New Policy Effective March 1：China's Public Hospitals No Longer Mandate CT Film Fees, Patients May Voluntarily Purchase at Cost Price

China's public healthcare system underwent a significant transformation on March 1, 2026, as the National Healthcare Security Administration and the National Health Commission jointly implemented new radiological examination pricing standards. The policy mandates that all public medical institutions abolish three categories of unreasonable charges that have long burdened patients undergoing CT examinations. Under the new rules, medical thermal film is no longer bundled into examination fees; patients may now voluntarily choose whether to purchase physical film prints at the actual procurement cost, with hospitals prohibited from marking up prices. Healthcare authorities project the reform will reduce patient expenses by over RMB 10 billion annually and eliminate approximately 200 million redundant examinations each year. The policy represents the most comprehensive national standardization of radiology service pricing in recent years.

The reform eliminates three specific charges that patients have long criticized as unfair. First, the mandatory CT film production and reprinting fees are abolished. Previously, hospitals routinely printed physical medical thermal film copies for every CT examination, charging patients between RMB 20 and RMB 80 regardless of whether the patient actually needed the film. Under the new policy, medical thermal film is removed from the examination price bundle entirely. Public hospitals must provide free electronic imaging and electronic reports that patients can access, save, and share via mobile phones or self-service kiosks. When patients genuinely require physical medical thermal film for referrals, reimbursement, or archival purposes, hospitals may sell the film at cost price—the actual procurement cost with zero markup—and only after obtaining the patient's informed consent.

Second, the policy eliminates split-item charges and unreasonable technical service fees. Some hospitals previously fragmented a complete CT examination into multiple line items—scanning fees, imaging fees, image processing fees, positioning fees—or charged extra technical operation fees for routine scans. The new rules mandate a single all-inclusive price per examination site: RMB 280 at tertiary hospitals, RMB 260 at secondary hospitals, and RMB 240 at primary care facilities. All routine operations, image processing, and data storage are included in this single fee, with no additional charges permitted. The all-inclusive pricing model eliminates the confusion of fragmented bills and prevents hospitals from disguising additional fees. Specialized procedures such as thin-slice scanning, multi-phase contrast enhancement, and three-dimensional reconstruction may still incur additional charges, but only with the patient's explicit informed consent.

Third, the policy abolishes cross-institution image retrieval fees and result-recognition review fees. The national government has simultaneously strengthened the mutual recognition of examination and test results across healthcare facilities. CT reports issued by secondary and above public medical institutions are now nationally interoperable and mutually recognized within their validity period. Hospitals may not charge fees for retrieving, reviewing, or verifying images from other institutions, nor may they force patients to undergo duplicate examinations. This provision not only saves money but also reduces unnecessary radiation exposure and saves time—particularly benefiting patients with chronic diseases, cancer, and cardiovascular conditions who require regular follow-up imaging. The national medical imaging cloud platform, currently accumulating over 430 million indexed records, further supports this interoperability by enabling cross-province image retrieval with patient authorization.

For patients, the new policy delivers tangible financial relief and greater autonomy. A patient from Zibo, Shandong province, who requires semi-annual lung CT, previously paid approximately RMB 50 per visit for four to five sheets of medical thermal film. Under the new rules, the patient can access cloud-based images via mobile phone QR code at no charge, saving over RMB 100 annually. Another patient, an 86-year-old undergoing pelvic CT after surgery, reported that the new policy made the entire process smoother and more transparent, with clear pricing and the option to decline film printing. The policy applies to all public medical institutions nationwide, including general hospitals, specialized hospitals, township health centers, and community health service centers. Private hospitals may refer to the policy, and designated medical insurance institutions are required to strictly comply.

For hospitals and medical thermal film suppliers, the policy introduces significant operational adjustments. Public hospitals must now provide digital imaging storage and upload services free of charge. Institutions unable to offer compliant digital imaging services must reduce relevant radiology examination prices by RMB 5 per patient. Medical thermal film is no longer included in examination prices; it may only be sold separately when patients request it and provide informed consent, at the actual procurement price with zero markup. This zero-markup requirement means hospitals cannot profit from medical thermal film sales, fundamentally altering the economics of film distribution. Some hospitals had already piloted this approach before the national mandate—Zibo Central Hospital began implementing the policy as early as August 1, 2025.

The policy's impact on China's medical thermal film market is expected to be substantial but nuanced. China's annual consumption of medical thermal film exceeds 650 million sheets, with a market value approaching RMB 6 billion. The new rules requiring voluntary purchase and zero-markup sales will likely reduce overall medical thermal film volume as more patients opt for free digital alternatives. However, medical thermal film retains essential use cases—surgical planning, multidisciplinary team meetings, patient consultations, and legal documentation—that will continue to sustain demand. The shift from mandatory bundling to voluntary purchase represents a transition from volume-driven to value-driven consumption of medical thermal film, where quality and clinical necessity rather than automatic inclusion determine usage.

The policy builds upon broader healthcare reforms including the separation of medical consumables from service prices, centralized procurement programs, and DRG/DIP payment system reforms. The National Healthcare Security Administration has emphasized that medical consumables should be gradually separated from price items, allowing market mechanisms and centralized procurement to play their roles. The new CT film policy exemplifies this principle in action—medical thermal film is now a separate, optional consumable rather than an automatic component of examination services. This alignment with broader reform direction suggests the policy will remain in effect and may extend to other imaging modalities and consumables.

Implementation oversight is robust. Local medical insurance departments were required to complete price item adjustments, system upgrades, and public notifications before March 1. Health commissions at all levels are responsible for monitoring service compliance and ensuring result recognition. Market supervision authorities are conducting price inspections and will penalize institutions that refuse to comply, impose hidden fees, or force bundling. Some regions, such as Zibo, have established special inspection teams to conduct on-site audits of hospital charging practices. These enforcement mechanisms ensure the policy's benefits reach patients as intended.

In conclusion, the March 1, 2026 policy eliminating mandatory medical thermal film charges represents a landmark achievement in China's healthcare pricing reform. By removing three categories of unreasonable fees—forced film charges, split-item service fees, and cross-institution retrieval fees—the policy delivers meaningful cost savings and greater transparency for patients. Medical thermal film remains available for patients who genuinely need physical copies, sold at cost with zero markup and only upon voluntary request. The reform projects annual patient savings exceeding RMB 10 billion and the elimination of approximately 200 million redundant examinations. For the medical thermal film industry, the policy accelerates the transition from bundled, volume-driven sales to value-driven, clinically indicated usage. As digital imaging infrastructure continues to expand—with 25 provinces having established provincial imaging clouds and the national medical imaging cloud platform accumulating over 430 million records—the complementary relationship between digital and physical imaging media will continue to evolve. The enduring clinical value of medical thermal film—durability, portability, and independence from digital infrastructure—ensures that this imaging medium will retain an essential role in Chinese healthcare, even as patients increasingly embrace the convenience and cost savings of digital alternatives.