随着国家医保局《按病组和病种分值付费2.0版分组方案》（医保办发〔2024〕9号）的实施，特例单议机制作为DRG/DIP体系的关键补偿制度，其区域实践差异已成为影响医保支付改革成效的重要变量。本文基于政策文本分析方法，系统梳理2022-2024年国家及六省份特例单议政策文件，聚焦申请条件、申报数量、裁定机制及审核流程等核心要素开展横向比较。研究发现：各地政策呈现“阈值设定差异化”（如费用倍数标准从2倍至5倍不等）、“新技术认定多维化”（涵盖创新技术、获奖技术及临床特色技术）、“审核机制智能化”（线上双盲评审占比提升至78%）等特征，但存在准入标准碎片化、区域协同不足等制度瓶颈。建议构建“国家基准框架+省级动态调整”的弹性机制，积极落地数字赋能及AI应用，探索评审机制改革，建立相应机制，以推进特例单议政策的规范化与精准化。

With the comprehensive implementation of the Diagnosis-Related Groups and Disease Intervention Package Version 2.0 Grouping Scheme（Medical Insurance Office Notice ［2024］ No. 9）by the National Healthcare Security Administration，the exceptional case review mechanism，as a critical compensatory component of the DRG/DIP system，has seen significant regional variations in practice，which have become a pivotal factor influencing the effectiveness of healthcare payment reforms.Based on the policy text analysis method，this paper systematically reviews the special-case single-review policy documents of the state and six provinces from 2022 to 2024. It conducts a horizontal comparison by focusing on core elements such as application conditions，the number of declarations，adjudication mechanisms，and review processes. The research findings reveal that the policies in different regions exhibit characteristics such as “differentiated threshold setting”（for example，the cost-multiple standard ranges from 2 times to 5 times），“multi-dimensional identification of new technologies”（covering innovative technologies，award-winning technologies，and clinically characteristic technologies），and “intelligent review mechanisms”（the proportion of online double-blind review has increased to 78%）. However，there are institutional bottlenecks such as fragmented access standards and insufficient regional coordination. It is recommended to establish a flexible mechanism of “national benchmark framework+provincial dynamic adjustment”，actively implement digital empowerment and AI applications，explore the reform of the review mechanism，so as to promote the standardization and precision of the special-case single-review policy.