The National Health Insurance Administration (NHIA) has allocated an estimated NT$1.648 billion for new items and increased payments under the NHI coverage effective April 1, 2026 to enhance healthcare quality and capacity. The initiative includes expanding pediatric care capacity, strengthening dialysis and home care payments, adding coverage for major trauma treatments, and advancing cancer radiation therapy.

Director-General Lian-Yu Chen of the NHIA stated that pediatric care takes precedence in this adjustment. The main focus areas include:

• Pediatric and Psychiatric Care: the add-on rate for pediatric specialists caring for critical pediatric patients in ICUs is raised from 140% to 160%. The inpatient consultation fee for pediatric ICU beds at medical centers will increase from 4,620 points to 5,005 points. The add-on rate for pediatric specialists treating patients under two years old in acute general beds has been raised from 150% to 210% (increasing from 1,170 points to 1,451 points). Psychiatric day ward care fee for patients under six years old has increased from 877 points to 1,623 points. In addition, payments for seven major neonatal surgeries have been raised. For instance, the fee for necrotizing enterocolitis surgery has increased from 47,035 points to 52,072 points. The NHIA is allocating NT$228 million for these adjustments, which are expected to benefit approximately 58,000 children annually.
• Dialysis and Home Care: the NHIA increase dialysis points by approximately 2.25% to balance medical institutions' costs. Hemodialysis payment increased from 3,912 points to 4,000 per session, and peritoneal dialysis payment increased from 8,675 points to 8,870 points per month. A total of NT$1.095 billion is allocated for the adjustment, benefiting around 96,000 patients. Additionally, all home care visitation fees (including hospice care) are increased by 5%, and a new pediatric add-on rate between 20% to 60% is added (with higher rates for younger patients). These measures aim to provide patients with continuous and comprehensive care at home, supported by NT$201 million in funding.

Director Pei-Shan Huang stated that, to enhance emergency care capacity for major traumas, treatments such as neck trauma exploration, torso cavity packing for hemostasis, and resuscitative endovascular balloon occlusion of the aorta (REBOA) have been included in the NHI coverage. The inclusions enable medical teams to provide immediate care for severe injuries and improve the timeliness of life-saving interventions. A total of NT$8 million is allocated, which is estimated to benefit 1,000 people a year.

Moreover, the NHIA has expanded the eligibility for stereotactic body radiation therapy (SBRT). Now, in addition to lung and liver cancer patients, patients with prostate cancer or those with oligometastatic lung cancer or oligometastatic liver cancer are eligible for SBRT under NHI coverage, as long as relevant conditions are aligned with international guidelines. The expansion enables patients to access more effective therapies with fewer side effects, benefiting an estimated 1,500 patients annually.

As the healthcare technology advances, the NHIA will continue to adjust the NHI payment scheme to meet clinical needs. The administration remains committed to collaborating with medical professionals to safeguard public health and achieve the vision of a "Healthy Taiwan".