2025年医保限定用药及诊疗项目规则数据集

该数据集是收集2025年期间国家及各省级医疗保障局当前执行的药品、诊疗项目目录和医疗服务价格项目规范、医疗保障基金结算清单填写规范等医保相关政策法规，再由医学专家进行人工整理和数字与加工后形成的规则数据集。数据涵盖医保相关规则集合。数据可用于医疗机构及医疗信息化厂商的医保基金智能审核系统的数据基础。This rule-based dataset is constructed by first collecting medical insurance-related policies, regulations and normative documents currently implemented in 2025, including drug catalogs, diagnosis and treatment item catalogs, medical service price item specifications, and medical insurance fund settlement list filling specifications, issued by the National and provincial medical security bureaus. These collected materials are then manually organized and digitally processed by medical experts. The dataset covers a comprehensive collection of medical insurance-related rules, and can serve as the data foundation for intelligent medical insurance fund review systems developed by medical institutions and medical information technology vendors.

搜集汇总

背景与挑战

背景概述

该数据集整合了2025年全国及省级医保局的药品诊疗目录、服务价格规范等政策文件，经医学专家整理形成标准化规则，主要服务于医保智能审核系统的开发与应用。