What do Level 1, Level 2, Level 3 and "Grade A Tertiary" mean for hospitals in China?

A hospital's "Level 1, Level 2, Level 3" is its level, while "Grade A" and similar terms are accreditation grades. "Grade A Tertiary" is often shortened to "Tertiary A", but this label alone cannot tell you whether a particular department can see you, whether a particular doctor is holding clinic, or whether a particular treatment is suitable for you. First be clear about the problem you are seeking care for, then check the team, services and times with the specific hospital campus.

Key points

• Hospital level and accreditation grade are not the same thing; a community health service center is a type of institution and cannot simply be equated with a Level 1 hospital.
• Routine follow-up for a stable chronic condition, common problems, complex diagnosis, or recovery after surgery may need different services; each institution's actual capabilities and admission conditions differ.
• The policy role of Level 3 hospitals focuses on acute, critical and severe illness and difficult, complex diseases, but not every Level 3 hospital can provide every technique or see you immediately.[1]
• For severe difficulty breathing, loss of consciousness, suspected stroke, heavy bleeding, or rapid worsening, call local emergency services nearby first; in mainland China, dial 120. Do not delay treatment while waiting for a hospital of a specific level.[2]

First distinguish hospital level, accreditation grade and tiered care

Term	What it tells you	What it cannot prove on its own
Level 1, Level 2, Level 3	Hospital level, used for institutional management and functional positioning at different tiers.	That the campus definitely has the specialty, beds or medicines you need.
Grade A, Grade B and other accreditation statuses	The hospital's accreditation grade or status for a given period; check the current results published locally.	A particular doctor's personal experience, current appointment availability, or individual treatment outcomes.
Tiered care	An arrangement in which different institutions cooperate by function, with referral and continuing care.	That every patient must pass through every level in a fixed order.

"Tertiary A" is short for "Grade A Tertiary". "Tertiary" (Level 3) indicates the level, and "Grade A" is the accreditation grade within that level; likewise, the "B" in "Tertiary B" is also an accreditation grade. Whether a hospital is public or non-public describes the nature of its sponsorship and does not equal the hospital's level; general hospitals, specialty hospitals and community health service centers are different types of institutions or services. [3][4]

What to ask Level 1, Level 2 and Level 3 hospitals

These are ways of deciding whom to approach for advice, not a way of triaging by disease name alone. Leave symptoms, tests and treatment needs to a doctor's judgment, and in severe situations use emergency services first.

• Level 1 hospitals and primary-care institutions: If your condition is stable and you need care for common illnesses, chronic disease monitoring or recovery-phase care, you can first ask whether a nearby institution can assess you, run tests or renew prescriptions. A community health service center is a primary healthcare institution and is not automatically called a "Level 1 hospital" just because it provides primary-care services; confirm specific services and medicines with each institution.[4]
• Level 2 hospitals: You can ask about the common-disease specialties you need, inpatient care, rehabilitation, nursing, or support for recovery after surgery. National policy emphasizes the role of Level 2 hospitals in linking Level 3 hospitals and primary-care institutions; departments and services differ by region and hospital, and it is not guaranteed that every hospital offers the same service.[5]
• Level 3 hospitals: For complex pathology or imaging review, difficult diseases, multidisciplinary collaboration and highly complex treatment, you can ask hospitals that have the relevant teams and support. National standards focus on acute, critical and severe illness, difficult and complex diseases, and specialty services; a Level 3 label does not guarantee that a treatment is suitable for you or that a bed is available.[1]

The same person may first be assessed by a specialist and then go to a nearby institution for follow-up or rehabilitation. First ask your current doctor to explain what is needed at each stage, where it can be provided, and who arranges the handover, passes on medical records and handles any changes. Whether a referral is required first and whether you can book directly should be confirmed separately with the target hospital and the insurance administrator.

Other accreditation results besides Grade A Tertiary

Accreditation looks at areas such as medical service capability, quality and safety, and management. Results and validity periods should be checked in information published by the competent authority, not in a hospital's old publicity. Taking Jiangsu Province's hospital accreditation measures as an example, accreditation grades for Level 3 hospitals include A, B and C, and the certificate's validity period is the same as the accreditation cycle; for other regions and institutions, check their own current rules.[6]

The national Accreditation Standards for Tertiary Hospitals (2025 edition) set the accreditation cycle for Level 3 hospitals at four years; it applies to Level 3 hospitals, and Level 2 hospitals may use it for reference, so you cannot assume that all institutions' certificates last four years.[1] Some institutions may be in an "ungraded" or changing accreditation status; check with the local competent authority for the institution's current level and result, and do not interpret "ungraded" directly as a conclusion about quality.

How to use this information to choose where to start

1. State the problem clearly first. Do you need a routine follow-up, a specialist opinion, surgery, hospital admission or rehabilitation? Do you have other conditions, or need support such as anesthesia, intensive care or blood transfusion? Ask your current doctor which decisions cannot wait.
2. Check the institution and campus. You can use the National Health Commission data query to look up the hospital's practice registration and doctor information; check level and accreditation grade separately in the current announcements of the local health authority. If you cannot find it, or the name or address does not match, ask the hospital and the competent authority to help verify.
3. Ask directly whether they can take on this need. Confirm with the target campus the department, doctor or team that would see you, whether they accept the patient's identification and existing records, the appointment time, and whether an in-person visit is still required before deciding on treatment; if other specialties or a transfer are needed, ask who is responsible for contacting them and handing over. Receiving your records or booking an outpatient visit does not mean admission or surgery has been arranged.
4. Check costs and follow-up. Ask the hospital about the outpatient category, cost estimate, payment method and follow-up arrangements; separately confirm with the insurer whether the specific campus and service are covered and whether pre-authorization is required. After treatment is completed, ask the local or home-area doctor who takes over to confirm who is responsible for follow-up tests, medicines and results.

If you are comparing a general hospital with a specialty hospital, different types of ownership, or two specific institutions, you can continue to How to compare hospitals relevant to your needs; that page provides the full comparison of team collaboration and care arrangements.

Frequently asked questions

Is a Grade A Tertiary hospital necessarily better for me than a Level 2 hospital?

Not necessarily. First look at the specific department, treatment, appointment time and follow-up care you need; complex problems may need a Level 3 hospital, while stable follow-up or recovery-phase care may also be done at a suitable Level 2 or primary-care institution.

Is a community health service center a Level 1 hospital?

They are not the same concept. A community health service center is one type of primary healthcare institution; ask the center whether it can provide a particular test, nursing care or medicine.[4]

Must I go to a primary-care institution first before I can go to a Level 3 hospital for an ordinary illness?

Do not assume that all patients must follow the same order. Ask the target hospital about its appointment rules and ask your insurer whether a referral is required; a doctor may also recommend a suitable starting point based on your condition. For acute, critical or severe illness, seek help nearby first.

Does every campus of a Grade A Tertiary hospital have the same specialties?

You cannot assume so. Before booking, ask whether the specific campus has the target department, tests, inpatient care and necessary backup support; campuses of hospitals with the same name may differ in location and services.

A hospital calls itself Grade A Tertiary. Where can I verify this?

Rely on the accreditation results currently made public by the local health authority, and check the hospital's legal name, the date of the result and the campus it applies to; if in doubt, confirm with the authority and the hospital.

Will medical insurance or commercial insurance automatically pay because of the hospital's level?

It is not determined by level alone. Check with the insurance administrator your own eligibility, the specific institution and service, and referral and pre-authorization requirements, and confirm with the hospital about direct billing, paying up front and receipts.

Is a hospital with an ungraded accreditation necessarily unsafe?

You cannot judge on "ungraded" alone. Check its practice registration, actual team and the support you need, find out what the local accreditation status means, and if necessary compare with your current doctor.

Sources

1. National Health Commission: Accreditation Standards for Tertiary Hospitals (2025 edition) and notice: role of Level 3 hospitals, application of the standards and cycle.
2. Beijing Communications Administration: Common emergency help numbers: medical emergency number in mainland China.
3. National Health Commission: Reply on hospital accreditation work: hospital level, accreditation grade and management.
4. Law of the People's Republic of China on Basic Medical and Health Care and Health Promotion: primary healthcare institutions and ownership types of medical institutions.
5. General Office of the State Council: Several Measures to Accelerate the Building of a Tiered Care System: primary care, Level 2 hospitals and referral collaboration; confirm actual services with the institution.
6. Jiangsu Province Hospital Accreditation Measures: example of Jiangsu Level 3 hospital grades and certificate validity, not to be generalized to the rules for all institutions nationwide.

Source check date: 2026 year 11 month 6 day. Accreditation rules and results may change; rely on the information published by the local competent authority at the time.