From now on, the price of manual therapy will be standardized at 43,850 won per session. The number of manual therapy sessions available in a year will be limited to 15. The Ministry of Health and Welfare said on the 1st that it decided this to reduce overtreatment and cut medical costs.
◇ Manual therapy management benefit launched… sessions limited to 15 a year
The Ministry of Health and Welfare will implement the manual therapy management benefit system starting today. A management benefit is an intermediate stage between covered and noncovered care. Patients pay 95% of the treatment cost, and national health insurance pays 5%. For covered care, national health insurance pays; for noncovered care, patients pay the full treatment cost.
Manual therapy has been a noncovered item not reimbursed by national health insurance. Prices varied by hospital, and it was easy to claim under indemnity insurance, making it a representative category for overtreatment. A ministry official said, "We are implementing the management benefit system to ease the burden of medical expenses on the public."
The government will limit manual therapy to two sessions per week and up to 15 sessions per year per patient. When joint contracture and other issues occur due to surgery or fractures, exceptions of up to 24 sessions per year are possible based on medical judgment. When individuals receive manual therapy for personal needs such as fatigue recovery or posture correction, national health insurance and indemnity insurance will not apply. It can be used at one's own expense.
The government says patients can first receive rehabilitation or physical therapy before manual therapy. For example, if a patient visits a hospital with a musculoskeletal problem, they can undergo about two weeks of rehabilitation, and if symptoms do not improve, they can choose manual therapy.
◇ "Infringement of treatment rights" vs. "low effectiveness of manual therapy"
The medical community argues that treatment rights are being infringed. With manual therapy prices falling and conditions becoming stricter, hospitals may scale back operations. There is concern that not only manual therapy but also other noncovered items could become subject to management benefits. The Korean Medical Association Organization held an "anti–manual therapy management benefit rally" on the 28th in Jung-gu, Seoul, and said, "Stop it immediately."
A ministry official, referring to this, explained, "Manual therapy has been noncovered because it is recommended as having low effectiveness," adding, "Clinicians can determine (based on the patient's condition) that manual therapy is not necessary or choose another treatment with better effectiveness."
The ministry says it limited the number of manual therapy sessions and other factors by reflecting medical community opinions. A ministry official said, "According to data related to indemnity insurance, manual therapy is performed an average of 12 times a year," adding, "Even if we limit it to 15 sessions a year, we can cover 95% of eligible patients." An official at the Health Insurance Review & Assessment Service (HIRA) said, "There may be exception groups that need additional manual therapy sessions (such as pediatric congenital muscular torticollis)," adding, "We will monitor in the second half and make adjustments where possible."