Government caps manual therapy prices and sessions, cutting national health insurance costs by 83%

The government's decision to bring manual therapy under a "managed benefit" regime — capping both prices and the number of sessions — is expected to hold annual national health insurance spending on the treatment to a maximum of 33.7 billion won (about $22.2 million).

That figure represents roughly one-sixth of the approximately 200 billion won ($132 million) currently billed to national health insurance each year through consultation fees and other charges tied to manual therapy.

According to government, medical and labor officials, the 10th session of the Health Insurance Policy Deliberative Committee, held June 4, set the reimbursement rate and coverage criteria for manual therapy under the managed benefit framework.

Under the managed benefit system, medical procedures requiring oversight of appropriate use are designated as provisional national health insurance items and reimbursed accordingly.

The committee set the price for a single 30-minute manual therapy session at 43,850 won, with the same rate applying uniformly across all types of medical institutions — from tertiary hospitals to neighborhood clinics.

Sessions are capped at twice a week and 15 times per year, regardless of the body part being treated. However, a physician may authorize up to 24 sessions annually, including the standard 15, based on medical judgment.

National health insurance will cover 5 percent of the treatment cost, with patients responsible for the remaining 95 percent.

The government estimates that implementing the system next month would cost the national health insurance fund between 20.8 billion won and 33.7 billion won annually.

"Hospitals typically bill national health insurance for consultation fees when providing manual therapy alongside physical therapy and other combined treatments — that amounts to about 200 billion won a year," a Ministry of Health and Welfare official said. "If we spend around 30 billion won from the national health insurance fund through the managed benefit system and control manual therapy through session limits, we are indirectly saving national health insurance money."

The official added that the managed benefit review cycle for manual therapy had been set at three years — the shortest of the three-, five- and 10-year options — and that an interim evaluation was planned in about 18 months to discuss possible adjustments to session limits.

The committee also required that basic physical therapy and simple rehabilitation treatment be administered before manual therapy.

Some observers have raised concerns that the arrangement could favor traditional Korean medicine clinics, which often combine chuna manipulation — a spinal adjustment technique — with manual therapy.

In response, the Ministry of Health and Welfare said it plans to prevent traditional Korean medicine clinics from administering chuna manipulation and manual therapy to the same patient at the same time.