China to Release National Medical Insurance Directory in Q4
China’s National Healthcare Security Administration (NHSA) announced on May 28 that the first batch of the National Basic Medical Insurance Medical Service Item Directory will be released in the fourth quarter of 2026, marking a historic step toward standardizing healthcare coverage across the country. The new directory, currently open for public comment until June 3, aims to unify medical service coverage under China’s basic insurance system, which covers over 1.3 billion people.
According to People’s Daily, the directory will initially cover 11 categories of medical services: clinical scale assessment, traditional Chinese medicine (including moxibustion, cupping, and tuina), external TCM treatment, TCM acupuncture, TCM bone-setting, special TCM therapies, oral implantology, assisted reproduction, obstetrics, radiological examination, and rehabilitation.
A Landmark Step for Healthcare Standardization
The directory represents the first-ever national-level effort to standardize which medical services are covered by basic medical insurance. For over two decades, medical service item management has been governed by a 1999 regulation (Document No. 22) from the Ministry of Labor and Social Security, which left significant room for provincial variation. Unlike drug catalogs, which achieved national standardization years ago, medical service coverage has remained fragmented, with each province determining its own payment scope based on local fund capacity and medical capabilities.
As CCTV News reported, the NHSA stated that the directory is being created “to further enhance the connotation of a unified national market, improve the efficiency of medical insurance fund utilization, and enhance the fairness, standardization, and uniformity of basic medical insurance.” The initiative is part of broader healthcare reforms under the “Healthy China” strategy and the push for a unified national market.
Phased Implementation and Timeline
The NHSA has outlined a three-phase process for developing the first batch of the directory. The preparation phase ran from April to June 2026, during which the work plan was consulted with the National Development and Reform Commission, Ministry of Finance, National Health Commission, State Administration of Traditional Chinese Medicine, and provincial medical insurance bureaus. The review phase will take place from July to September 2026, involving surveys, expert evaluations, and fund impact assessments. The release phase is scheduled for October to November 2026.
According to the China News Service, the NHSA estimates it will take approximately two years to complete the formulation and release of the full directory. An NHSA official explained, “Since this is the first time such a directory is being formulated, all work must start from scratch and be explored comprehensively.”
Strategic Implementation Approach
The directory will first be implemented for patients seeking cross-provincial medical treatment before gradually expanding nationwide. This phased approach reflects the pragmatic recognition of regional economic and medical disparities across China’s 31 provinces. Currently, 29 provinces have already unified their provincial medical service item insurance payment scopes, laying groundwork for national standardization.
As Guangming Online reported, the NHSA emphasized that nationwide full implementation will not be mandatory immediately after the directory is issued. Instead, the agency plans to leverage the directory’s implementation to guide localities in gradually controlling existing stock and adjusting increments, allowing for an orderly transition.
Implications for Patients and the Healthcare System
The inclusion of assisted reproduction in the first batch aligns with China’s evolving population policy, as the country moves from its former one-child policy to actively encouraging births. All 31 provinces and the Xinjiang Production and Construction Corps have already included assisted reproduction in medical insurance coverage since January 1, 2025.
The directory’s strong emphasis on traditional Chinese medicine — with six of the 11 categories dedicated to TCM therapies — signals continued state support for integrating TCM into mainstream healthcare. For patients, the directory promises greater certainty about what is covered, particularly for those seeking cross-provincial treatment. For healthcare providers, it will require alignment of service coding and pricing with new national standards.
What to Watch For
As the review phase begins in July, key questions remain about the financial impact on the national medical insurance fund, how provinces with more generous coverage will handle the transition, and which categories will be prioritized in subsequent batches. The NHSA’s two-year timeline for completing the full directory suggests that healthcare stakeholders across China should prepare for a gradual but transformative shift toward nationally standardized medical insurance coverage.