The National Health Insurance Administration (NHIA) has increased payments for pediatric care, childbirth, inpatient nursing care, and major surgeries. These adjustments aim to better reflect the contributions of healthcare professionals, improve the care environment, and enhance the quality of healthcare services for the public.

• Working Environment for Nurses and Inpatient Care (NT$2.137 billion): The NHIA has increased payments for acute beds and special beds by 5%, raised inpatient care fees for chronic beds and chronic psychiatric beds by 10%, and increased the add-on reimbursement for acute general beds in remote areas from 15% to 30%.

• Obstetrics and Gynecology (NT$1.77 billion): Reimbursement for childbirth has been increased by 50%, reimbursement for high-risk obstetric surgeries has been doubled, and reimbursement for difficult and complex deliveries has been tripled. In total, these measures are estimated to benefit approximately 110,000 maternity patients. In addition, for patients with high-risk or rare complications, such as amniotic fluid embolism, severe preeclampsia with a high risk of organ failure, or pulmonary arterial hypertension, the Diagnosis Related Group (DRG) payment system will not apply; these cases will be reimbursed under the fee-for-service payment system.

• Pediatric Care (NT$231 million): A 10% add-on reimbursement has been introduced for inpatient consultations provided by pediatric specialists for patients under 19 years of age, payment points have been increased for 15 items of pediatric cardiac catheterization and surgeries, and the reimbursement program for early intervention outpatient services has been amended.

• Neurosurgery (NT$300 million): The reimbursement adjustments primarily target central nervous system surgeries. Previously, when two procedures were performed through the same incision, the first procedure was reimbursed in full, while the second received 50% reimbursement. Under the new policy, 11 NHI-covered central nervous system procedures will receive full reimbursement for patients with multiple traumatic injuries who qualify for catastrophic illness certification.

• Plastic Surgery (NT$290 million): Reimbursement has been adjusted for 38 items of burn injury treatments and multi-layer skin graft procedures. For example, payment points for burn wound treatment have increased from 4,431–17,854 to 10,319–33,916 points, depending on the total body surface area (TBSA) affected by burns.

• Gastrointestinal Surgery (NT$260 million): Payments have been adjusted for 21 gastrointestinal procedures, including those involving the liver, pancreas, gallbladder, and stomach. The payments have increased from 30,068–105,371 to 58,955–206,610 points. Given the complexity of pancreatectomy for malignant tumors, the NHIA has added three procedures, including the Whipple procedure with lymph node dissection and vascular reconstruction to the coverage. Depending on the extent of pancreatic resection, payments range from 76,642 to 268,593 points.

• Cancer-Related Colorectal Surgery (NT$220 million): The NHIA has increased payments for 11 cancer-related procedures, including left hemicolectomy or sigmoid colectomy with anastomosis and lymph node dissection, with increases ranging from 15% to 218%.

• Orthopedics (NT$70 million): Periacetabular osteotomy (39,623 points) and non-fusion surgery for early-onset scoliosis (70,420 points) have been added to the NHI coverage. Additionally, the payment points for four other orthopedic surgeries have been increased by 35% to 157%.

NHIA Director General Lian-Yu Chen stated that the NHIA will continue to align with the Healthy Taiwan policy and adjust healthcare service reimbursement based on clinical practice and healthcare workforce needs, while ensuring the sustainability of the NHI program and safeguarding public health.