Jakarta, hainews.id – Pemerintah merilis aturan baru terkait standar tarif (tarif kapitasi) pelayanan kesehatan di fasilitas kesehatan tingkat pertama FKTP) yang dilayani olek klinik, dokter keluarga, hingga puskesmas dan fasilitas rujukan tingkat lanjutan. Tarif kapitasi ini akan menjadi rujukan pembayaran oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan pada 2023 ini.
Aturan kapitasi 2023 ini tertuang dalam Peraturan Menkes Nomor 3 Tahun 2023 tentang Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan.
“Tarif kapitasi adalah besaran pembayaran per kapita per bulan yang dibayar di muka oleh BPJS Kesehatan kepada Fasilitas Kesehatan Tingkat Pertama berdasarkan jumlah peserta yang terdaftar tanpa memperhitungkan jenis dan jumlah pelayanan kesehatan yang diberikan,” tulis peraturan yang ditandatangani Menteri Kesehatan Budi Gunadi Sadikin, Minggu (15/1/2023).
Puskesmas sebesar Rp3.600 sampai dengan Rp9.000 per peserta per bulan
Rumah sakit Kelas D Pratama, klinik pratama, atau fasilitas kesehatan yang setara sebesar Rp9.000 sampai dengan Rp16.000 per peserta per bulan
Praktik mandiri dokter atau praktik dokter layanan primer sebesar Rp8.300 sampai dengan Rp15.000 per peserta per bulan; dan
Praktik mandiri dokter gigi sebesar Rp3.000 sampai dengan Rp4.000 per peserta per bulan.
Besaran tarif kapitasi terhitung 2023 ini nantinya akan disesuaikan dengan negosiasi dan penilaian oleh BPJS Kesehatan. “Besaran tarif sebagaimana dimaksud pada ayat (1) ditetapkan oleh BPJS Kesehatan berdasarkan kesepakatan dengan asosiasi fasilitas kesehatan,” tulis pasal 5 ayat (2) aturan teranyar ini.
Sementara itu dalam aturan sebelumnya yakni Peraturan Menkes Nomor 52 Tahun 2016 tentang Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan, standar tarif kapitasi di Fasilitas Kesehatan Tingkat Pertama (FKTP) ditetapkan sebagai berikut:
Puskesmas atau fasilitas kesehatan yang setara sebesar Rp3.000 sampai dengan Rp6.000 per peserta per bulan
Rumah sakit Kelas D Pratama, klinik pratama, praktik dokter, atau fasilitas kesehatan yang setara sebesar Rp8.000 sampai dengan Rp10.000 per peserta per bulan; dan
Praktik perorangan dokter gigi sebesar Rp2.000 per peserta per bulan.
“Besaran tarif kapitasi yang diterima oleh FKTP ditentukan melalui proses seleksi dan kredensial yang dilakukan oleh BPJS Kesehatan melibatkan Dinas Kesehatan Kabupaten/Kota dan/atau Asosiasi Fasilitas Kesehatan dengan mempertimbangkan sumber daya manusia, kelengkapan sarana dan prasarana, lingkup pelayanan, dan komitmen pelayanan,” tulis aturan itu.
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