China Standardizes Medical Testing Fees Nationwide

China’s National Healthcare Security Administration (NHSA) has officially released the “Guidelines for Establishing Medical Testing Service Price Items (Trial)”, marking the completion of all 40 batches of medical service price project establishment guidelines and creating a unified national standard for laboratory testing fees. The new framework covers 662 main items, 114 additional charge items, and 7 extension items across clinical testing, blood transfusion, microbiology, molecular diagnostics, biochemistry, and immunology, according to People’s Daily.

A Landmark in Healthcare Price Reform

The release on August 14 represents the culmination of a reform program that began in 2021, when the NHSA started systematically issuing medical service price guidelines in batches following a “mature one batch, release one batch” approach. The NHSA announced that the unified national medical service price project system is now essentially formed, ending years of fragmented regional pricing that saw provinces managing over 2,000 separate testing items with significant cost variations.

The scale of the problem was substantial. For example, thromboelastography testing cost 360 yuan in some regions but only 100 yuan in others, while gastrin-releasing peptide precursor testing ranged from 149 yuan to just 40 yuan per item. These disparities created confusion for patients, billing difficulties for hospitals, and oversight challenges for regulators.

Key Reform Innovations

The guidelines introduce several significant changes to how medical testing is priced and delivered. Most notably, they shift from pricing based on testing methodology to pricing based on service output. For instance, glucose testing previously had separate price items for dry chemistry, enzymatic, and enzyme electrode methods—now unified as a single “glucose testing fee,” ensuring the same test costs the same regardless of method, as reported by China News Service.

The guidelines also establish a tiered discount system for combined testing: tests with 5 or fewer indicators are charged at 80% of the standard price, 10 or fewer at 70%, and more than 10 at 60%. This incentivizes efficient multi-marker testing while reducing patient burden.

A notable “missing data reduction” policy requires medical institutions to store and upload testing data to receive full payment. Failure to comply results in a 10% reduction per test indicator (capped at 5 yuan), while using reference intervals inconsistent with national industry standards for 17 specific tests triggers a 5% reduction per indicator. These mechanisms are designed to facilitate cross-regional result recognition and advance health data digitalization.

Supporting Innovation and Diagnostic Value

The guidelines add over 130 new testing items to the national unified fee catalog, including tumor organoid culture and drug sensitivity testing for precision oncology. The NHSA also incorporated “making diagnostic analysis and issuing diagnostic reports” into the service output and price composition of more than 10 testing items, including bone marrow morphology testing and microbiological identification, recognizing the diagnostic value of laboratory medicine.

According to the 21st Century Business Herald, Jiang Changsong, a researcher at Capital Medical University’s National Medical Insurance Research Institute, described price items as “the passport for innovative technologies to enter the hospital system.” He noted that without corresponding charging price items, even the most advanced medical technology would struggle to benefit patients.

Industry Impact and Market Reshaping

China’s in vitro diagnostics (IVD) reagent market reached approximately 130 billion yuan (about $18 billion) in 2025, making it a significant segment of the healthcare industry. The standardization is expected to trigger a major industry reshuffle, as companies can no longer profit from methodology-based price differences.

As Guangming Online reported, Wang Xiaoning, director of the NHSA Price and Procurement Department, explained that price items are both the basis and boundary for hospital charging, and essentially a market access system. The clarification of price anchor points makes the profit space of new technologies quantifiable and predictable, potentially encouraging more provinces to invest in high-end medical facilities.

The China Economic Net noted that the guidelines also formally incorporate AI-assisted diagnostics as an extension item without additional charge, recognizing AI as part of standard testing services.

Looking Ahead

The NHSA has stated it will guide provincial medical insurance bureaus to accelerate implementation of the 40 batches of guidelines, scientifically calculate price levels, and promote relative balance in regional pricing to achieve a national “single ruler” in medical service pricing. As the Chinese government website confirmed, the reform’s true test lies in hospital billing windows and every patient’s payment receipt.

For patients, the reform promises reduced costs through bundled testing discounts and unified pricing. For hospitals, testing departments transition from profit centers to cost centers, requiring strict cost control and data standardization. For the IVD industry, the new rules demand a focus on efficiency, digitalization, genuine innovation, and cost control.

As the guidelines move from policy documents to implementation across China’s provinces, the healthcare system is entering a new era of standardized, transparent medical pricing—one where the same test costs the same whether performed in Beijing or a remote county hospital.