▲ Manual therapy (The photo above is not related to the content of the article.)
The government expects that by classifying manual therapy as a "managed benefit" and limiting its price and frequency, the annual cost to the national health insurance fund will be capped at a maximum of 33.7 billion won.
The Ministry of Health and Welfare explained that considering the current annual health insurance claims related to manual therapy, such as consultation fees, amount to approximately 200 billion won, the fiscal impact of transitioning to a managed benefit system is about one-sixth of the current related expenditure.
According to the government, the medical community, and labor circles on Wednesday (June 10), the 10th Health Insurance Policy Deliberation Committee held on the 4th of this month established the fee schedule and coverage criteria for manual therapy as a managed benefit.
A "managed benefit" refers to a system where medical services requiring appropriate utilization management are selected as preliminary health insurance items for coverage.
At the committee meeting, it was decided that the price for a 30-minute session of manual therapy would be set at 43,850 won, with the same rate applied across all types of medical institutions, from tertiary hospitals to local clinics.
The frequency of treatment is limited to twice a week and a total of 15 times per year, regardless of the area being treated.
However, patients may receive up to 24 sessions of manual therapy per year, including the initial 15, based on a physician's medical judgment.
For the treatment cost, the national health insurance will cover 5%, while the patient will be responsible for the remaining 95%.
The government estimates that if this system is implemented starting next month, the annual health insurance expenditure for manual therapy will range from a minimum of 20.8 billion won to a maximum of 33.7 billion won.
A Ministry of Health and Welfare official explained, "Hospitals typically bill health insurance for consultation fees while performing manual therapy in combination with physical therapy, which amounts to about 200 billion won annually. By spending around 30 billion won from the health insurance fund (as a managed benefit) and controlling manual therapy through frequency limits, we are effectively saving health insurance funds indirectly."
The official added, "We have set the evaluation cycle for manual therapy as a managed benefit to three years, the shortest among the three-, five-, and ten-year options. We also plan to conduct an interim evaluation in about a year and a half to discuss potential adjustments to the frequency limits."
At the same committee meeting, it was also mandated that basic physical therapy and simple rehabilitation therapy must be performed prior to manual therapy.
Some have pointed out that this structure might ultimately favor traditional Korean medicine clinics, as they often combine Chuna manual therapy with manual therapy.
In response, the Ministry of Health and Welfare stated, "This is not a structure that favors traditional Korean medicine hospitals," and added that they plan to manage the system to prevent traditional Korean medicine clinics from performing both Chuna manual therapy and manual therapy on the same patient simultaneously in the future.
※ Please note: This article was translated by AI and may contain errors.