THE MINISTRY OF THE SOCIALIST REPUBLIC OF VIETNAM

HEALTH Independence - Freedom - Happiness

-------- ---------------
No.04/2017/TT-BYT Hanoi, April 14, 2017

CIRCULAR

PROMULGATING THE SCHEDULE, RATES AND CONDITIONS OF PAYMENT OF COSTS OF

COVERED MEDICAL SUPPLIES TO HEALTH INSURANCE PARTICIPANTS

Pursuant to the Law on Health Insurance;

Pursuant to the Government's Decree No. the Government's Decree No. 63/2012/ND-CP dated August
31, 2012 on defining the functions, tasks, powers and organizational structure of the Ministry of
Health;

Pursuant to the Government's Decree No. 105/2014/ND-CP dated November 15, 2014 on specifying
and guiding the implementation of a number of articles of the Law on Health Insurance;

Pursuant to the Government's Decree No. 70/2015/ND-CP dated September 1, 2015 on specifying and
guiding the implementation of a number of articles of the Law on Health Insurance applied to the
People’s Army, Police and Ciphering officers;

Upon the request of the Director of the Health Insurance Department,

The Minister of Health hereby issues the Circular promulgating the schedule, rates and conditions of
payment of costs of covered medical supplies to health insurance participants.

Article 1. Schedule of medical supplies of which health insurance coverage is provided for health
insurance participants

1. The Schedule of medical supplies of which health insurance coverage is provided for health
insurance participants, which is prescribed in the Appendix 01 hereto attached, shall comprise medical
consumables, man-made alternatives, replacements, implants and dedicated devices or accessories
(hereinafter referred to as medical supplies).

2. The Schedule of medical supplies given in the Appendix 01 hereof shall serve as the basis for the
health insurance fund’s payment of costs of medical supplies to health insurance participants in
accordance with laws on heath insurance.

Article 2. Compilation and use of the Schedule of medical supplies of which health insurance
coverage is provided for health insurance participants at healthcare service establishments

1. The Schedule of medical supplies used at health care service establishments must be compiled based
on the Schedule of medical supplies given in the Appendix 01 hereto attached; demands for medical
examination and treatment services; available personnel competence and capacity of medical
equipment; list of medical technical services (hereinafter referred to as medical services) that has been
approved by competent authorities and were actually consumed in the previous year according to the
rules of safety, rationality, efficiency, conformity to medical service demands, relevance to payment
capability of the health insurance fund; must prefer medical supplies that are domestically
manufactured, have reasonable quality and prices.

2. After arriving at contractor selection results, healthcare service establishments shall send social
security authorities the following documents for payment purposes:

a) The list of schedules of medical supplies of which costs have not been charged into prices of medical
services, medical examination services and treatment bed days or lump-sum prices for specific visits of
patients at healthcare service establishments, which is compiled by completing the form given in the
Appendix No.02 hereto attached (both in a written document and electronic excel file format);

b) The decision on approval of the contractor selection plan and the decision on approval of results of
selection of medical supplies contractors (both in a document and electronic excel file format).

3. If non-public healthcare service establishments choose to apply Article 52 of the Law on

Procurement for their purchases of medical supplies, they must compile the list of schedules of medical
supplies of which costs have not been charged into prices of medical services, medical examination
services and treatment bed days or lump-sum prices for specific visits of patients at these
establishments by completing the form given in the Appendix No.02 hereto attached and submit it to
the relevant social security authority.

Article 3. General payment guide

1. The health insurance fund shall not make separate payments for medical supplies of which costs
have been charged into prices of medical services, medical examination services, treatment bed days or
lump-sum prices for specific visits of patients.

2. The health insurance fund shall make payments for medical supplies of which costs have not been
charged into prices of medical services, medical examination services, treatment bed days or lump-sum
prices for specific visits of patients as follows:

a) Payment bases shall be composed of:

- Actual quantity of medical supplies consumed by patients;

- Purchase prices of medical supplies prescribed by laws on procurement; if purchase prices of medical
supplies are higher than the health insurance fund's payment or coverage amounts specified in the 5th
column of the Schedule of medical supplies of the Appendix 01 hereto attached, payment bases shall be
payment or coverage amounts specified in the 5th column of the Schedule of medical supplies of the
Appendix 01 hereto attached;

- Conditions, rates and amounts of payment which are specified in the 5th column of the Schedule of
medical supplies in the Appendix 01 hereto attached;

- Scope and level of health insurance coverage which are specified in laws on health insurance;
b) The amount of payment of total cost of medical supplies in each use of medical service shall not
exceed 45 months' base pay amount; this regulation shall not apply to medical supplies for which rates
of payment are prescribed in the 5th column of the Schedule of medical supplies in the Appendix 01
hereto attached;

Example 1 (Illustration of Point b Clause 2 Article 3): The amount of payment of total cost of medical
supplies for a single use of medical services by an insured patient during the period when the statutory
base pay equals VND 1,210,000 shall be calculated as follows:

- If this patient is the participant in the health insurance program who is entitled to a cover for 100% of
medical examination and treatment costs, the amount of payment of total cost of medical supplies for a
single use of medical services by the patient shall be determined as 45 x 100% x 1,210,000 = VND
54,450,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 95% of
medical examination and treatment costs, but whose accumulated consecutive period of health
insurance participation is not more than 5 years, the amount of payment of total cost of medical
supplies for a single use of medical services by the patient shall be determined as 45 x 95% x 1,210,000
= VND 51,727,500;

- If this patient is the participant in the health insurance program who is entitled to a cover for 95% of
medical examination and treatment costs and whose accumulated consecutive period of health
insurance participation is more than 5 years:

+ If this patient has not yet made any co-payments for medical examination and treatment costs
incurred within a year till the date of use of medical services, the amount of payment of total cost of
medical supplies for a single use of medical services by this patient shall be determined as 45 x 95% x
1,210,000 = VND 51,727,000;

+ If this patient has already made co-payments for medical examination and treatment costs incurred
within a year till the date of use of medical services of which the amount has reached 6 months' base
pay amount, the amount of payment of total cost of medical supplies for a single use of medical
services by this patient shall be determined as 45 months’ base pay amount equal to VND 54,450,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 80% of
medical examination and treatment costs, but whose accumulated consecutive period of health
insurance participation is not more than 5 years, the amount of payment of total cost of medical
supplies for a single use of medical services by the patient shall be determined as 45 x 80% x 1,210,000
= VND 43,560,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 80% of
medical examination and treatment costs and whose accumulated consecutive period of health
insurance participation is more than 5 years:

+ If this patient has not yet made any co-payments for medical examination and treatment costs
incurred within a year till the date of use of medical services, the amount of payment of total cost of
medical supplies for a single use of medical services by this patient shall be determined as (45 x 80% x
1,210,000) + (45 x 20% - 6) x 1,210,000 = VND 47,190,000;
+ If this patient has already made co-payments for medical examination and treatment costs incurred
within a year till the date of use of medical services of which the amount has reached 6 months' base
pay amount, the amount of payment of total cost of medical supplies for a single use of medical
services by this patient shall be determined as 45 months’ base pay amount equal to VND 54,450,000.

Example 2 (Illustration of Point a, b Clause 2 Article 3: If total cost of medical supplies is greater than
45 months’ base pay amount): During the period when the base pay amount per a month is VND
1,210,000, it is presumed that the patient is provided with 01 medical supply (item A) and 02 medical
supplies (item B) for his/her single use of medical services. If the purchase price of item A is VND
50,000,000 and its amount of payment covered by the health insurance fund as specified in the 5th
column of the Schedule of medical supplies given in the Appendix 01 hereto attached is VND
42,000,000; the purchase price of item B is VND 10,000,000 and its amount of payment covered by the
health insurance fund as specified in the 5th column of the Schedule of medical supplies given in the
Appendix 01 hereto attached is unidentified,

total cost of medical supplies (cost of item A is calculated based on the amount of payment specified in
the 5th column of the Schedule of medical supplies given in the Appendix 01 hereto attached and cost of
item B is calculated based on its purchase price) for his/her single use of medical services shall be
calculated as 42,000,000 x 1 + 10,000,000 x 2 = VND 62,000,000. As this cost is greater than 45
month’s base pay amount (VND 54,450,000), the health insurance fund shall agree with the amount of
payment for total cost of medical supplies to insured patients entitled to different levels of coverage
which is the same as that amount of payment specified in Example 1 (Illustration of Point b Clause 1
Article 3).

Example 3 (Illustration of Point a, b Clause 2 Article 3: If total cost of medical supplies is less than 45
months’ base pay amount): The patient is provided with 01 medical supply (item A), 02 medical
supplies (item B) and 03 medical supplies (item C) in his/her single use of medical services. If the
purchase price of item A is VND 40,000,000 and its amount of payment covered by the health
insurance fund as specified in the 5th column of the Schedule of medical supplies given in the Appendix
01 hereto attached is VND 35,000,000; the purchase price of item B is VND 3,000,000 and its amount
of payment covered by the health insurance fund as specified in the 5th column of the Schedule of
medical supplies given in the Appendix 01 hereto attached is unidentified; the purchase price of item C
is VND 2,000,000 and its amount of payment covered by the health insurance fund as specified in the
5th column of the Schedule of medical supplies given in the Appendix 01 hereto attached is
unidentified.

Total cost of medical supplies (cost of item A is calculated based on the amount of payment specified
in the 5th column of the Schedule of medical supplies given in the Appendix 01 hereto attached and cost
of item B and item C is calculated based on their purchase prices) for his/her single use of medical
services shall be calculated as 35,000,000 x 1 + 3,000,000 x 2 + 2,000,000 x 3 = VND 47,000,000. As
this cost is less than 45 months’ base pay amount (VND 54,450,000), the health insurance fund shall
cover it for the patient as follows:

- If this patient is the participant in the health insurance program who is entitled to a cover for 100% of
medical examination and treatment costs, the amount of payment of total cost of medical supplies for a
single use of medical services by the patient shall be determined as 47,000,000 x 100% = VND
47,000,000;
- If this patient is the participant in the health insurance program who is entitled to a cover for 95% of
medical examination and treatment costs, but whose accumulated consecutive period of health
insurance participation is not more than 5 years, the amount of payment of total cost of medical
supplies for a single use of medical services by the patient shall be determined as 47,000,000 x 95% =
VND 44,650,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 95% of
medical examination and treatment costs and whose accumulated consecutive period of health
insurance participation is more than 5 years:

+ If this patient has not yet made any co-payments for medical examination and treatment costs
incurred within a year till the date of use of medical services, the amount of payment of total cost of
medical supplies for a single use of medical services by this patient shall be determined as 47,000,000
x 95% = VND 44,650,000;

+ If this patient has already made co-payments for medical examination and treatment costs incurred
within a year till the date of use of medical services of which the amount has reached 6 months' base
pay amount, the amount of payment of total cost of medical supplies for a single use of medical
services by this patient shall be equal to VND 47,000,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 80% of
medical examination and treatment costs, but whose accumulated consecutive period of health
insurance participation is not more than 5 years, the amount of payment of total cost of medical
supplies for a single use of medical services by the patient shall be determined as 47,000,000 x 80% =
VND 37,600,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 80% of
medical examination and treatment costs and whose accumulated consecutive period of health
insurance participation is more than 5 years:

+ If this patient has not yet made any co-payments for medical examination and treatment costs
incurred within a year till the date of use of medical services, the amount of payment of total cost of
medical supplies for a single use of medical services by this patient shall be determined as (47,000,000
x 80%) + (47,000,000 x 20% - 6 x 1,210,000) = VND 39,740,000;

+ If this patient has already made co-payments for medical examination and treatment costs incurred
within a year till the date of use of medical services of which the amount has reached 6 months' base
pay amount, the amount of payment of total cost of medical supplies for a single use of medical
services by this patient shall be equal to VND 47,000,000.

c) If more drug-eluting stents are used in the coronary stenting technique, the amount of payment of
total cost of medical supplies in a single use of medical services by an insured patient shall be subject
to the payment guide specified in Point b Clause 2 of this Article, in addition to which the health
insurance fund shall agree to provide a cover for another half (1/2) of cost of the second stent at the
purchase price defined by the healthcare service establishment which does not exceed VND
18,000,000;

Example: Drug-eluting stent A is purchased by a healthcare service establishment at the price of VND
40,000,000; the amount of payment of cost of a drug-eluting stent that is specified in the 5th column of
the Schedule of medical supplies given in the Appendix 01 hereof is VND 36,000,000. An insured
patient is hospitalized at a healthcare service establishment to be provided with the stenting service that
requires placement of 03 items of drug-eluting stent A. Total cost of other medical supplies which have
not yet been included in the price of medical service, medical examination service, treatment bed day
or the lump-sum price of all costs incurred by each patient (hereinafter referred to as other medical
supplies) is VND 15,000,000; the amount of payment for these medical supplies at the 5th column of
the Schedule of medical supplies given in the Appendix 01 hereto attached is unidentified.

- If this patient is the participant in the health insurance program who is entitled to a cover for 100% of
medical examination and treatment costs, the amount of payment of total cost of medical supplies for a
single use of medical services by the patient shall equal VND 54,450,000 the same as that calculated in
the example 1 (illustration of Point b Clause 2 Article 3). Total cost of 01 item of drug-eluting stent A
which is calculated based on the amount of payment specified in the 5th column of the Schedule of
medical supplies given in the Appendix 01 hereto attached and other medical supplies is calculated as
36,000,000 + 15,000,000 = 51,000,000; this cost is less than VND 54,450,000. The health insurance
fund shall pay the patient (i) cost of the first stent and other medical supplies which equals VND
51,000,000; (ii) cost of the second stent which equals ½ x 36,000,000 = VND 18,000,000; (iii) shall not
pay the patient cost of the third stent. In aggregate, the health insurance fund shall pay the patient total
cost of medical supplies for his/her single use of medical services which equals:

51,000,000 + ½ x 36,000,000 = VND 69,000,000;

- If this patient is the participant in the health insurance program who is entitled to a cover for 80% of
medical examination and treatment costs, but whose accumulated consecutive period of health
insurance participation is not more than 5 years, the amount of payment of total cost of medical
supplies for his/her single use of medical services shall equal 43,560,000 the same as that in the
example 1 (illustration of Point b Clause 2 Article 3). Total cost of 01 item of drug-eluting stent A
which is calculated based on the amount of payment specified in the 5th column of the Schedule of
medical supplies given in the Appendix 01 hereto attached and other medical supplies is calculated as
36,000,000 + 15,000,000 = 51,000,000; this cost is greater than VND 43,560,000. In aggregate, the
health insurance fund shall pay the patient total cost which is calculated as:

43,560,000 + ½ x 36,000,000 = VND 61,560,000.

d) Participants in the health insurance program that are provided in Point b Clause 1 Article 4 of the
Government’s Decree No. 105/2014/ND-CP dated November 15, 2014 and Article 2 of the
Government’s Decree No. 70/2015/ND-CP shall not be required to comply with Point b Clause 2
Article 3 of this Circular and the limit on rate of payment for medical supplies that is prescribed in the
5th column of the Schedule of medical supplies given in the Appendix 01 hereto attached.

3. If medical items which are classified into a medical specialty are used in medical services classified
into another medical specialty, the health insurance fund shall agree to make payment for them under
the provisions of this Circular.

Example: Costs of guide wires of all kinds and sizes classified into the interventional cardiology and
radiology (Group 7.1) which are used in medical services of either the interventional cardiology or the
gastroenterology (Group 7.4) shall be covered by the health insurance fund.
4. Costs of medical supplies included in the Schedule of medical supplies given in the Appendix 01
hereto attached that are manufactured by healthcare service establishments on their own shall be
covered by the health insurance fund when they are used by these establishments. Directors of
healthcare service establishments shall be responsible for approving manufacturing processes, quality
standards and prices of products manufactured on their own and sending social security authorities
written notifications used as payment bases.

5. The health insurance fund shall not make its payments if:

a) Costs of medical supplies have been covered by the state budget or other funds;

b) Medical supplies intended for medical services have not yet approved for use by competent
authorities or fall outside of the scope of entitlements in accordance with laws on health insurance.

6. Where non-public healthcare service establishments choose to buy medical supplies in accordance
with Article 52 of the Law on Procurement, the health insurance fund shall make its payments for these
medical supplies at their purchase prices which do not exceed the winning prices of medical supplies of
same categories (same commercial names, types, technical criteria, quality standards, manufacturers
and countries of origin) and according to the contract execution period prescribed in the decision on
approval of contractor selection results of healthcare service establishments in the following order of
priority:

a) Public healthcare service establishments at the provincial level that have the largest proposed
number of beds within their provinces;

b) Other healthcare service establishments at the provincial level or those at the central level that are
located within these provinces, if medical supplies are not mentioned in the contractor award results at
healthcare service establishments at the provincial level that have the largest proposed number of beds;

c) Healthcare service establishments at the provincial level or those at the central level that are located
within adjacent provinces, if medical supplies are not mentioned in the contractor award results at
public healthcare service establishments at the provincial level or those at the central level located
within these provinces;

d) Other healthcare service establishments at the central level, if medical supplies are not mentioned in
the contractor award results at public healthcare service establishments at the provincial level or those
at the central level located within adjacent provinces.

Article 4. Guide to payment for certain types of medical supplies

1. The health insurance fund shall make its payments for medical supplies of various types and price
levels at the purchase prices of healthcare service establishment in accordance with laws on
procurement on condition that these payments shall not exceed amounts of payment specified in the 5th
column of the Schedule of medical supplies given in the Appendix 01 hereto attached, and according to
the payment guide specified in Article 3 hereof. Where the patient chooses to use medical supplies of
which prices are greater than stated amounts of payment, (s)he shall, on his/her own, be liable for the
difference between the purchase price and amount of payment made by the health insurance fund.
2. The health insurance fund shall make its payments for medical supplies for which amounts of
payment are specified in the 5th column of the Appendix 01 hereto attached according to the general
payment guide referred to in Article 3 hereof (regulations on amounts of payment of total cost of
medical supplies are not applied) and rates of payment specified in the 5th column of the Schedule of
medical supplies given in the Appendix 01 hereto attached.

Example: The winning price for supply of the set of resin microspheres filled with Y-90 radioactive
isotope to a healthcare service establishment is VND 380,000,000.

Resin microspheres filled with Y-90 radioactive isotope are specified in the Schedule of medical
supplies given in the Appendix 01 hereto attached and are relative to the stipulated rate of payment
which equals 40%.

If the patient is the participant in the health insurance program who is entitled to 100% of cover of
costs of medical examination, treatment and liver cancer treatment services that require use of sets of
resin microspheres filled with Y-90, including microspheres, lead pots, vials, tubes containing standard
doses, cannula, needles and syringes particularly intended for administering radioactive granules, the
health insurance fund shall pay an amount calculated as 380,000,000 x 40% x 100% = VND
152,000,000.

3. In respect of medical supplies of which determination of the quantity is difficult:

a) Based on medical conditions and frequency of rendering of medical services, healthcare service
establishments shall set the limit on use of these supplies and notify this in writing to social security
authorities.

b) The health insurance fund shall make its payment for costs of medical supplies for each use of
medical service which is determined as the purchase price multiplied by (x) the designated limit;

c) If, according to the medical indication, the patient is prescribed only a part of medical supplies
purchased by a healthcare service establishment and the rest of medical supplies is not used for certain
reasons (e.g. no user, insufficient quantity or expiration), the health insurance fund shall pay all costs
incurred from use of these medical supplies at their purchase price.

4. In respect of medical supplies of which the measurement unit is “set”, the health insurance fund shall
make its payment as follows:

a) If all components of the “set” are entirely used, full payment for the whole set shall be made;

b) If one or several components of the “set” are used,

- the full payment for the whole set shall be made in the event that the rest of components of the "set” is
unusable. Healthcare service establishments shall take an inventory of unusable components and notify
this in writing to health insurance authorities;
- The payment for each used component at its predetermined price shall be made in the event that
separate prices of specific components of the “set” are available;

- If there is none of separate prices of specific components used, based on the purchase price of the
“set” and particular characteristics of specific medical supplies, healthcare service establishments shall
take an inventory of components already used, not yet used and notify this in writing to health
insurance authorities for payment purposes.

Article 5. Provisions on payment for reused medical supplies.

1. The health insurance fund’s payment for reusable medical supplies according to the Ministry of
Health’s instructions on the reuse process and times shall conform to instructions provided by the
Ministry of Health.

2. In respect of reusable medical supplies of which instructions for the process and times of reuse have
not yet been provided by the Ministry of Health or manufacturers, Directors of healthcare service
establishments shall, depending on medical requirements, reality and upon the request of the Scientific
Advisory Board or Medicine and Therapy Board (if mandated by Directors of healthcare service
establishments), set up and approve the reuse process and times, and notify social security authorities in
writing for payment purposes. Sum of payment for medical supplies for a single use shall be identical
and determined according to the following formula:

Gvtyt
Payment sum = + Chskk
ntb
Where:

a) Gvtyt means the price of a medical item that is calculated according to the price at which it is
purchased in accordance with laws on procurement;

b) ntb means within-year average times of use which are calculated according to the formula ntb =
nsdtt(previous year) x k. If it is the first year that a healthcare service establishment reuses medical supplies, ntb
is calculated after Director of this establishment consults it from other establishment; additionally,
based on capacity and frequency of performing medical services in which reused medical supplies are
used within a specified year, and opinions of the Scientific Advisory Board or the Medicine and
Therapy Board (if mandated by the Director of the healthcare service establishment) in that
establishment, the Director shall make his/her decision and notify this in writing to social security
authorities;

c) nsdtt(previous year) means average times of actual use within the preceding year which are calculated as
total number of uses of medical supplies by a patient within the preceding year divided by total
quantity of medical supplies already used within that preceding year;

d) k means the risk adjustment coefficient value of 0.8;

dd) Chskk means cost of sterilization, drying and disinfection allocated for a single use of medical
supplies which is calculated according to the following formula:
 (ntb – 1) x Chskktt
Chskk =
ntb
Where: Chskktt means total actual cost of sterilization, drying or disinfection (inclusive of cost of
electricity, water, disinfectant, gloves, packaging, damage to sterilization and drying equipment and
wage) incurred in each time of sterilization, drying or disinfection of a unit of medical supplies.

3. In the beginning of a specified year or prior to commencement of reuse of medical supplies, based on
medical requirements, reality and technical conditions of a healthcare service establishment, the
Director of that establishment shall notify social security authorities of:

a) Maximum times of use (ntd) of each item of medical supplies. Each item of medical supplies shall
not be used in excess of the maximum times of use;

b) Sum of payment for medical supplies in each use, subject to provisions laid down in Clause 1 and 2
Article 5 hereof.

4. At the end of a specified year, healthcare service establishment and social security authority shall
define average times of actual use of medical supplies within that year (nsdtt(within year)) as the basis for
calculation of actual times of use (ntb) for the next year and adjust payment of total cost of insured
medical examination and treatment services incurred at this establishment within that year under the
following circumstances:

a) If average times of actual use within a specified year (nsdtt(within year)) are greater than times of restricted
use (ngh) qualifying for health insurance coverage (ngh= 1.3 x ntb), an adjustment in which total cost of
insured medical examination and treatment service is reduced shall be calculated based on average
times of actual use that exceed times of restricted use as follows:

Gvtyt
Decreasing adjustment = (nsdtt(within year) - ngh) x number of medical supplies used within year x
ntb

b) If average times of actual use within a specified year (nsdtt(within year)) are less than average times of use
(ntb), an adjustment in which total cost of insured medical examination and treatment service is
increased shall be calculated based on the difference portion between average times of use and average
times of actual use within year as follows:

Gvtyt
Increasing adjustment = (ntb – nsdtt(within year)) x number of medical supplies used within year x
ntb

Example: A healthcare service establishment conducts reuse of medical item A.

In 2015, there are 10 times of use of item A; the quantity of item A used is 02 units; price of each unit
is VND 10,000,000; actual cost of each time of sterilization, drying and disinfection for a unit of item
A is VND 200,000.

In the beginning of 2016, healthcare service establishment determines and notifies social security
authority in writing of:
- Maximum times of use of item A is 07. This means that in 2016 each unit of item A is not used in
more than 07 times;

- Sum of payment for medical supplies for a single use is determined as follows:

Average times of actual use (nsdtt) of medical supplies of 2015:

nsdtt(year 2015) = 10/2 = 5 times

Average times of use of 2016:

ntb = nsdtt(year 2015) x k = 5 x 0.8= 4.0

Cost of sterilization, drying and disinfection allocated for a single use of item A:

(4-1) x 200,000
Chskk = = VND 150,000
4
Sum of payment for item A for a single use of 2016 is determined as follows:

Gvtyt 10,000,000
Sum of payment + Chskk + 150,000 = VND 2,650,000
ntb 4
At the end of 2016, healthcare service establishment and social security authority define average times
of actual use of item A of 2016 ((nsdtt(year 2016)):

Total times of a patient’s use of item A in 2016

nsdtt(year 2016) =
Total consumption of item A of 2016
Times of restricted use qualifying for health insurance coverage:

ngh = 1.3 x ntb = 1.3 x 4 = 5.2

If nsdtt(year 2016)= 4.5, compare ntb= 4.0 ≤ nsdtt(year 2016) ≤ ngh = 5.2. In this case, adjustment to total cost of
insured medical examination and treatment services within year at the healthcare service establishment
is not required. Sum of payment for item A for a single use of 2016 is VND 2,650,000.

If nsdtt(year 2016)= 6.5 > ngh=5.2, decreasing adjustment to total cost of insured medical examination and
treatment services within year at the healthcare service establishment is made as follows:

Decreasing adjustment
Gvtyt
= (nsdtt(year 2016) - ngh) x Total consumption of medical supplies of 2016 x
ntb
= (6.5 – 5.2) x Total consumption of medical supplies of 2016 x (10,000,000 /4.0)= (6.5
– 5.2) x Total consumption of medical supplies of 2016 x (10,000,000 /4.0)

If nsdtt = 3 < 4.0, increasing adjustment to total cost of insured medical examination and treatment
services within year at the healthcare service establishment is made as follows:
 Gvtyt
Increasing adjustment = (ntb – nsdtt(year 2016)) x Total consumption of medical supplies of 2016 x
ntb
= (4.0 -3) x Total consumption of medical supplies of 2016 x (10,000,000/4)= (4.0 -3) x
Total consumption of medical supplies of 2016 x (10,000,000/4)

Article 6. Implementation

1. The Ministry of Health shall assume the following responsibilities:

a) Implement, check and inspect compliance with this Circular throughout the nation;

b) Undertake and cooperate with related authorities in resolution of difficulties that may arise during
implementation of this Circular; update and revise the Schedule of medical supplies given in Appendix
01 hereto attached.

2. The Social Security of Vietnam shall assume the following responsibilities:

a) Conduct implementation of and make payment for medical supplies in compliance with this Circular
and other relevant legislative documents;

b) Cooperate with the Ministry of Health and relevant entities in handling any difficulty that may arise
in the course of implementation.

3. The Departments of Health of centrally-affiliated cities and provinces shall assume the following
responsibilities:

a) Implement, check and inspect compliance with this Circular throughout their jurisdictions;

b) Undertake and cooperate with relevant entities in handling any difficulty that may arise in the course
of implementation.

4. Health administrations of Ministries or sectoral departments shall be responsible for implementing

and auditing compliance with this Circular within their jurisdiction.

5. Healthcare service establishments shall assume responsibilities:

a) Provide medical supplies on time, in full and in compliance with regulations according to the
Schedule of medical supplies which have been established, and in conformity with medical demands of
health insurance participants;

b) Manage and use medical supplies in accordance with regulations, ensure safety, relevance, cost
efficiency and conformity with quality standards; make payments according to the rules of timeliness,
correct category, correct quantity, correct price and correct cost;

c) Build the Schedule of medical supplies to be purchased or used at each establishment in accordance
with Clause 1 Article 2 hereof;

d) Send social security authorities documents specified in Clause 2 and 3 Article 2 hereof as the basis
for payment of costs of medical supplies;
dd) Issue the process for sterilization, drying and disinfection of reused medical supplies at healthcare
service establishments; bear responsibility and ensure quality of reused medical supplies;

e) Provide invoices or documents evidencing purchases of medical supplies in respect of those of

which costs have not yet been included in prices of medical services, medical bed days or lump-sum
prices for specific visits of patients in each session of inspection and audit of costs of insured medical
examination and treatment services;

g) Send a written proposal for revision or supplementation of the Schedule of medical supplies
specified in Appendix 01 hereof where appropriate to the reality and in conformity with medical
requirements of patients to the Ministry of Health (Department of Health Insurance) or the Departments
of Health of centrally-affiliated cities and provinces that proceed with preparing a consolidated report
for submission to the Ministry of Health (Department of Health Insurance), or to other competent
authorities for submission of a consolidated report to the Ministry of Health.

Article 7. Transitional provisions

1. If health insurance participants are hospitalized prior to the date of entry into force of this Circular
and discharged from hospital within or after the date of entry into force of this Circular, provisions laid
down herein shall prevail.

2. In respect of medical supplies present in the Schedule annexed to the Circular No. 27/2013/TT-BYT
dated September 18, 2013 of the Minister of Health that introduces the Schedule of medical supplies of
which costs are covered by the health insurance fund (hereinafter referred to as Circular No.
27/2013/TT-BYT) and documents guiding the Circular No. 27/2013/TT-BYT, but not listed in the
Schedule of medical supplies given in Appendix 01 hereof, the health insurance fund shall continue to
make its payments until the number of medical supplies of which contracts for provision are awarded
according to the results of selection of contractors supplying medical supplies, and contracts with
suppliers for supply have been signed prior to this Circular’s entry into force, is used up.

3. In respect of medical supplies which are listed in the Schedule annexed to the Circular No.
27/2013/TT-BYT and documents guiding the Circular No. 27/2013/TT-BYT, but for which conditions,
rates and amounts of payment are prescribed in this Circular, the health insurance fund shall make its
payments in conformity with conditions, rates and amounts of payment specified herein from the date
of entry into force of this Circular.

Article 8. Reference clause

In case reference documents used in this Circular are replaced, amended or supplemented, the newest
versions of these documents created after being so replaced or amended shall become effective.

Article 9. Entry into force

1. This Circular shall enter into force from June 1, 2017.

2. The Circular No. 27/2013/TT-BYT and documents guiding the Circular No. 27/2013/TT-BYT shall
become invalid from the date of entry into force of this Circular.
In the course of implementation of this Circular, if there is any difficulty or proposal for revision or
supplementation of this Circular, entities, organizations and individuals shall consult with the Ministry
of Health (Department of Health Insurance) about any possible solution./.

PP. THE MINISTER

THE DEPUTY MINISTER

Pham Le Tuan

APPENDIX 01

SCHEDULE OF MEDICAL SUPPLIES QUALIFYING FOR HEALTH INSURANCE COVERAGE

(Annexed to the Circular No. 04/2017/TT-BYT of the Minister of Health dated April 14, 2017)

Group Group and category of Unit of

No. Note
code medical supplies measurement
(1) (2) (3) (4) (5)
Group 1. Cotton,
Do not qualify for
N01.00.000 antiseptic liquids and
separate payments
wound cleansers
N01.01.000 1.1 Cotton
Cotton wools or cotton
Gram, kg,
1 N01.01.010 impregnated with
bag, roll
solutions
Sterile cotton and cotton
2 N01.01.020 Wad, piece
swabs of all sizes
1.2 Antiseptic liquids
N01.02.000
and wound cleansers
Antimicrobial hand
sanitizers used for medical
3 N01.02.010 Ml, litre
check-ups, surgeries,
operations or tests
Antiseptic wound Ml, litre,
4 N01.02.020
cleansers bottle
5 N01.02.030 Solutions used for Ml, litre
disinfection and
sterilization of medical
 instruments
Antibacterial sterilizer
solutions used in medical
6 N01.02.040 Ml, litre
labs, operating rooms and
patient rooms
Solutions used for
7 N01.02.050 cleaning medical Ml, litre
instruments
Group 2. Bandages,
gauzes and other
N02.00.000 dressings used for
stopping bleeding and
healing wounds
Do not qualify for
N02.01.000 2.1 Bandages
separate payments
Powder bandages, fabric
bandage padding, tubular
8 N02.01.010 Roll
stockinette bandages of all
sizes
Stretch and elastic
9 N02.01.020 Roll, pad
bandages of all sizes
Orthopaedic and trauma
10 N02.01.030 Roll
cast of all sizes
Crepe bandages, plasters
11 N02.01.040 Roll, pad
of all sizes
Dressings of all sizes used
12 N02.01.050 for surgeries, wounds, Roll, pad
burns and ulcers
Umbilical bandages of all
13 N02.01.060 Roll, piece
sizes
Sterile bandages of all
14 N02.01.070 Roll, pad
sizes
Do not qualify for
N02.02.000 2.2 Adhesive bandage
separate payments
15 N02.02.010 Eyelid plasters of all sizes Pad
Adhesive bandages of all
16 N02.02.020 Roll, pad
sizes
N02.03.000 2.3 Gauzes, bandages
and dressings used for
injury or wound
 treatment
Alginate dressings of all
17 N02.03.010 Pad
sizes
Roll, pack,
18 N02.03.020 Gauzes of all sizes
pad
Sterile adhesive gauze
pads of all sizes stuck to
19 N02.03.030 Pad
wounds, incisions and
sutured wounds
Hydrocolloid dressings of
20 N02.03.040 Pad
all sizes
Hydrogel dressings of all
21 N02.03.050 Pad
sizes
Umbilical gauzes of all
22 N02.03.060 Pad
sizes
Activated carbon gauzes
23 N02.03.070 (absorbent or non- Pad
absorbent) of all sizes
Gauze sponges or foam
24 N02.03.080 Pad
dressings of all sizes
Dressings or knitted and
woven gauzes of all sizes
25 N02.03.090 impregnated with Pad
antibiotic or antimicrobial
agents
Antibacterial plasters of
26 N02.03.100 Pad
all sizes
2.4 Homeostatic and
N02.04.000
wound healing materials
Topical sprays used for
27 N02.04.010 decubitus ulcer prevention Bottle, jar
and treatment
Hemostatic gauze dressing
28 N02.04.020 Pad
of all sizes
(Biological) topical skin
29 N02.04.030 or tissue adhesives used Jar, pad, kit
for surgeries
Nosebleed dressings all
30 N02.04.040 Pad, bar
sizes
31 N02.04.050 Hemostatic materials Pad, bar, kit
 (wax, bone, surgicel,
merocel, spongostan,
gelitacel, floseal
hemostatic and liotit)
Materials used for
negative pressure wound
therapy (including sponge
32 N02.04.060 Set
pads, catheter connectors,
intravenous cannulas and
fixation adhesive plaster)
Group 3. Syringes,
needles, catheters, gloves
N03.00.000 and other medical
supplies used for patient
care
N03.01.000 3.1 Syringes
Feeding syringes of all
33 N03.01.010 Item
sizes
Disposable syringes of all
34 N03.01.020 Item
sizes
High pressure syringes of
35 N03.01.030 Item
all sizes
Syringes of all sizes
36 N03.01.040 designed for automatic Item
power injectors
Reusable syringes of all
37 N03.01.050 Item
sizes
Insulin syringes of all
38 N03.01.060 Item
sizes
Disposable syringes with
39 N03.01.070 attached needles of all Item
sizes
Syringes of all sizes
40 N03.01.080 designed for syringe Item
pumps
N03.02.000 3.2 Needles
Blood sampling pens of all
41 N03.02.010 Item
sizes
Winged infusion needles
42 N03.02.020 Item
of all sizes
 Blood sampling needles of
43 N03.02.030 Item
all sizes
Needles of all sized
44 N03.02.040 designed for implantable Item
subcutaneous ports
Needles of all sizes used
45 N03.02.050 Item
for skin prick tests
Blood collection and
46 N03.02.060 medicine extraction Item
needles of all sizes
Intravenous cannulae of
47 N03.02.070 Item
all sizes
Disposable needles of all
48 N03.02.080 Item
sizes
Injection stopper (with or
49 N03.02.090 without heparin) of all Unit, piece
sizes
3.3 Puncture, biopsy and
N03.03.000
other needles
Puncture probes or
50 N03.03.010 Item
needles of all sizes
Cell aspiration needles of
51 N03.03.020 Item
all sizes
Bone marrow aspiration
52 N03.03.030 Item
needles of all sizes
Needles of all sizes for
53 N03.03.040 percutaneous abscess Item
drainage
Needles for measuring
54 N03.03.050 central venous pressure Item
(CPV) of all sizes
Needles of all sizes used
55 N03.03.060 Item
in ultrasound transducers
General or regional
56 N03.03.070 anesthetic needles of all Item
sizes
Hemodialysis needles of
57 N03.03.080 Item
all sizes
Disposable biopsy needles
58 N03.03.090 Item
of all sizes
 Reusable biopsy needles
59 N03.03.100 Item
of all sizes
Reusable bone marrow
60 N03.03.110 Item
biopsy needles of all sizes
Localization needles of all
61 N03.03.120 Item
sizes
Radiofrequency ablation
62 N03.03.130 needles, tips and catheters Item
of all sizes
Laser needles, thermal
ablation tips, wires and
63 N03.03.140 Item
intravenous catheters of
all sizes
Visceral puncture and
64 N03.03.150 Item
biopsy needles of all sizes
Bone puncture and biopsy
65 N03.03.160 Item
needles of all sizes
Do not qualify for
N03.04.000 3.4 Acupuncture needles
separate payments
Acupuncture needles of all
66 N03.04.010 Kit, item
sizes
3.5 Infusion and guiding
N03.05.000
catheters
Guidewires and infusion
catheters of all sizes
(inclusive of attached
67 N03.05.010 Set
connectors, manifolds,
stopcock and connecting
tubes)
Nasal oxygen cannulas of
all sizes (inclusive of
68 N03.05.020 Set
adapters and connecting
tubes)
Intravenous cannulas of
69 N03.05.030 all sizes used for blood or Set
blood product transfusion
Catheters and extension
70 N03.05.040 Item
sets of all sizes
Intravenous cannulas of
71 N03.05.050 all sizes used for infusion Set
pumps
 Injection locks with or
without catheters and
tubes of all sizes used for
72 N03.05.060 Item
fluid infusion, blood
transfusion and nasal
oxygen supply.
Do not qualify for
N03.06.000 3.6 Gloves
separate payments
73 N03.06.010 Rubber gloves of all sizes pair
Patient care and treatment
74 N03.06.020 Pair
gloves of all sizes
Gloves of all sizes used
75 N03.06.030 Pair
for health examination
Sterile gloves of all sizes
used for functional
76 N03.06.040 Pair
assessment and medical
test
Sterile gloves of all sizes
77 N03.06.050 used for major or minor Pair
surgeries
3.7 Sachets, bags, bottles,
Do not qualify for
N03.07.000 jars and other packing
separate payments
materials
Feeding tubes or catheters
78 N03.07.010 Piece, set
of all sizes
Collector bags for
measurement of
79 N03.07.020 Item
postpartum blood loss of
all sizes
Sterile bags or sachets of
80 N03.07.030 Item
all sizes
Food, fluid or nutrient
81 N03.07.040 Item
bags or pots of all sizes
Intravenous feeding bags
82 N03.07.050 or bottles of all sizes for Item
medical equipment
Bags, sachets, cassettes of
all sizes for collecting or
83 N03.07.060 Item
measuring waste bodily
products and fluids
84 N03.07.070 Bags, bottles or boxes of Item
 all sizes for containing
clinical specimens
85 N03.07.080 Artificial anus bags Item
Group 4. Tubes,
N04.00.000 cannulas, lines, shunts,
adapters and catheters
N04.01.000 4.1 Tubes or cannulas
86 N04.01.010 Cannulas of all sizes Item
Cannulas of all sizes for
87 N04.01.020 tracheal intubation and Item
dilation
Disposable endotracheal
88 N04.01.030 tubes of all sizes Set
(including carlene tubes)
Reusable endotracheal
89 N04.01.040 Set
tubes of all sizes
Dilation tubes or kits of all
90 N04.01.050 Piece, set
sizes
Middle ear ventilating
91 N04.01.070 Item
tubes of all sizes
02-prong CPAP oxygen
92 N04.01.080 Item
sondes of all sizes
93 N04.01.090 Sondes of all sizes Item
4.2 Shunts, drains, and
N04.02.000 effusion or aspiration
tubes
Disposable stomach wash
94 N04.02.010 Set
kits of all sizes
Stomach wash sondes of
95 N04.02.020 Item
all sizes
Drains of all sizes for
96 N04.02.030 Item
bodily fluid effusion
Kehr drains of all sizes for
97 N04.02.040 Item
bodily fluid effusion
Vacuum aspirators of all
98 N04.02.050 Item
sizes
Suction pipes or tubes of
99 N04.02.060 all sizes for sputum, fluid, Piece, set
air and fat tissue suction
 Wash and suction tubes or
100 N04.02.070 lines of all sizes designed Set
for surgical equipment
4.3 Connecting tubes,
N04.03.000
lines or connectors
Guide wire sets for
101 N04.03.010 administration of fluids to Set
joints of all sizes
Blood filtering line sets of
102 N04.03.020 Set
all sizes
Disposable oxygen supply
103 N04.03.030 Set
lines of all sizes
104 N04.03.040 Transfer sets of all sizes Item
2-line hubs with biosafety
105 N04.03.050 Piece, set
connectors of all sizes
Titanium connectors or
106 N04.03.060 connecting catheters of all Item
sizes
Lines for heart-lung
107 N04.03.070 Set
machines of all sizes
Glass tubes for lacrimal
108 N04.03.080 Set
canalicular intubation
Connecting tubes, lines
and adapters of all sizes
109 N04.03.090 Item
designed for medical
devices
Connecting tubes, lines
and adapters of various
110 N04.03.100 types and sizes for Piece, set
operative procedures and
patients’ care
Line kits of all sizes for
111 N04.03.110 Set
peritoneal dialysis
Line kits of all sizes for
high-frequency ventilators
112 N04.03.120 (including ventilating line Set
kits, masks and vibrating
membranes)
N04.04.000 4.4 Catheters
113 N04.04.010 Catheters of all sizes Item
 Guiding catheters of all
114 N04.04.020 Item
sizes
Micro-catheters of all
115 N04.04.030 Item
sizes
Minicaps for transfer sets
of catheters particularly
116 N04.04.040 Item
designed for peritoneal
filtration of all sizes
Group 5. Surgical
N05.00.000 sutures, thread materials
and scalpels
Do not qualify for
N05.01.000 5.1 Surgical sutures
separate payments
Surgical sutures of all
117 N05.01.010 Item
sizes
Do not qualify for
N05.02.000 5.2 Surgical threads
separate payments
Threads of all sizes for
Strand, roll,
118 N05.02.010 fixation of artificial
skein
intraocular lens
Special surgical sutures of Strand, roll,
119 N05.02.020
all sizes skein
Non-absorbable threads of Strand, roll,
120 N05.02.030
all sizes skein
121 N05.02.040 Suture threads of all sizes Strand, skein
Slowly absorbable threads Strand, roll,
122 N05.02.050
of all sizes skein
Fast absorbable threads of Strand, roll,
123 N05.02.060
all sizes skein
Surgical steel threads or Strand, roll,
124 N05.02.070
wires skein
Alternate materials of
125 N05.02.080 surgical threads of all Pad
sizes
Medium absorbable Strand, roll,
126 N05.02.090
threads of all sizes skein
N05.03.000 5.3 Surgical scalpels
127 N05.03.010 Disposable neutral plates Item
for electric scalpels of all
 sizes
Surgical scalpels and
128 N05.03.020 Item
blades of all sizes
Disposable integral
129 N05.03.030 scalpels with fixed Item
handles of all sizes
Ablation electrodes
(monopolar, bipolar,
integrated monopolar and
bipolar), electric scalpels,
laser scalpels, ultrasonic
scalpels, plasma scalpels,
130 N05.03.040 Item
radio scalpels, ultrasonic
scalpels for liver resection,
vessel sealing scalpels,
tissue sealing scalpels of
all sizes (including scalpel
handles and fibers)
Surgical wire saws of all
131 N05.03.050 Strand, string
sizes
Graft blades, cutting
blades, cartilage incision
132 N05.03.060 scalpel and ablation blades Piece, set
of all sizes (including
scalpel handles)
Tissue cutting scalpel
133 N05.03.070 blades, tissue chopping Item
blades of all sizes
Disposable scalpel blades
134 N05.03.080 Item
of all sizes
Radiofrequency incision
135 N05.03.090 and ablation blades of all Item
sizes
Group 6. Prosthetics and
N06.00.000
implants
6.1 Artificial valves and
N06.01.000
blood vessels
Artificial blood vessels of
136 N06.01.010 Unit, segment
all sizes
Artificial drainage valves
137 N06.01.020 Set
of all sizes
138 N06.01.030 Artificial heart valves, Item
 aortic valves of all sizes
139 N06.01.040 Artificial heart valve rings Item
- In respect of
aortic valve
replacement
surgeries, make
payments in case
of aortic valvular
stenosis or
regurgitation due to
aortic valve
Artificial heart valves calcification.
140 N06.01.050 combined with biostents Item
of all sizes - In respect of
pulmonary valve
replacement
surgeries, make
payments in case
of pulmonary
valvular stenosis or
regurgitation due to
aortic valve
calcification.
Make payments for
surgeries for aortic
valve stenosis or
regurgitation
Mechanical or biological
141 N06.01.060 Item combined with
aortic valves of all sizes
aortic root
aneurysm,
dissection or
abscess.
142 N06.01.070 Biological pulmonary Item Make payments for
valves of all sizes surgeries for
replacement of
pulmonary valve or
trunk due to the
following
pathological
conditions:

- Pulmonary valve
stenosis,
regurgitation or
defect (for
example, Fallot’s
 tetralogy disease);

- Pulmonary atresia
with intact or
perforated
ventricular septum;

- Pulmonary valve
infective
endocarditis;

- Double outlet
right ventricle;

- Aortic
displacement
combined with
pulmonic stenosis,
etc.

- Other conditions
that cause failures
to reconstruct valve
or pulmonary
artery using other
materials.
N06.02.000 6.2 Stents

Payment sum:
143 N06.02.010 Coronary artery stents of Item VND 20,000,000
ordinary types (non- per each.
medicated) of all sizes
Payment sum:
Drug-eluting coronary
144 N06.02.020 Item VND 36,000,000
artery stents of all sizes
per each.
Payment sum:
Renal artery stents of all
145 N06.02.030 Item VND 20,000,000
sizes
per each.
Payment sum:
Limb artery stents of all
146 N06.02.040 Item VND 20,000,000
sizes
per each.
Payment sum:
Carotid artery stents of all
147 N06.02.050 Item VND 30,000,000
sizes
per each.
148 N06.02.060 Thoracic aortic stent grafts Item Payment sum:
 VND 260,000,000
of all sizes
per each.
Payment sum:
Abdominal aortic stent
149 N06.02.070 Item VND 280,000,000
grafts of all sizes
per each.
Payment sum:
VND 220,000,000
per each.

Payments are made

in case of:

- Wide-necked
unruptured cerebral
aneurysm or a
grant aneurysm
posing a risk of
compression or an
aneurysm
developing against
the direction of
blood flow or post
Intravenous stents of all embolic
150 N06.02.080 sizes for channeling blood Item recanalization or
flow impossibility of
treating an
aneurysm by
inserting a metal
coil;

- An aneurysm
already ruptured in
the period of
stability;

- An aneurysm
already ruptured
prior to the period
of stability but
unlikely to be
treated by solely
using a metal coil.
Payment sum:
Covered stent scaffolds of
151 N06.02.090 Item VND 70,000,000
all sizes
per each.
152 N06.02.100 Stents of all sizes Item
 6.3 Artificial intraocular
N06.03.000
lens
Artificial intraocular lens
Payment sum:
(IOL, toric IOL) of all
153 N06.03.010 Item VND 3,000,000
sizes (tough, soft and
per each.
hanging)
6.4 Artificial bones,
N06.04.000 cartilages, joints and
tendons
Artificial rounded bone
top kits of all sizes
154 N06.04.010 Set
(rounded bone heads and
associated parts)
Artificial vertebrae, spinal
fusions, intervertebral Item, piece,
155 N06.04.020
discs used for spinal box
surgeries of all sizes
Artificial tendons of all
156 N06.04.030 Segment
sizes
Biological ceramic of all
157 N06.04.040 sizes used for replacing Item
natural bones
(Total or partial) artificial
158 N06.04.050 joints or joint cavities of Set
all sizes
Payment sum:
N06.04.051 Total hip joints of all sizes Set VND 45,000,000
per each.
Payment sum:
Partial hip joints of all
N06.04.052 Set VND 35,000,000
sizes
per each.
Payment sum:
N06.04.053 Knee joints of all sizes Set VND 45,000,000
per each.
Payment sum:
N06.04.054 Shoulder joints of all sizes Set VND 35,000,000
per each.
Artificial cartilages of all Segment,
159 N06.04.060
sizes piece
Stored bones, biological
160 N06.04.070 products of all sizes used Item
for replacing natural bones
 Small bones used for
surgeries for
161 N06.04.080 Item
reconstruction of sound
transmission systems
Segment,
162 N06.04.090 Artificial bones of all sizes
piece
6.5 Patches, grafts or
N06.05.000
implants
Biological patches of
163 N06.05.010 Pad
various types
Groin hernia, abdominal
164 N06.05.020 Item
wall grafts of all sizes
Cranial implants of all
165 N06.05.030 Pad
sizes
Cardiac patches, vascular
166 N06.05.040 Pad
patches of all sizes
6.6 Other replacement,
N06.06.000 grafting or implantation
materials
167 N06.06.010 Skin grafts of all sizes Sheet, piece
Other biological
168 N06.06.020 membranes of all sizes for Sheet, piece
treatment procedures
Biological glues used for
169 N06.06.030 medical treatment Jar, tube
processes
170 N06.06.040 Amnions of all sizes Sheet, piece
Prosthetic tissue
171 N06.06.050 regeneration films of all Unit, piece
sizes
Cultivated keratinocytes,
fibroblasts of all sizes for
172 N06.06.060 Sheet, piece
treatment of burns or other
injuries
Artificial meninges,
173 N06.06.070 artificial grafts or patches Unit, piece
films of all sizes
Incubation, cultivation
174 N06.06.080 films and products of all Unit, piece
sizes
 Group 7. Medical
N07.00.000 supplies used in several
departments
7.1 Medical supplies
used in interventional
N07.01.000
cardiovascular and
radiology specialties
Intravascular ultrasound
catheter kits of all sizes
175 N07.01.010 (including ultrasound Set
probes and conduit
sheaths)
Cannulas of all sizes for
176 N07.01.020 transfusion of cardioplegia Set
solutions
Catheterization kits of all
sizes for intravenous
therapy (including: shunts,
177 N07.01.030 Set
guidewires, catheters for
guiding optical cables and
ablation lines)
Kits for ligation of atrial
septal defects, ventricular
178 N07.01.040 septal defects, arterial Set
duct, left atrium and other
cardiovascular defects
Stent grafting instrument
179 N07.01.050 Set
kits of all sizes
Instrument kits of all sizes
180 N07.01.060 for RF treatment of Set
arrhythmia
Instrument kits of all sizes
181 N07.01.070 for transcatheter treatment Set
of atrial fibrillation
Instrument kits of all sizes
for measurement of
182 N07.01.080 Set
fractional flow reserve and
catheterization
183 N07.01.090 Instrument kits of all sizes Set
for coronary rotablation
(including rotawires,
lubricant rotaglides,
rotalink burrs, rotalink
 rotablator advancers)
Instrument kits of all sizes
for collecting blood clots
(including suction tubes,
microcatheters for blood
184 N07.01.100 Set
clot removal and
rotablation and stents for
pulling blood clots out,
etc.)
Catheterization instrument
kits (including puncture
185 N07.01.110 Set
needles, guide wire,
introducer sheath)
Heart valve repair
instrument kits of all sizes
186 N07.01.120 Set
(including balloons and
other accessories)
Embolisation instrument
187 N07.01.130 Set
kits of all sizes
Coil insertion instrument
188 N07.01.140 Item
kits of all sizes
Instrument kits for
intracardiac
electrophysiology
189 N07.01.150 Set
exploration (machines,
electrodes, etc.) of all
sizes
Instrument kits of all sizes
for replacement of heart
190 N07.01.160 valve through catheters, Set
repair of heart valve
through catheters
Instrument kits of all sizes
for cardiac catheterization
for hemodynamic
exploration and arterial
191 N07.01.170 Set
imaging (catheters for
imaging of coronary
artery, other arteries, heart
chambers)
192 N07.01.180 Instrument kits of all sizes Set
for cardiac catheterization
for hemodynamic
exploration and heart
 chamber imaging
Amplatzer parachute-
193 N07.01.190 shaped delivery Set
instrument kits of all sizes
Disposable instrument kits
194 N07.01.200 for oesophageal vein Set
ligation
Cardiopulmonary bypass
195 N07.01.210 Set
kits of all sizes
Cardiopulmonary bypass
kits for cardiac procedures

(including:

- Artificial lung (including

reservoirs, oxygen
blenders, heat
exchangers);
N07.01.211 Set
- Circuit system associated
with the steam trap

- Blood filter;

- Cannula connected to
blood vessels

- Connector or Y-junction
N07.01.212 Extracorporeal membrane Set
oxygenation kits for
intensive care

(including:

- Artificial lung (including

oxygen blender, heat
exchanger);

- Circuit;

- Components for
insertion of cannulas into
blood vessels (including
artery and vein);
 - Closed blood reservoir;

- Compact centrifuge
pump;

- Blood filter;

- Flow sensor.
Pressure pumps of all
196 N07.01.220 Piece, set
sizes
High pressure pumps of
197 N07.01.230 all sizes for imaging of Set
cardiovascular chambers
Balloons, intra-aortic
counterpulsation balloon
198 N07.01.240 pumps, dissection balloon Piece, set
pumps, blocker balloons
of all sizes
High pressure pump lines,
199 N07.01.250 photoresist high pressure Item
pump lines of all sizes
High pressure guide wires
200 N07.01.260 of all sizes for Set
measurement of FFR
201 N07.01.270 Guide wires of all sizes Item
Parachute-shaped
amplatzer occluders, self-
202 N07.01.280 expanded wire mesh Piece, set
parachute-shaped stents of
all sizes
Parachute-shaped devices
of all sizes for control of
embolism downstream in
the coronary artery and
203 N07.01.290 Item
other arteries for
prevention of deep venous
thrombosis during
interventional procedures
Instruments of all sizes for
204 N07.01.300 Item
coronary fixation
205 N07.01.310 Instruments of all sizes for Item
inserting or cutting metal
coils (coil-pushing wires
 and coil-cutting wires)
Vein sealing instrument
206 N07.01.320 kits of all sizes (angioseal; Set
perclose…)
Multi-snare instruments of
207 N07.01.330 all sizes for removing Item
foreign bodies
Instruments of all sizes for
208 N07.01.340 removal of atherosclerotic Item
plaques
CO2 blowers with water
209 N07.01.350 Item
insufflations of all sizes
Apex hanging instruments
210 N07.01.360 Item
of all sizes
Venous embolization
211 N07.01.370 Jar, tube
glues (Onyx, Histoacryl..)
Needles of all sizes for
212 N07.01.380 aspiration of gases at the Item
artery root
213 N07.01.390 IVC filters of all sizes Item
Pacemakers of all sizes
214 N07.01.400 (including machine units Set
and circuits)
Payment sum:
Single-chamber
N07.01.401 Set VND 42,000,000
pacemakers
per each.
Payment sum:
N07.01.402 Dual-chamber pacemakers Set VND 70,000,000
per each.
Triple-chamber
pacemakers for cardiac Payment sum:
N07.01.403 resynchronization during Set VND 240,000,000
heart failure treatment per each.
process
Pacemakers with Payment sum:
N07.01.404 implantable cardioverter Set VND 260,000,000
defibrillator per each.
Intracoronary, carotid,
215 N07.01.420 peripheral vascular shunts Item
of all sizes
 Embolisation materials
216 N07.01.430 (PVA plastic, lipiodol Piece, bar, jar
particles, etc.) of all sizes
Embolization materials of
217 N07.01.440 all sizes for liver cancer Piece, bar, jar
treatment
Temporary embolization
218 N07.01.450 materials (spongel) of all Piece, bar, jar
sizes
Micro guide wires of all
219 N07.01.460 Item
sizes
Coils and matrix coils of
220 N07.01.470 Item
all sizes
Instrument kits of all sizes
for RF treatment of
arrhythmia using the 3D
221 N07.01.480 Set
mapping of cardiac
anatomy –
electrophysiology
Pulling balloons of all
222 N07.01.490 Piece, set
sizes
Do not qualify for
223 N07.01.500 X-ray films of all sizes Item
separate payments
7.2 Blood purification,
hemodialysis, peritoneal
N07.02.000
filtration, peritoneal
dialysis
Disposable emergency
224 N07.02.010 peritoneal dialysis kits of Set
all sizes
Peritoneal filtration,
peritoneal dialysis
instruments (including
225 N07.02.020 Set
dedicated catheters,
titanium connectors and
circuits)
Disposable blood
226 N07.02.030 Set
transfusion kits of all sizes
Plasma separators and
227 N07.02.040 Each, set
guidewires of all sizes
228 N07.02.050 Filters and guide wires of Set
all sizes used in
 continuous molecular
absorption techniques
Blood purification filters,
membranes and associated
guide wires of all sizes for
229 N07.02.060 continuous renal Each, set
replacement therapies and
continuous blood
ultrafiltration
Blood purification filters
and membranes, and guide
230 N07.02.070 wires of all sizes for Set
periodic hemodialysis
(artificial kidney)
Artificial kidneys of all
231 N07.02.080 sizes used for Each
hemodialysis
7.3 Opthalmology,
N07.03.000 otorhinolaryngology and
odonto-stomatology
External tooth locks of all
232 N07.03.010 sizes designed as threaded Set
rods for dental treatment
Disposable scleral scalpels
233 N07.03.020 of all sizes for vitrectomy Set
and rectinal surgery
Artificial anterior
234 N07.03.030 chambers of all sizes for Set
corneal transplantation
Ophthalmic emulsions or
Ampoule,
235 N07.03.040 solutions for Phaco
tube
cataract surgery
Surgical pigments for
236 N07.03.050 Ampoule, ml
ophthalmic operations
Disposable or reusable
tips or instrument kits of
all sizes for vitrectomy,
237 N07.03.060 Kit, item
anterior segment anatomy,
papillary membrane
anatomy and lens anatomy
238 N07.03.070 Disposable probes of all Kit, item
sizes for quick tonsil
surgeries or nasal
 coblation
Electrical cautery probes
of all sizes used for
239 N07.03.080 intraocular thermal Item
coagulation during the
vitrectomy process
240 N07.03.090 Phaco tips of all sizes Unit
Freezing probes of all
241 N07.03.100 Unit
sizes for sclera treatment
Disposable blades of all
sizes used for
laryngectomy, functional
242 N07.03.110 Item
endoscopic sinus
surgeries, adenoid
removal
Cables, guidewires; laser
probes, laser illuminators
243 N07.03.130 Item
of all sizes for ophthalmic
surgeries
Glaucoma sutures of all
244 N07.03.140 Unit
sizes for scleral surgeries
Intraocular scissors of all
245 N07.03.150 Unit
sizes
Disposable clamps of all
sizes for peeling off
246 N07.03.160 internal limiting Item
membranes (in vitrectomy
and rectinal surgeries)
Nasal, ear and sinus
247 N07.03.170 meroches and sponges of Item
all sizes
Intraocular magnets of all
248 N07.03.180 Set
sizes
Shunts and express
249 N07.03.190 Glaucoma filtration Item
devices of all sizes
Silicone hoses, oils, belts,
250 N07.03.200 sheets of all sizes used in Piece, bottle
opththalmic surgeries
251 N07.03.210 Disposable or reusable Unit
pincers of all sizes used
for peeling off membrane
 during eye surgeries
Capsular tension rings of
252 N07.03.220 Item
all sizes
Make payments for
medical procedures
involving ocular
Positively charged surface
Ampoule,
253 N07.03.230 emulsions for ocular interventional
tube
surface protection surgeries or
operations. Do not
qualify for separate
payments
Nerve monitoring
254 N07.03.240 Item
electrodes of all sizes
Vacuum assisted closure
255 N07.03.250 Sheet, piece
pads of all sizes
Electric voice and larynx
256 N07.03.260 Item
prostheses of all sizes
Filling materials of all
257 N07.03.270 sizes used for eyeball Unit, piece
evisceration surgeries
N07.04.000 7.4 Gastroenterology
High-frequency electrical
instrument kits of all sizes
used for haemorrhoid
surgeries (including
258 N07.04.010 haemorrhoidectomy Set
HCPT kits, haemostatic
clamps, coagulation
instruments, high-
frequency guidewires)
Instrument kits of all sizes
for percutaneous gastric
opening (including
259 N07.04.020 Set
puncture needles, dilation
cannulas and lines with
fixing straps)
Anal dilator kits of all
260 N07.04.030 Set
sizes
261 N07.04.040 Automatic tools or devices Set
of all sizes used for longo
technique (including
associated rings or
 staplers)
Automatic ablation and
suture tools or devices of
all sizes used in Doppler
262 N07.04.050 Set
technique (including
hemorrhoidal artery
probes)
Gastrointestinal tract
(esophagus, stomach,
263 N07.04.060 duodenum, small bowel, Item
rectum and large intestine)
polyp snares of all sizes
Support sheets, drapes and
mesh netting of all sizes
264 N07.04.070 Pad, sheet
for medical treatment and
surgery
Instruments of all sizes for
removing intestinal
265 N07.04.090 Kit, item
worms, helminthes or
foreign bodies
Baskets, balloons of all
sizes for extraction of
266 N07.04.100 stones, foreign bodies, Item
polyps and clinical
specimens
N07.05.000 7.5 Urology
Urological cartridges,
clips and ablation or
267 N07.05.010 Item
suture instruments of all
sizes
Nephrostomy intubation
kits of all sizes (including
puncture needles, dilation
268 N07.05.020 Kit, item
catheters, sondes J-J and
tubes for draingage of
fluids)
Peritoneal dialysis kits of
269 N07.05.030 Set
all sizes
Plastic dilators associated
with amplatzers of all
270 N07.05.040 Set
sizes for percutaneous
nephrolithotomy
271 N07.05.050 Plastic ureter dilators of Set
 all sizes
Wire probes of all sizes
272 N07.05.060 Item
for ureteral lithotripsy
Nephrolithotomic tips or
273 N07.05.070 Item
electrodes of all sizes
Cables; laser emitting
diodes of all sizes for
274 N07.05.080 Item
prostatic hyperplasia
treatment
Electrodes of all sizes for
endoscopic ablation
275 N07.05.090 prostatic hyperplasia Item
enucleation and ablation
surgeries
Dormia air ventilators for
276 N07.05.100 endoscopic ureteral Item
nephrolithotomy
7.6 Traumatology and
N07.06.000
orthopaedics
Powder bandage coats and
277 N07.06.010 Item
splints of all sizes
Spinal orthosis vests and
278 N07.06.020 orthopedic shoes of all Unit
sizes
Cement dispensing
instrument kits of all sizes
279 N07.06.030 (including puncture Set
needles, cement, pressure
pumps)
Nails, splints, clips,
needles, screws and braces
280 N07.06.040 Piece, set
of all sizes used for
orthopaedic surgery
Frames, belts, splints or
torsion shafts of all sizes
281 N07.06.050 for traumatology and Piece, set
orthopaedics and
rehabilitation purposes
Load bearing chest plates
282 N07.06.060 Item
of all sizes
283 N07.06.070 Chemical cement of all Gram, bottle
sizes used for
 verterbroplasty,
cranioplasty and
arthroplasty
Surgical water pump lines,
electrical ablators,
284 N07.06.080 Item
electrical ablation knife
handles of all sizes
Orbital bone (orbital floor)
reconstruction, cranial
285 N07.06.090 Pad, sheet
reconstruction materials of
all sizes
7.7 Hematology and
N07.07.000
blood transfusion
Toolkits of all sizes for
286 N07.07.010 separating leukocytes, Set
platelets and plasmas
Stem cell separation
287 N07.07.020 Set
toolkits of all sizes
Histocompatibility
288 N07.07.030 determination toolkits of Set
all sizes
Leukocyte films of all
289 N07.07.040 Item
sizes
Group 8. Medical
supplies used in other
N08.00.000
medical diagnoses and
therapies
Surgical cartridges and
290 N08.00.010 Item
sutures of all sizes
Compression bandages of
291 N08.00.020 all sizes for venous Item
treatment
Autoclave tapes of all
292 N08.00.030 Roll
sizes
Pressure transfusion bags
293 N08.00.040 Item
of all sizes
Surgical camera protective
294 N08.00.050 Item
bags of all sizes
Protective bags of all sizes
295 N08.00.060 for protection of ultrasonic Item
scanning apparatus
 Disposable blood pressure
measurement bags of all
296 N08.00.070 Unit
sizes for newborns or
adults
Kits of all sizes for
effusing bodily fluids or
297 N08.00.080 abscesses (including Set
puncture needles, dilation
or draining tubes)
Kits of all sizes for
intubating chemical
298 N08.00.090 infusion catheters Set
(puncture needles, tubes
and guidewires)
Disposable or reusable
299 N08.00.100 Set
probes of all sizes
Intracranial pressure
300 N08.00.110 measurement kits of all Set
sizes
Oxygen volume and
301 N08.00.120 arterial blood gas test kits Set
of all sizes
Thermal tumor ablation
kits of all sizes, including
302 N08.00.130 thermal ablation needles, Set
connecting wires and
adhesive electrodes
Disposable endotracheal
303 N08.00.140 Set
tubes of all sizes
Chemical infusion
304 N08.00.150 Set
chambers of all sizes
Disposable SpO2 sensors
305 N08.00.160 Item
of all sizes
Surgical cold-light cables
306 N08.00.170 Unit
of all sizes
Surgical photography tips
307 N08.00.180 Set
of all sizes
308 N08.00.190 Conical probes of all sizes Item
Probes of all sizes for
309 N08.00.200 endoscopic bile duct Item
lithotripsy
 Venous cautery tips or
310 N08.00.210 Unit
welding blades of all sizes
Disposable wash and
311 N08.00.220 aspiration catheter tips of Item
all sizes
Cables and invasive blood
312 N08.00.230 pressure sensors (dome) of Set
all sizes
Tongue depressors (made
313 N08.00.240 from wood, stainless steel Item
or metal) of all sizes
Adhesive electrode pad,
adhesive electrodes, Item, piece,
314 N08.00.250
electrode cushions of all unit
sizes
Clips or clamps of all
315 N08.00.260 Item
sizes
316 N08.00.300 Catheter sheaths Item
317 N08.00.310 Masks of all sizes Unit, piece
Surgical drill bits
318 N08.00.330 (including cutters) of all Piece, set
sizes
Air filtration films of all
319 N08.00.340 Item
sizes
Antibacterial filtration
320 N08.00.350 Item
films of all sizes
Disposable surgical
321 N08.00.360 Set
staplers of all sizes
Thermal insulation sheets
322 N08.00.370 Item
of all sizes
Epidural anesthesia kits of
323 N08.00.380 Set
all sizes
Transducers of all sizes
324 N08.00.400 for radiofrequency Set
ablation
Continuous blood
325 N08.00.410 Bag
purification dialysates
326 N08.00.420 Preservation media for Ml, litre
tissues, glands and
corneas; cardioplegic
 solutions of all types
Radioactive seed
327 N08.00.430 implantation instruments Set
of all sizes
Guide instruments for
microsurgical treatment of
ventricular tumors and
328 N08.00.440 Set
PTD instruments for
malign brain tumors of all
sizes
Brachytherapy
instruments (including
implant tools, implant
needles for cervix, uterus,
vagina, rectum, breast,
329 N08.00.450 Set
sinuses, soft tissues, skins,
nasopharynx, esophagus,
trachea, bronchus, lung
and lymph node, etc.) of
all sizes
Resin microspheres filled Make payments at
with Y-90 (including the rate of 40% in
microspheres, lead pots, case of primary
vials, tubes containing liver cancer or
330 N08.00.460 standard doses, cannula, Set secondary liver
needles and syringes cancer which has
particularly intended for not metastasized to
administering radioactive other body parts or
granules) is inoperable.
Disposable plastic trocars
331 N08.00.470 of all sizes for endoscopic Kit, item
surgeries
Group 9. Medical
replacement parts or
Do not qualify for
N09.00.000 supplies used for certain
separate payments
diagnostic and
therapeutic equipment
332 N09.00.010 Infrared lamps of all sizes Unit
Ultraviolet lamps of all
333 N09.00.020 Unit
sizes
Beam emitters of
334 N09.00.030 radiotherapy accelerators Item
of all sizes
 SPECT pen point markers
335 N09.00.040 Item
of all sizes
336 N09.00.050 Phantoms of all sizes Set
Body fixation sheets of all
337 N09.00.060 sizes for accelerated Item
radiotherapy

------------------------------------------------------------------------------------------------------
This translation is made by THƯ VIỆN PHÁP LUẬT, Ho Chi Minh City, Vietnam and for reference
purposes only. Its copyright is owned by THƯ VIỆN PHÁP LUẬT and protected under Clause 2,
Article 14 of the Law on Intellectual Property.Your comments are always welcomed