자동차보험 진료수가에 관한 기준, 심사지침(21년 5월 기준)

 

자동차보험 수가는 건강보험 기준과는 

동일한 점도 있지만 다른 점도 많습니다.

 

기준에 대해 알아두면 좋으니, 참고하기 바랍니다.

 

 

자동차보험진료수가에 관한 기준
(국토교통부 고시 제2020-1136호)

 

제1장 총칙 ····················································································································3
제2장 진료의 기준 및 진료수가의 인정범위 및 산정방법 ················································4
제3장 진료수가의 청구･지급절차 및 방법 등 ·································································8
제4장 보칙 ····················································································································8
(별표 1) 건강보험기준과 달리 적용하는 사항 ································································12
(별표 2) 건강보험기준에 규정되지 않았거나 요양급여로 정하지
아니한 진료항목에 대한 사항 ··········································································15
(별표 3) 자동차보험 진료수가 적용기준 및 방법에 관한 세부사항 ································21
(별표 4) 교통사고환자 시범재활치료 항목 및 기준에 관한 사항 ····································30
(별지 제1호 서식) 교통사고환자 진료기록 확인 요청서 ·················································39
(별지 제2호 서식) 교통사고환자에 대한 진료비 지급보증 중지 통보서 ·························40
(별지 제3호 서식) 교통사고 입원환자 퇴원 가능 소견서 ···············································41
(별지 제4호 서식) 입원진료비 지급보증 중지(불가) 통보서 ···········································42
(별지 제5호 서식) 교통사고환자 진료비 안내문 ····························································43
(별지 제6호 서식) 자동차보험 시범재활치료계획 및 환자동의서 ···································44
(별지 제7호 서식) 재활치료계획서 ················································································45
(별지 제8호 서식) 재활심리상담(개인) 결과서 ······························································46
(별지 제9호 서식) 자동차보험 재가적응훈련계획 및 동의서 ··········································47
(별지 제10호 서식) 요양병원 환자지원 심층평가표 ······················································48
(별지 제11호 서식) 요양병원 퇴원지원 표준계획서 ······················································53

 

국토교통부 행정해석

「자동차보험진료수가에 관한 기준」 일부 개정 관련 Q&A 안내 ········································57
자동차보험진료수가 한방물리요법의 진료수가 및 산정기준 알림 ·····································58
「정신건강복지법」 관련 시범사업 수가 자동차보험 적용 알림 ··········································60
자동차보험진료수가 관련 사항 알림(타 요양병원 간 입원료 체감제) ·······························…61

 

자동차보험 심사지침

1. 행위 ···························································································································65
2. 검사 ···························································································································67

 

국민건강보험법 시행규칙

(별표 7) 보조기기에 대한 보험급여기준 ··········································································71

 

산업재해보상보험 요양급여 산정기준

(별표 2) 산재보험에서 추가로 인정하는 요양급여의 범위 및 비용산정기준 ·····················85
제 1 절 치과보철 ·········································································································85
제 2 절 재활보조기구 ··································································································88
제 4 절 화상환자에게 인정하는 약제 및 치료재료 등 ················································100
제 7 절 치료보조기구 ································································································101
제10절 재활치료료 ···································································································102
제11절 냉각부하검사료 ····························································································107
산재보험 요양급여 산정기준 관련 청구코드 ···································································108

 

응급의료수가기준

응급의료수가기준 ··········································································································121
(별표 1) 응급의료수가 기준액표 ····························································································123
응급의료에 관한 법률 ····································································································125
응급의료에 관한 법률 시행규칙 ·····················································································125
(별표 1) 응급증상 및 이에 준하는 증상 ·················································································126
(별표 3) 이송처치료의 기준 ···································································································127

 

자동차손해배상 보장법

제1장 총칙 ················································································································131
제2장 손해배상을 위한 보험 가입 등 ··········································································135
제3장 자동차보험진료수가 기준 및 분쟁 조정 ····························································158
제4장 책임보험등 사업 ······························································································165
제5장 자동차사고 피해지원사업 ·················································································171
제6장 자동차손해배상진흥원 ·····················································································201
제6장의2 자동차사고 피해지원기금 ···········································································206
제6장의3 자율주행자동차사고조사위원회 ·································································210
제7장 보칙 ················································································································217
제8장 벌칙 ················································································································233
제9장 범칙행위에 관한 처리의 특례 ···········································································238

 

 

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