This article systematically reviews the policy texts and practical cases related to the management of excluded medical consumable charge across various provinces. It conducts a historical analysis and examines current characteristics and future development prospects of management models for excluded medical consumable charge in China. The research shows that in terms of the evolution of management models, each province has used "excluded content" as the core management framework in the past, and adapted policies based on local practical needs. However, there are differences in the management standards for excluding charges for the same medical consumables among provinces. During the implementation of the “separation of technology and consumable” reform and the introduction of relevant guides for project initiation, three management models have been initially formed nationwide, namely supporting chargeable consumables for the guides, compiling a catalog (list) of separately chargeable consumables, and implementing the national nonbasic material consumption list. These three models, in order, show the practical characteristics of steady transition, system optimization, and one-step implementation. At the same time, research has found that the boundaries and attributes of charging for a few basic consumables still need to be further clarified. Based on those findings, this paper recommends that we advance the national standardized management of excluded medical consumable charge in a phased and prudent manner, following the operational logic of “transition first, integration next, followed by fine-tuning”. Concurrently, we should establish and refine a dynamic adjustment mechanism for excluded consumable charge, in order to provide practical guidance for enhancing the efficiency of medical consumable charge management and balancing the interests of multiple stakeholders.