Circular No. 43/2017/TT-BYT stipulates the loss rate for traditional herbal medicines and the settlement of loss costs at medical examination and treatment facilities.

CIRCULAR

Regulations on the rate of loss for traditional herbal medicines and the settlement of loss costs at medical examination and treatment facilities.

costs of losses at medical examination and treatment facilities.

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Pursuant to the Medicine LawNo. 105/2016/QH13 April 6, 2016;

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 on the functions, tasks, powers, and organizational structure of the Ministry of Healthy of Health and Traditional Medicine organize credit institutions, foreign bank branches are responsible for organizing the implementation of this Circular.policies;

1. Accounting accounts reflect regularly, continuously, systematically the situation of assets, receipt and use of funds at the unit; monitor revenue, expenses, results of operations, and other items at the unit.n lThe Minister of Health issues this Circular regulating the rate of loss for traditional herbal medicines and the settlement of loss costs at medical examination and treatment facilities as follows:, amended and supplemented by Decree No. 109/2025/NĐ-CP and Decree No. 193/2025/NĐ-CP Article 2. This Circular applies to agencies, organizations, and individuals related to the export of medicinal plants listed in this Circular.

Article 1. This Circular stipulates the principles for establishing the rate of loss and provides guidance on implementing and settling health insurance costs for traditional herbal medicines (referred to as herbal medicines) during processing, storage, and weighing at medical examination and treatment facilities covered by health insurance.

Article 1. Scope of Regulation and Applicability

Article 2. This Circular applies to medical examination and treatment facilities that use herbal medicines in their medical examination and treatment activities.

Clause 1. The rate of loss of herbal medicines during the processing stage is the percentage lost after processing compared to the weight of raw medicinal materials before processing.

Article 2. Interpretation of Terms

Clause 2. The rate of loss of herbal medicines during the storage and weighing stages is the percentage lost during storage and weighing compared to the initial weight of the herbal medicines.

Article 3. Principles for determining the rate of loss of herbal medicines

Clause 1. The list of rates of loss for herbal medicines is established based on the parts used of medicinal materials to determine the rate of loss according to the principle that medicinal materials, herbal medicines with similar structures, parts used, and processing methods will have similar or nearly similar rates of loss.

Clause 2. The rate of loss is determined based on the actual processing of herbal medicines, ensuring consistency with the processing methods and procedures for medicinal materials and herbal medicines as prescribed in Circular No. 30/2017/TT-BYT dated July 11, 2017 of the Minister of Health guiding the processing methods for traditional herbal medicines and the documentation provided by medical examination and treatment facilities.

Article 4. Maximum rate of loss regulations for herbal medicines

Clause 1. Attached to this Circular is the List of maximum rates of loss for herbal medicines during processing for use at medical examination and treatment facilities (hereinafter referred to as the List).

Clause 2. The maximum rate of loss for herbal medicines during storage and weighing is determined based on the parts used: For roots, rootstocks, fruits, seeds, and barks, the rate is 2%; for other parts, it is 3%.

Article 5. Guidance on implementing the rate of loss for herbal medicines during processing, storage, and weighing

Clause 1. In cases where medical examination and treatment facilities purchase unprocessed medicinal materials, the rate of loss is calculated based on the rate of loss of each processing stage. For example, if unprocessed Huang Qi is purchased, the rate of loss for Huang Qi is calculated as follows: If sliced Huang Qi is used, the maximum rate of loss is calculated based on the processing stage at 10.0%; if honey-fried Huang Qi is used, the maximum rate of loss is 15.0%.

Clause 2. In cases where medical examination and treatment facilities purchase processed medicinal materials for further processing, the rate of loss is calculated based on the rate of loss of the complex processing stage minus the rate of loss of the preliminary processing stage. For example, if Bai Shao has been preliminarily processed (sliced), only the rate of loss during further processing is calculated, which is the rate of loss of the complex processing stage (18.0%) minus the rate of loss of the preliminary processing stage (14.0%), resulting in 4%.

Clause 3. In cases where medical examination and treatment facilities purchase ready-made herbal medicines as prescribed by the Ministry of Health, only the rate of loss during storage and weighing is calculated.

Clause 4. For herbal medicines or processing methods not included in the List attached to this Circular: Provincial Departments of Health shall examine and reach agreement with provincial social insurance agencies to decide the applicable rate of loss for traditional medicine medical examination and treatment facilities within their jurisdiction based on written proposals from medical examination and treatment facilities and the guidelines set out in Article 6 of this Circular.

4. For medicinal herbs or processing methods of medicinal herbs not included in the List attached to this Circular: The Department of Health of the province or centrally governed city shall examine and reach agreement with the provincial social insurance agency to determine the loss rate applicable to traditional medicine medical examination and treatment facilities within their jurisdiction based on the written proposal from the medical examination and treatment facility and the guidance provided in Article 6 of this Circular.

Article 6. Guidelines for health insurance payment regarding the rate of loss of medicinal herbs

1. The maximum rate of loss of medicinal herbs during processing, storage, and distribution as stipulated in Article 4 of this Circular shall serve as the basis for traditional medicine examination and treatment facilities to calculate service fees for medical examinations and treatments and health insurance payments.

2. During the procurement of medicinal herbs for examination and treatment facilities, purchase invoices must clearly indicate the state of the herbs: unprocessed, semi-processed, or fully processed, serving as the basis for calculating and applying the appropriate loss rate according to actual conditions.

3. Examination and treatment facilities shall establish a list of traditional medicinal herbs according to Model 01 in Circular No. 05/2015/TT-BYT dated March 17, 2015, issued by the Minister of Health on the List of Traditional Chinese Medicine, Herbal Medicines, and Traditional Medicinal Herbs within the scope of health insurance payment, and submit it to the health insurance agency, while providing relevant documentation related to the record-keeping of the previous year's herb processing work (Appendix 2 - Record Book for Traditional Medicinal Herb Processing Work issued together with Circular No. 05/2014/TT-BYT dated February 14, 2014, issued by the Minister of Health detailing the use of herbal medicines and traditional medicinal herbs in examination and treatment facilities) to build a list of herbs used in processing and compounding at examination and treatment facilities.

4. Based on the condition of the herbs when purchased by examination and treatment facilities (unprocessed, semi-processed, fully compounded) and the requirements for their use (semi-processing, compounding), examination and treatment facilities shall establish the rate of loss of herbs after processing based on the records of batches processed at the facility.

5. Social Insurance agencies shall base their payments on the actual loss rates during processing, the method and process of herbal medicine and herb processing, and the documentation provided by examination and treatment facilities, but not exceeding the maximum loss rate specified in this Circular.

6. Payment for the cost of loss of herbs in health insurance payments shall be based on the purchase price of the herbs as stipulated at examination and treatment facilities (purchase invoices for herbal medicines must clearly indicate the condition of the herbs at the time of purchase), the actual loss rate of herbs during processing, and the loss rate during storage and distribution, determined by the following formula:

Where:

+ P₁: Purchase price of the herbs.

+ P₂: Price of the herbs including the loss cost in health insurance payment.

+ H₁: Actual loss rate during processing at examination and treatment facilities.

+ H₂: Loss rate during storage and distribution as stipulated in this Circular.

Article 7. Effective Date

1. This Circular takes effect from January 1, 2018.

2. Circular No. 49/2011/TT-BYT dated December 30, 2011, issued by the Minister of Health on the issuance and guidance on the application of loss rates for herbal medicines and traditional medicinal herbs in processing, storage, and distribution, ceases to be effective from the date this Circular takes effect.

Article 8. Transitional Provisions

In cases where examination and treatment facilities have used the loss rate list for herbs in processing issued together with Circular No. 49/2011/TT-BYT dated December 30, 2011, issued by the Minister of Health on the issuance and guidance on the application of loss rates for herbal medicines and traditional medicinal herbs in processing, storage, and distribution before the date this Circular takes effect for health insurance payments, they may continue to apply it for thirty days from the date this Circular takes effect.

Article 9. Cross-References

In case the regulatory legal documents and provisions cited in this Circular are amended, supplemented, or replaced, they shall be implemented according to the new regulatory legal documents.

Article 10. Responsibility for Implementation

1. The Ministry of Health is responsible for updating, amending, and supplementing the list issued together with this Circular.

2. The Traditional Medicine and Herbal Medicine Management Department, the Medical Examination and Treatment Management Department, the Planning and Finance Department, subordinate units under the Ministry of Health, sectoral healthcare units, provincial and municipal health departments directly under the central government, and examination and treatment facilities are responsible for implementing this Circular.