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The latest outpatient reimbursement policy in 2023
1. Outpatient reimbursement scope: According to the medical insurance implementation regulations, the latest outpatient reimbursement policy in 2023 expanded the reimbursement scope and increased outpatient reimbursement for chronic diseases. The scope of reimbursement for chronic diseases is selected from the items listed in the Catalogue of Chronic Disease Diagnosis and Treatment Projects of Residents' Medical Insurance, and the specific reimbursement policy is determined according to the actual situation. 2. Outpatient reimbursement ratio: The latest outpatient reimbursement policy in 2023 clarified the reimbursement ratio, which is related to the disease. The reimbursement rate for general diseases is 70%, and the reimbursement rate for special diseases can be as high as 90%. The reimbursement ratio depends on the actual situation. 3. Reimbursement ceiling: In 2023, the latest outpatient reimbursement policy determined the reimbursement ceiling, and the reimbursement ceiling for a single disease was 5,000 yuan, depending on the actual situation. 4. Reimbursement conditions: The latest outpatient reimbursement policy in 2023 clarified the reimbursement conditions, mainly including: (1) patients must hold valid medical insurance cards; (2) Reimbursement items must be treated in hospitals recognized by medical insurance agencies; (3) Reimbursement expenses shall conform to the expense standards stipulated in the medical insurance policy; (4) Reimbursement expenses can only be reimbursed after being approved by the audit institution.