Decree No. 175 / 2021 Coll.
Order on how to measure the cost of health services for redistribution purposes
Valid
Order
Effective from 30.04.2021
175
DECLARATION
of 23 April 2021
on how the cost of health services is measured for redistribution purposes
According to § 21f (d) of Act No. 592 / 1992 Coll., on Insurance for Public Health Insurance, as amended by Act No. 145 / 2017 Coll.:
Subject matter
This Decree regulates, for the purpose of redistribution, the method of valuation of health services costs reported in 2020.
Method of pricing the cost of health services
(1) Health insurance undertakings shall, for the purpose of redistribution, measure the costs of health services declared in 2020 in accordance with other public health insurance legislation.
(2) The costs of acute bed care are measured by the product of the value of the point of CZK 1.58 and the number of points of health performance laid down by Decree No. 134 / 1998 Coll., which issues a list of health performance with points, as amended, for the relevant health performance in the year in which the health services were provided. In addition to the valuation according to the first sentence, the amount of CZK 59 064 is added for each treatment day no. 00051 to 00078 according to Decree No. 134 / 1998 Coll. declared for hospitalized patients with a diagnosis of U07.1 according to the international classification of diseases 1).
(3) The costs of health services provided by special bed care providers and subsequent and long-term bed care providers, with the exception of the costs of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive intensive rehabilitation and long-term intensive nursing care, are to be valued in accordance with the Annex to this Decree.
(4) The cost of health services included in the capitalisation payment for providers in the field of general medical practice and providers in the field of practical medicine for children shall be valued at the amount of the basic capitalisation rate for the converted number of insured persons according to Annex 2, Part A, point 1 of Decree No. 305 / 2020 Coll., establishing the method of including compensation in the amount of compensation for the services paid in 2020, as amended, at CZK 48 per insured person and month.
(5) The cost of health services, the reimbursement of which is laid down in Decree No. 305 / 2020 Coll. in Czech crowns and the valuation of which is not covered by paragraphs 2 to 4, is valued at the amount set out in Decree No. 305 / 2020 Coll.
(6) The cost of health services not covered by paragraphs 2 to 5 shall be measured by the product of the value of the point referred to in Paragraph 3 and the number of points of performance laid down in Decree No 134 / 1998 Coll. in the year in which the health services were provided.
(7) The cost of health services not covered by paragraphs 2 to 6 shall be valued at the amount of remuneration applied for the services provided.
The valuation in accordance with Paragraph 2 (6) shall apply to:
a) outpatient care declared in the expertise 603 and 604 according to Decree No. 134 / 1998 Coll. the value of the point in the amount of CZK 1.13,
b) haemodialysis care value of a point of CZK 0,96,
(c) health services declared by the health rescue service provider value of a point of CZK 1.19; the same value of the point shall also be used for the evaluation of health services provided by patient transport providers of emergency care;
d) health services declared in the medical emergency service value of a point of CZK 1.05,
e) special outpatient care value of a point of CZK 1,19,
(f) health services declared by providers in the field of practical medicine and practical medicine for children and adolescents, including the performance of transport of health workers declared by these professionals, value of the point of CZK 1.26,
g) outpatient care in expertise 809 and 810 according to Decree No. 134 / 1998 Coll., including magnetic resonance imaging, computer tomography and densitometry, value of the point of 1,08 CZK,
h) outpatient care in expertise 222, 403, 801, 802, 807, 812 to 819 and 823 according to Decree No. 134 / 1998 Coll., except for cervical screening performance, the value of the point of 0,78 CZK,
i) outpatient care in professionals 911, 914, 916, 921, 925 and 926 according to Decree No. 134 / 1998 Coll., including the performance of transport of health workers declared by these professionals, value of the point of 1.09 CZK,
j) outpatient care in professionals 902 and 917 according to Decree No. 134 / 1998 Coll., including the performance of transport of health workers declared by these professionals, the value of the point of 0,96 CZK,
k) health services declared by the health transport service provider value point of CZK 1.21,
l) health services of follow-up intensive care, follow-up ventilation care, follow-up complex intensive rehabilitation and long-term intensive nursing care declared by the providers of post and long-term bed care value point of CZK 1.18,
m) outpatient care not mentioned in points (a) to (l) value of the point of CZK 1.18.
Repeal
Decree No. 170 / 2020 Coll., on the method of measuring the cost of health services for redistribution purposes, is repealed.
Efficacy
This Decree shall take effect on 30 April 2021.
Minister for Health:
Prof. MUDr. Arenberger, DrSc., MBA, v. r.
Minister of Finance:
JUDr. Schiller, Ph.D., v. r.
Annex to Decree No 175 / 2021 Coll.
Valuation of the cost of health services declared by special bed care providers and subsequent and long-term bed care, except for the cost of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive rehabilitation treatment and long-term intensive nursing care
The costs of health services declared by special bed care providers and subsequent and long-term bed care, with the exception of the costs of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive rehabilitation treatment and long-term intensive nursing care, are valued according to the type of day and patient category under Decree No. 134 / 1998 Coll. as follows:
| Ošetřovací den | Pro kategorii pacienta 1 podle vyhlášky č. 134/1998 Sb. | Pro kategorii pacienta 2 podle vyhlášky č. 134/1998 Sb. | Pro kategorii pacienta 3 podle vyhlášky č. 134/1998 Sb. | Pro kategorii pacienta 4 podle vyhlášky č. 134/1998 Sb. | Pro kategorii pacienta 5 podle vyhlášky č. 134/1998 Sb. |
|---|---|---|---|---|---|
| 00005 | 1 604,97 | 1 736,15 | 1 921,12 | 2 077,42 | 2 322,58 |
| 00021 | 2 187,03 | 2 356,11 | 2 571,71 | 2 746,03 | 2 920,33 |
| 00022 | 2 044,79 | 2 197,94 | 2 963,42 | 3 185,46 | 3 389,65 |
| 00023 | 1 934,65 | 2 272,30 | 2 473,14 | 2 658,76 | 3 027,70 |
| 00024 | 1 916,08 | 2 075,86 | 2 257,64 | 2 410,81 | 2 561,77 |
| 00025 | 5 050,08 | 5 327,88 | 5 637,70 | 5 763,75 | 5 899,51 |
| 00026 | 2 550,85 | 2 851,23 | 3 096,58 | 3 268,33 | 3 783,59 |
| 00027 | 2 061,54 | 2 296,03 | 2 910,80 | 3 130,55 | 3 220,60 |
| 00028 | 3 024,00 | 3 167,06 | 3 422,39 | 3 787,62 | 4 049,22 |
| 00029 | 2 462,92 | 2 628,72 | 2 821,40 | 3 085,90 | 3 334,78 |
| 00030 | 1 902,22 | 1 998,11 | 2 128,66 | 2 226,36 | 2 324,04 |
| 00031 | 547,46 | ||||
| 00032 | 547,46 |
1) Communication from the Czech Statistical Office No. 464 / 2017 Coll., on updating the International Statistical Classification of Diseases and Associated Health Problems (MKN-10).
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Regulation Information
| Citation | Decree No 175 / 2021 Coll., on how to measure the cost of health services for redistribution purposes |
|---|---|
| Regulation Type | Order |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 27.04.2021 |
|---|---|
| Effective from | 30.04.2021 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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