Under Decision 2775 issued by the Ministry of Health and effective from August 29, 2025, each X-ray scan must last at least six minutes, while each echocardiography procedure must take no less than 30 minutes to be eligible for payment from the health insurance fund. If these time thresholds are not met, medical facilities may not be reimbursed for related examination and treatment costs.

Recent implementation has revealed multiple shortcomings in administrative procedures and reimbursement processes, prompting concern among healthcare workers, particularly those working in diagnostic imaging.

N.T.D, MA, a diagnostic imaging doctor in HCMC, said the regulation does not align with current professional practice. With advances in technology, modern equipment, and improved physician expertise, an X-ray scan can be completed within seconds.

“Doctors just press a button and the scan is done. It is impossible to make patients lie in the X-ray room for six minutes just to meet reimbursement requirements,” N.T.D said.

Similarly, in echocardiography practice, some cases require only two to three minutes to clearly detect abnormalities, while others may take 10 to 15 minutes or longer. Current regulations require every echocardiography session to last at least 30 minutes, so doctors have to wait out the required time even when results are already available.

“If applied rigidly, one echocardiography machine can only perform about eight cases in a morning. Consequently, patients have to wait a very long time, leading to frustration and potential conflict within hospitals,” Dr. N.T.D said.

He noted that medical expertise cannot be evaluated with a stopwatch because some pathologies are obvious within minutes, while others require more time.

Associate Prof Nguyen Hoai Nam, former senior lecturer at the University of Medicine and Pharmacy, HCMC, also described the regulation as problematic in health insurance reimbursement. He said many regulations are making professional work more difficult and failing to reflect the true nature of medical examination and treatment.

Nam noted that with today’s advanced equipment, an X-ray scan takes only five to 10 seconds to complete. In many cases, doctors can identify pathology as soon as the ultrasound probe is placed.

“It is unreasonable to force patients to wait just to legitimize reimbursement procedures,” he said.

Nam emphasized that if doctors work too hastily or carelessly, patients themselves will complain. Professional effectiveness should be evaluated based on diagnostic accuracy, not execution time. Some doctors can identify lesions at a glance, while others may take much longer and still miss abnormalities. That is a matter of expertise, not time.

In response to feedback from medical workers, Dr Nguyen Trong Khoa, deputy director of the Medical Examination and Treatment Management Department under the Ministry of Health, said the ministry has worked with the insurance authority to clarify interpretations and make appropriate adjustments.

According to Dr. Khoa, the Ministry of Health has held several meetings with Social Security to develop more realistic guidelines. Specifically, the Ministry will coordinate with the Radiological Society to standardize professional processes based on a national survey, thereby adjusting the average time for X-rays and other diagnostic imaging techniques.

The Ministry of Health will also send an official document to the Ministry of Finance and Vietnam Social Security (VSS) to review appraisal and payment activities to ensure they fit medical practice.

Experts explain that an X-ray session includes the entire process: waiting for one’s turn, patient reception, preparation, technical execution, film reading, and returning results. Therefore, insurance payments or rejections should not be based solely on the machine's operating time. The 6-minute mark is currently intended only as the average time for a standard X-ray.

Deputy Director Nguyen Trong Khoa affirmed that time norms are for reference only and are not mandatory requirements for every specific case. The duration of a technique depends on the complexity of the disease, the doctor's skill, and the equipment.

“Health insurance inspection and reimbursement should focus on the appropriateness of indications and professional processes, rather than rigidly applying time thresholds,” Khoa said.

Vo Thu