2025年12月5日，国家医保局向各省医保局下发了《手术和治疗辅助操作类医疗服务价格项目立项指南（征 求意见稿）》（以下简称立项指南（征求意见稿）、或征求意见稿），用于在医保体系内部征求意见。 （注意： 文件属于医保体系内部研讨性质， 并非最终执行文件。 网站没有公示，思宇也不能公开传播全文。 中关村联新生物医药 产业联盟拟于本周组织闭门交流会，感兴趣的朋友欢迎报名，报名链接附文末，也可点击阅读原文。） 这是继33批学科类立项指南之后（截至2025年9月28日为33批），首次横向针对外科辅助技术链进行系统分 类。 在庞杂、快速演进的创新技术体系面前，此类机制性的整理工作难度极高，也体现出医保部门希望通过 建立统一、可兼容、可延展的框架，为未来创新技术的规范使用与稳定演进打下基础。 这不仅是价格项目层 面的 文件 ，更是夯实行业基础制度、提升医疗服务透明度与可评价性的 扎实工作成果 。 根据以往公开信息查询，我们发现文件涉及四个"首次"： 一旦落地，该框架将直接关联3D重建、术前规划、导板打印、术中影像、AR/VR成像、导航系统、手术能量 平台、AI手术辅助、远程手术、介入治疗以及神外、骨科、肝胆、胸外、泌尿等 ...

Core Viewpoint - The article discusses a long-term reform in China's medical service pricing system, which aims to unify the vast discrepancies in medical service pricing across different regions, ultimately leading to a standardized national pricing system [1][4][14]. Group 1: Reform Background and Objectives - The reform has been ongoing for 25 years, with multiple changes in management and reform plans [1]. - The goal is to consolidate the 5,000 to 23,000 medical service pricing items across various regions into a consistent national pricing system [1][6]. - The National Healthcare Security Administration (NHSA) has initiated a new round of medical service pricing reform since 2021, with significant acceleration noted in 2024 [1][2]. Group 2: Implementation Challenges - Hospitals are experiencing considerable pressure due to the accelerated pace of the reform, with the complexity of the new guidelines expected to surpass previous reforms like DRG/DIP [3][13]. - The existing chaos in medical service pricing, with over 30,000 items lacking standardization, has led to significant management challenges and confusion in pricing relationships [4][6]. - The NHSA has issued 28 batches of "Project Establishment Guidelines," which include around 1,200 main projects and over 500 additional items, aiming to standardize the pricing structure [8][12]. Group 3: Future Directions and Considerations - The NHSA plans to release all "Project Establishment Guidelines" by 2025, with ongoing efforts to address the complexities of integrating new and existing projects [2][12]. - The new guidelines emphasize the separation of technical costs and consumables, which raises questions about how to charge for new technologies and materials [10][17]. - There are concerns regarding the balance between reflecting clinical labor value, ensuring the sustainability of the healthcare fund, and considering patient affordability [16].