Starting January 1, Hong Kong’s Hospital Authority (HA) will introduce a new tiered payment system for certain non-urgent outpatient radiology services, aiming to reduce patient no-shows, shorten lengthy wait times, and optimize resource allocation within the public healthcare system. This overhaul involves itemized charges for imaging procedures performed following discharge or set via clinical appointments, moving away from the previous universal free structure for these categories. While core emergency care and inpatient imaging will remain entirely free, patients booking non-urgent tests like CT, MRI, and specialized ultrasounds must now pay a subsidized fee, capped at HK$500 per procedure.
New Payment Structure Takes Effect
The updated fee schedule groups non-urgent radiology into three categories: basic, advanced, and premium. Basic services, primarily covering plain X-ray examinations, will continue to be administered free of charge. Advanced procedures, which include services such as fluoroscopy and contrast-enhanced ultrasound, will cost HK$250 per item. Premium services—encompassing highly demanded and resource-intensive modalities such as MRI, angiography, and interventional radiology—will incur a charge of HK$500 per item.
A critical component of this change is the mandatory advance payment requirement for non-urgent appointments. For services booked after the new year, patients must settle their fees at least 14 days prior to their scheduled appointment date; failure to pay will result in automatic cancellation of the slot. The HA will manage this transition with a three-month grace period at the beginning of the year, allowing same-day payment for bookings secured before the New Year holiday. Full enforcement of the 14-day prepayment rule begins in mid-April.
Addressing No-Shows and Reducing Wait Times
Hospital Authority officials noted that approximately 10% of patients currently fail to attend their booked appointments, resulting in wasted capacity and prolonged delays for others. By requiring prepayment, the HA anticipates a significant reduction in appointment cancellations and no-shows, freeing up scarce slots for patients with urgent clinical needs.
The impact on waiting times is expected to be substantial. Demand for diagnostic imaging has surged in recent years, with annual CT scans increasing from roughly 439,000 in the 2014/15 fiscal year to about 691,000 in 2023/24. Waits for non-urgent imaging can be staggeringly long. In 2023/24, routine cases faced median waiting times exceeding three years for both CT (192 weeks) and MRI (190 weeks). Officials project that the streamlined system could cut wait times for the highest-priority cases from an average of three weeks down to one week, significantly improving timely access for critically ill patients.
Protecting Access and Resource Management
Despite the introduction of fees, the HA maintains a substantial subsidy level estimated at around 90% of the actual cost for these procedures, ensuring the system remains accessible. To protect vulnerable populations, the HA has emphasized that full fee waivers are available for patients experiencing financial hardship. Patients who have not applied for a waiver in advance will still receive their necessary examination, and assistance will be provided afterward to complete the application process.
The move is framed as a necessary measure for sustainable public healthcare management. While basic X-rays are low-resource procedures, services like MRI and angiography require complex, expensive equipment and highly specialized staffing, justifying the modest co-payment. Appointments cancelled due to non-payment require a fresh medical referral for rebooking. Furthermore, scheduled appointments that are missed or cancelled within 14 days of the date will not be refunded, except with valid medical justification or if a clinician determines the service is no longer required. The HA will send payment reminders through its mobile application, HA GO, and via mail.