Currently, the aggregation standards for medical charge items in China are not fully unified, and various regions have developed multiple versions of aggregation standards during policy implementation, affecting the comparability of expense categories across regions. This study reviews relevant policies on item aggregation standards and regional differences in practice, and analyzes the main issues and their causes in the process of docking multiple versions of aggregation systems with current item initiation guidelines. Based on this, this study proposes suggestions for accelerating the development of standardized and normalized item initiation guidelines for medical charge item aggregation standards, which includes compiling item initiation guidelines for various disciplines released in batches, uniformly adding relevant information derived from item aggregation standards; classifying and accepting new price item applications based on the degree of technological innovation, and clarifying the aggregation standards for newly established items.