In most areas, the basic medical insurance does not reimburse PETCT, but some areas can be partially reimbursed, and some stipulate the reimbursement conditions; In addition, commercial medical insurance that can cover self-paid medical treatment can be reimbursed for PETCT as follows:
1.Basic medical insurance: PETCT is actually a self-paid program, so basic medical insurance in most areas is not reimbursed. However, some regions can make partial reimbursement for PETCT, or reimbursement after specifying reimbursement conditions, for example, some cities can make reimbursement or partial reimbursement under certain conditions. The cities that can be reimbursed for PETCT examination are Beijing and Shenzhen. Beijing medical insurance designated hospitals can be partially reimbursed, of which Peking University Cancer Hospital can be reimbursed more than 2,000 yuan; In Shenzhen, the condition for reimbursement is that it must be a tumor examination, and there is a comprehensive medical insurance to reimburse. In addition, PETCT examination in Hunan Province can also be reimbursed. In addition, in Liaoning, Xinjiang and other places, the cost of the contrast agent for PETCT examination can be reimbursed.
2.Commercial Medical Insurance: Reimbursement is provided if it is a reasonable and necessary PETCT expense incurred during the hospitalization. However, because PETCT is a self-paid medical expense, only commercial medical insurance that can cover out-of-pocket medical expenses can be reimbursed, otherwise it will not be reimbursed. In addition, if the PETCT expenses are incurred while visiting a general outpatient clinic, then it is usually only reimbursed by commercial medical insurance that covers out-of-pocket expenses and can cover general outpatient services.