An analysis and evaluation of the direct settlement policy for cross-regional medical treatment under basic medical insurance can provide valuable reference for the formulation, adjustment, and refinement of relevant policies in the future. This study examines ten national-level policies concerning direct settlement for cross-regional medical treatment, employing a PMC index model for quantitative assessment. Findings reveal that the average PMC index for these policies stands at 6.88, with six policies rated as excellent and four as good, indicating generally sound quality in national-level policies. Nevertheless, certain policies exhibit room for improvement in policy timeliness, target groups, content, and tools. Accordingly, the following recommendations are proposed: Coordinate the sequencing of policy objectives to enhance the synergy of policy timeliness; Strengthen multi-departmental collaboration to improve the coordination among issuing authorities; Optimise the structure of policy instruments to balance the frequency of use across the three categories.