In clinical surgery, surgical robots are important auxiliary tools, with multiple technical advantages such as more accurate, less trauma, and fast postoperative recovery, but due to the high cost of surgical robot surgery, many patient families are often deterred
.
In order to reduce the burden on patients, Shanghai and Beijing have successively included laparoscopic surgical robots and robotic-assisted orthopedic surgeries into the local medical insurance payment directory, and have made provisions
for product range, robot manufacturers and types of surgery.
On September 23, the Hunan Provincial Medical Insurance Bureau issued the Notice on Regulating the Use and Charging Behavior of Surgical Robot Auxiliary Operating System, clarifying the definition, charging method and pricing
of surgical robots.
It is worth mentioning that this is the first provincial document issued nationwide to regulate the surgical robot auxiliary operating system, clarify the medical service charges and medical insurance payment policies, covering orthopedics, head and neck surgery, thoracic surgery, cardiac surgery and many other departments
.
By definition, surgical robots include all kinds of auxiliary operating equipment, platforms, systems or tools
under similar names.
Medical institutions should reasonably use surgical robot-assisted operating systems in accordance with the scope of application of the equipment registration certificate and the indications for clinical surgical use, and shall not exceed the scope and overuse them
.
The notice clarifies that the surgical robot auxiliary operating system only plays the function of surgical planning, including but not limited to the application of artificial intelligence, augmented reality, mixed reality, holograms, glasses-free eye 3D and other digital, visual or intelligent innovative general technologies, to assist in surgical planning, preoperative simulation, etc.
, and the value of auxiliary operations is reflected in the price of surgery, and no additional project charges are made
.
For remote provision of inter-hospital surgical planning services, fees shall be charged according to the remote consultation of a single discipline and shall not be charged
separately.
If the surgical robot auxiliary operating system only has and plays the navigation and positioning function, 40% is added for each operation, and the core surgical price is more than 5,000 yuan per case, and the charging standard is capped
at 2,000 yuan per case.
The surgical robot auxiliary operating system belongs to the "auxiliary surgical equipment and auxiliary surgical system using robotic technology" (referred to as RA equipment/system, including but not limited to the surgical instrument control system such as "Da Vinci surgical robot"), which is added
according to the corresponding surgical items.
If the surgical robot-assisted operating system only completes or participates in completing some of the core operational steps (including remote surgical operations) to achieve surgical goals under the control of medical personnel, an additional 80%
will be charged.
If the surgical robot-assisted operating system completes or participates in the completion of all core operational steps (including remote surgical operations) to achieve surgical goals under the control of medical personnel, an additional 300%
will be charged.
The Notice also points out that if the above-mentioned additional charges occur at the same time, the fees shall be charged according to the highest proportion of the additional charges, and the charges
shall not be superimposed on each other.
It is worth noting that the additional fees of the surgical robot-assisted operating system are temporarily not included in the scope of payment of the medical insurance fund, and are adjusted
according to the procedures according to factors such as the guarantee needs of medical service projects, the income and expenditure of the fund, and the affordability.
The domestic surgical robot market started late, but the rapid development, Northeast Securities Research Report pointed out that China's surgical robot related market size has increased from 853 million yuan in 2016 to 2.
935 billion yuan in 2020, with an annual compound growth rate of 36.
2%, and it is expected to reach 58.
426 billion yuan
in 2030.
The industry said that the document released by Hunan Province, from the perspective of long-term development or affecting the market of more than 50 billion yuan, will help squeeze out the inflated water of low-value surgical robots, force domestic enterprises to innovate and upgrade, and help the commercialization of
domestic surgical robots.
