Objective: Based on the longitudinal perspective, this paper organizes and analyzes the contents and characteristics of the changes within the nine editions of the National Healthcare Insurance Drug Catalog on proprietary Chinese medicine and Chinese herbal medicine decoction pieces, offering insights for the development and enhancement of healthcare insurance policies concerning Chinese medicine. Methods: The documentary analysis method was mainly used to analyze the relevant important policy documents. Descriptive analysis was adopted to compare and analyze the adjustments of western medicines, proprietary Chinese medicine and Chinese herbal medicine decoction pieces in the National Healthcare Insurance Drug Catalog over the past years. Results: The number of proprietary Chinese medicines in the catalog showed an upward trend, but the growth rate slowed down, with an average annual growth rate of 10.66%, which exceeded that of western medicines. By 2023, the number of proprietary Chinese medicines in the catalog has increased by 701 compared with the first edition, with an increase rate of 112.70%. In terms of the proportion of Class A drugs, western medicine was always higher than proprietary Chinese medicines, but the gap between the two is narrowing year by year. The number of proprietary Chinese medicines during the agreement period of negotiated drugs continued to increase, although the proportion was insufficient. In the classification of proprietary Chinese medicines, internal medicine medications accounted for the largest proportion. The management of Chinese herbal medicine decoction pieces has shifted from an exclusion regulation to an admission regulation, ensuring the fairness of medication in various regions. Conclusion: The longitudinal analysis shows that the adjustment of the number and structure of proprietary Chinese medicine and Chinese herbal medicine decoction pieces is more reasonable, and the number of proprietary Chinese medicines has increased significantly, which fully reflects the increasing support of the healthcare insurance system for Chinese medicine.