standard dose tubes, conducting wires,
specialized radioactive microsphere injection pump needle)
Set
Reimbursement at a rate of 40% in cases of
non-metastatic primary liver cancer or non-metastatic secondary liver cancer
that is inoperable.
b) The following medical equipment is added:
No.
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Item name
Unit of
Measurement
Note
88a
N04.01.031
Hi_low EVAC
Piece
Reimbursement in case the patient requires
mechanical ventilation for over 48 hours
97a
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Closed drainage system
Set
Reimbursement in case of brain surgery
130a
N05.03.041
Wireless ultrasonic scalpel, including:
- Handpiece
- Generator
- Battery
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Set, Piece
174a
N06.06.090
Deep Brain Stimulation (DBS) electrode system
(Machine), including:
- DBS generator
- DBS electrode set
- Electrode extension cords
System
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Reimbursement amount: VND 240.000.000
7. The phrase “vật tư y tế” (“medical supplies”)
and the phrase “trang thiết bị y tế” (“medical equipment and supplies”) are
replaced with the phrase “thiết bị y tế” (“medical equipment”) in all articles,
clauses, points, and appendices of Circular No. 04/2017/TT-BYT.
Article 2. Implementation
1. This Circular comes into force from September
01, 2025.
2. Clause 6 Article 3 and the phrase “Không thanh
toán riêng” (“No separate reimbursement”) in the column "Notes" of Appendix
01 issued with Circular No. 04/2017/TT-BYT are annulled.
Article 3. Transition clauses
1. Supplies that are not medical devices but listed
in Appendix 01 issued with Circular No. 04/2017/TT-BYT shall be subject to the
provisions of Circular No. 04/2017/TT-BYT and this Circular until there are
regulations on reimbursement for supplies of the Minister of Health, except for
regulations on marketing authorization.
2. Patients who are health insurance participants
admitted for inpatient or day treatment before the effective date of this
Circular and completed their inpatient or day treatment (discharged from the
hospital) from the effective date of this Circular shall comply with the
provisions of this Circular for the entire treatment period.
Any difficulties or proposals to amend or
supplement that arise during
implementation must be reported to the Ministry of Health (Health Insurance
Department) for consideration and
settlement./.
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PP. MINISTER
DEPUTY MINISTER
Tran Van Thuan