According to the official website of the National Healthcare Security Administration, public primary healthcare institutions are an important component of the basic medical service system, including community health service centers, township health centers, village clinics, etc. Their diagnosis and treatment volume has always accounted for more than 50% of the total diagnosis and treatment volume, ensuring that residents can obtain medical services nearby within 15 minutes. Some netizens have expressed confusion when registering and paying for medical treatment at grassroots medical institutions. Why do some institutions charge general diagnosis and treatment fees while others charge examination fees? What is the difference between the two? What is the general diagnosis and treatment fee? In 2010, the General Office of the State Council issued the "Opinions on Establishing and Improving the Compensation Mechanism for Grassroots Medical and Health Institutions" (Guobanfa [2010] No. 62), which clarified that registration fees, examination fees, injection fees (including intravenous infusion fees, excluding drug fees), and pharmaceutical service costs would be integrated into general diagnosis and treatment fees, and would no longer be charged separately. In layman's terms, the general diagnosis and treatment fee is a package of medical services provided by primary healthcare institutions on a daily basis, implemented as a "package fee", limited to public primary healthcare institutions such as community health service centers, township health centers, and village clinics. The main consideration is that primary healthcare institutions are limited by their technical capabilities, and a large number of surgical treatment projects cannot be carried out. Packaging and charging for common primary healthcare services is conducive to stabilizing the income of primary healthcare institutions. How to determine the price level of general diagnosis and treatment fees in various regions? Medical service prices are subject to localized management, with specific price levels determined by provincial medical insurance bureaus and some prefecture level people's governments with price management authority. The Opinion of the General Office of the State Council on Consolidating and Improving the Basic Drug System and the New Mechanism for Grassroots Operation (State Council Document [2013] No. 14) proposes that each region should reasonably determine the general diagnosis and treatment fee standards for grassroots medical and health institutions based on actual conditions, with a principle of around 10 yuan. Various regions have further clarified the general diagnosis and treatment fee charging standards based on this standard and actual conditions, but there are certain differences in price levels. In 2024, the National Healthcare Security Administration will compile and issue guidelines for comprehensive diagnosis and treatment projects, retaining the price item of "general diagnosis and treatment fees" and guiding localities to accelerate the implementation of docking. As of now, 24 provinces have implemented the comprehensive examination project guidelines, and in terms of price levels, the price levels in various regions have remained stable at around 10 yuan. For general medical expenses, medical insurance departments in various regions are included in the reimbursement scope of the medical insurance fund, and patients only need to pay 1-3 yuan after reimbursement. How are the general diagnosis and treatment fees or outpatient examination fees charged? According to current policies, general diagnosis and treatment fees and outpatient examination fees cannot be charged at the same time, and the specific implementation of which price item is determined by the local medical insurance department. If primary medical institutions charge general diagnosis and treatment fees, they cannot charge additional fees such as injection fees and intravenous infusion fees that are already included in the general diagnosis and treatment fees. If primary medical institutions charge outpatient examination fees, they can charge injection fees, infusion fees, and other fees based on the actual medical services provided. According to the patient's desired medical situation, outpatient examination fees can be divided into the following categories: first, outpatient examination fees (general outpatient), which correspond to services provided by Western medicine departments such as filing, understanding the condition, reading examination and testing results, and developing diagnosis and treatment plans; The second is the outpatient examination fee (TCM syndrome differentiation and treatment), which corresponds to the services provided by TCM departments such as filing, understanding the condition, syndrome differentiation and treatment, and making syndrome diagnosis; The third is the outpatient examination fee (pharmaceutical outpatient), which corresponds to the medication guidance, consultation and other services provided; The fourth is the outpatient examination fee (nursing outpatient), which corresponds to the nursing consultation, physical examination, evaluation and other services provided. In response to the needs of follow-up patients for medication, consumables, examination and testing prescription continuation services, the project guidelines establish outpatient examination fees (convenient outpatient clinics) to facilitate follow-up patients in prescribing medication. In addition, the project guidelines for comprehensive examination clearly stipulate that the examination services provided by deputy directors and chief physicians (pharmacists) can be charged in addition to the regular examination fees. (New Society)