Decree No. 65 / 2025 Coll.
Order on how to measure the cost of health services for the purpose of reallocation of public health insurance premiums
Valid
Effective from 01.04.2025
65
DECLARATION
of 6 March 2025
on how the cost of health services is to be measured for the purpose of reallocating public health insurance premiums
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 purposes of redistribution, the method of measuring the costs of health services declared in 2024.
Method of pricing the cost of health services
For the purposes of redistribution, health insurance companies shall measure the costs of health services declared in 2024, provided that they have been declared in accordance with the legislation.
(1) The costs of emergency bed care shall be assessed in accordance with paragraphs 2 to 5.
(2) Cases of hospitalisation of patients that were terminated in 2022 and in which, before 2024, health care was not reported to the extent that it was possible to build a hospitalisation case, and before 2022, no healthcare was reported, the product of the basic rate of CZK 62 236 and the relative weights assigned to hospitalisation cases determined according to the Czech Statistical Office Communication No. 385 / 2021 Coll., will be valued by updating the Classification of hospitalised patients of CZK-DRG (hereinafter "CZ- DRG 2022 '). Patient hospitalisation cases will be compiled on the basis of care reported between 2022 and 2024. In the evaluation of patients hospitalisation cases according to the first sentence, the medicinal products listed in Annex 12 to Decree No 396 / 2021 Coll., establishing the values of the points, the amount of remuneration for the services paid and the regulatory restrictions for 2022, and the medicinal products not included under the nomenclature CZ- DRG 2022 in the calculation of the relative weights shall not be included; the medicinal products are assessed in accordance with Section 9.
(3) Cases of hospitalisation of patients that were terminated in 2023 and for which no health care was reported before 2024 to the extent that a hospitalisation case could be compiled and no healthcare was reported before 2022, the product of the basic rate of CZK 68460 and the relative weights assigned to hospitalisation cases determined according to the Czech Statistical Office Communication No. 302 / 2022 Coll., will be valued by updating the Classification of hospitalised patients of CZK-DRG (hereinafter "CZ- DRG 2023 '). Patient hospitalisation cases will be compiled on the basis of care reported between 2022 and 2024. In the evaluation of patients hospitalisation cases according to the first sentence, the medicinal products listed in Annex 12 to Decree No. 315 / 2022 Coll., setting the values of the points, the amount of the payments for the services paid and the regulatory restrictions for 2023, and medicinal products not included under the nomenclature CZ- DRG 2023 in the calculation of relative weights, shall not be included; the medicinal products are assessed in accordance with Section 9.
(4) Cases of hospitalisation of patients who were terminated in 2024 and who were not reported before 2024 to the extent that the hospitalisation case could be compiled and no health care was reported before 2022, the product of the basic rate of CZK 75,000 and the relative weights assigned to hospitalisation cases determined according to the Czech Statistical Office Communication No. 300 / 2023 Coll., will be valued by updating the Classification of hospitalised patients of CZK-DRG (hereinafter "CZ- DRG 2024 '). Patient hospitalisation cases will be compiled on the basis of care reported between 2022 and 2024. In the evaluation of patients hospitalisation cases according to the first sentence, the medicinal products listed in Annex 12 to Decree No 319 / 2023 Coll., establishing the values of the points, the amount of the payments for the services paid and the regulatory restrictions for 2024, and medicinal products not included under the nomenclature CZ- DRG 2024 in the calculation of the relative weights, shall not be included; the medicinal products are assessed in accordance with Section 9.
(5) The care declared in 2024 and provided in the context of hospitalisation of patients, which cannot be compiled according to the CZ- DRG 2022, CZ- DRG 2023 or CZ- DRG 2024 on the basis of the care declared in the years 2022 to 2024, is not considered to be declared in 2024.
The costs of extramural care relating to cases of hospitalisation of patients under § 3 are included in the assessment under § 3 and are no longer appreciated. Extramural care means extramural care according to Annex 1 to Decree No 396 / 2021 Coll., Annex 1 to Decree No 315 / 2022 Coll. and Annex 1 to Decree No 319 / 2023 Coll.
The cost of health services provided by special bed care providers and subsequent and long-term bed care providers, with the exception of the cost of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive intensive rehabilitation care and long-term intensive nursing care, shall be valued in accordance with the Annex to this Decree.
The cost of the health services included in the surrender payment for providers in the field of general medical practice and providers in the field of practical medicine for children and young people 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 to Decree No. 319 / 2023 Coll. of CZK 58 per insured person and month. The cost of health services included in the aggregated remuneration for dental care providers is valued at CZK 21 per registered insured person and month.
The cost of health services, the amount of which is set in Decree No. 319 / 2023 Coll. in Czech crowns and the awards of which are not subject to § 3 to 6, is valued at the amount set out in this decree.
The cost of health services not covered by Sections 3 to 7 shall be evaluated by the product of the value of the point referred to in Section 10 and the number of performance points determined in accordance with the list of performance effective in the year in which the health services were provided, if they can be assessed in this manner.
The cost of health services not subject to the evaluation of paragraphs 3 to 8 shall be valued at the amount of remuneration applied for the services provided.
The valuation according to § 8 applies to:
a) outpatient care declared in expertise 603 and 604 according to the performance list value of the point of CZK 1.10,
b) haemodialysis care value of a point of CZK 1.20,
(c) health services declared by health care providers and health services reported by patient transport providers of urgent care value of a point of CZK 1.37,
d) medical services declared in the medical emergency service value of a point of CZK 1.20,
e) special outpatient care value of a point of CZK 1.34,
(f) health services declared by providers in the field of general 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 1.23,
g) outpatient care in expertise 809 and 810 according to the list of performances, including magnetic resonance, computer tomography and densitometry, value of the point of 0,86 CZK,
h) outpatient care in expertise 222, 403, 801, 802, 807, 812 to 819 and 823 according to the performance list, except for cervical screening and prostate cancer screening, value of a point of CZK 0,86,
i) outpatient care in the 911, 914, 916, 921, 925 and 926 expertise according to the performance list, including the performance of transport of health workers declared by these professionals, value of the point of CZK 1.07,
j) outpatient care in expertise 902 and 917 according to the performance list, including the performance of the transport of health workers declared by these professionals, the value of a point of CZK 0.80,
k) health services declared by the health transport service provider value point of CZK 1.41,
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 providers of subsequent and long-term bed care value of a point of 1.58 CZK for treatment day 00015, 1.54 CZK for treatment day 00017, 1.52 CZK for treatment day 00020 and 1.27 CZK for treatment day 00033 and treatment day 00035,
m) outpatient care not mentioned in points (a) to (l) value of the point of CZK 1.02.
Repeal
Decree No. 102 / 2024 Coll., on the method of valuation of the cost of health services for the purpose of reallocation of public health insurance premiums, is hereby repealed.
Efficacy
This Decree shall take effect on 1 April 2025.
Minister for Health:
Prof. MUDr. Válek, CSc., MBA, EBIR, v. r.
Minister of Finance:
Ing. Stanjura v. r.
Annex
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 cost of health services declared by special bed care providers and subsequent and long-term bed care, with the exception of the cost of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive rehabilitation care and long-term intensive nursing care, shall be evaluated according to the type of day and patient category according to the performance list as follows:
| Kód ošetřovacího dne | Pro kategorii pacienta 1 podle seznamu výkonů | Pro kategorii pacienta 2 podle seznamu výkonů | Pro kategorii pacienta 3 podle seznamu výkonů | Pro kategorii pacienta 4 podle seznamu výkonů | Pro kategorii pacienta 5 podle seznamu výkonů | |
|---|---|---|---|---|---|---|
| 00005 | 2 119,52 | 2 292,76 | 2 560,51 | 2 768,84 | 3 095,59 | |
| 00021 | 3 100,05 | 3 339,72 | 3 645,32 | 3 892,42 | 3 867,94 | |
| 00022 | 2 488,83 | 2 675,24 | 3 640,34 | 3 913,11 | 4 163,94 | |
| 00023 | 2 385,92 | 2 802,33 | 3 078,25 | 3 309,30 | 3 768,51 | |
| 00024 | 2 527,98 | 2 738,79 | 3 006,21 | 3 210,16 | 3 411,17 | |
| 00025 | 6 830,38 | 7 206,10 | 7 695,75 | 7 867,81 | 8 053,13 | |
| 00026 | 4 022,10 | 4 495,73 | 4 882,59 | 5 153,40 | 5 443,83 | |
| 00027 | 2 774,87 | 3 090,50 | 3 954,28 | 4 252,80 | 4 375,13 | |
| 00028 | 3 073,48 | 3 218,88 | 3 510,59 | 3 885,23 | 4 153,58 | |
| 00029 | 2 710,01 | 2 892,44 | 3 133,20 | 3 426,93 | 3 703,32 | |
| 00030 | 2 625,53 | 2 757,87 | 2 965,27 | 3 101,37 | 3 237,44 | |
| 00031 | 690,66 | - | - | - | - | |
| 00032 | 690,66 | - | - | - | - | |
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Regulation Information
| Citation | Decree No. 65 / 2025 Coll., on how to measure the cost of health services for the purpose of redistribution of public health insurance premiums |
|---|---|
| Regulation Type | - |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 18.03.2025 |
|---|---|
| Effective from | 01.04.2025 |
| Effective until | - |
| Status | Valid |
Public Contracts 1
Dodatek č. 1 Smlouvy o dílo - změna výše limitu
Zdravotní ústav se sídlem v Ústí nad Labem
Zdravotní ústav se sídlem v Ostravě
1 452 000 CZK
18.11.2025
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