HONG KONG – Starting Jan. 1, Hong Kong’s public healthcare system, managed by the Hospital Authority (HA), will implement a new itemized charging structure for non-urgent outpatient and post-discharge radiological services. This overhaul seeks to optimize resource allocation, curb “no-show” appointments, and shorten substantial waiting times for advanced imaging procedures like CT and MRI scans. The new policy mandates advance payment for services, although basic X-ray examinations will remain free of charge.
The new structure divides non-emergency radiology into three tiers: basic, advanced, and premium, with fees capped at HK$500 per procedure. Urgent imaging performed in the Accident and Emergency Department or during inpatient care will continue to be provided without charge. Officials state that the primary goal is to shift resources toward the most clinically urgent cases by improving appointment attendance and generating revenue to offset the rising cost of complex diagnostics.
New Payment Rules to Curb Missed Appointments
A core component of the reform is the requirement for patients to settle non-urgent radiology fees at least 14 days before their scheduled appointment date. The HA noted that approximately 10% of current appointments are missed, significantly wasting clinical capacity. By introducing a mandatory prepayment system, the authority aims to ensure capacity is utilized efficiently.
The implementation will include a phased rollout. A three-month transition period, running from January through March, will allow patients to make same-day payments if their appointment was booked before the New Year. The full 14-day prepayment rule becomes mandatory from mid-April onward. Failure to pay within the deadline will result in automatic cancellation, requiring a fresh medical referral to rebook.
The fee structure reflects the complexity and resources required for each service:
- Basic Services: Plain X-rays remain free.
- Advanced Services: Procedures like fluoroscopy and contrast-enhanced ultrasound will cost HK$250.
- Premium Services: Complex modalities, including MRI, angiography, and interventional radiology, will be charged the maximum of HK$500.
Addressing Decades-Long Wait Times
The charging mechanism is a direct response to soaring demand and ballooning public waiting lists. Data shows that annual CT scans increased from approximately 439,000 in 2014/15 to 691,000 in 2023/24, while MRI scans rose from 82,000 to 111,000 during the same period.
The increasing volume has resulted in unsustainable delays for non-urgent patients. Median waiting times for routine CT and MRI scans exceed three and a half years (192 and 190 weeks, respectively). While first-priority cases currently wait around three weeks for these high-demand scans, the HA projects that the new framework could cut those priority waits in half, from about two weeks down to one.
The HA emphasized that a high subsidy level—approximately 90% of the actual cost—will be retained across the system, ensuring essential services remain affordable. Furthermore, comprehensive fee waivers are available for patients experiencing financial hardship.
A strict cancellation policy accompanies the new payment rules: missed appointments or cancellations made less than 14 days before the appointment will not be refunded, except in cases supported by valid medical documentation or clinical assessment. Patients will receive payment reminders via the HA GO mobile application or postal mail.
The long-term impact is expected to generate a more accountable system, reducing unnecessary scheduling blockages and reallocating scarce, expensive diagnostic slots to patients with the most pressing clinical needs.