Circular No. 20/2022/TT-BYT dated December 31st, 2022 of the Minister of Health on introduce nomenclatures and payment rates, conditions of chemical medications, biologicals, radiopharmaceuticals and tracers under health insurance policyholders’ received coverage.

This Circular promulgates Nomenclatures, payment rates, conditions of chemical medications (Appendix I), radiopharmaceuticals (Appendix II), applicable from March 1st, 2023.

Notably, according to the regulations at Article 3, the health insurance fund shall pay for a medication when the prescription for such medication is conformable to the prescription stated in one of the following documents:

- The leaflet attached to the dossier of registration of the medication licensed by the Ministry of Health;

- The leaflet attached to the dossier of registration of the proprietary medicine or reference biological licensed by the Ministry of Health;

- The guidelines for diagnosis and treatment adopted by the Ministry of Health;

- The most updated version of the National Pharmacopoeia of Vietnam.

However, the health insurance fund shall not pay for a medication if:

- The decision on suspension or recall of the medication or the batch comprising that medication is adopted;

- The cost of that medication has been included in the price of technical, medical examination and medical bed service or the lump-sum price per a patient case in accordance with regulations in force;

- The portion of the cost of that medication is paid by the state budget or other sources of fund;

- That medication is used in clinical tests or scientific researches.

This Circular takes effect from March 1, 2023.

To replace Circular No. 30/2018/TT-BYT dated October 30, 2018, Circular No. 01/2020/TT-BYT dated January 16, 2020, Circular No. 20/2020/TT-BYT dated November 26, 2020.