Orthopedics leads non-covered treatment costs, followed by neurosurgery, internal medicine

Non-covered medical treatment costs at hospital-level institutions under national health insurance rose about 9 percent from the previous half-year period in September 2025, exceeding 700 billion won ($522 million). Orthopedics accounted for the largest share of such costs, followed by neurosurgery and internal medicine.

The Ministry of Health and Welfare and the National Health Insurance Service released a second-half 2025 non-covered treatment reporting system analysis on Wednesday. It showed hospital-level institutions with 30 or more beds logged a total of 749.9 billion won in costs across 1,251 non-covered items in September 2025. That marked a roughly 9.3 percent increase from 686.4 billion won in the first half of the year.

Health authorities attributed the increase to the number of reporting institutions rising from 4,000 to 4,098 over the same period. The average non-covered treatment cost per institution also rose by 11.38 million won.

Non-covered treatments are items not covered by national health insurance, meaning patients must pay the full cost themselves. The government has run the non-covered treatment reporting system since September 2023 to track the scale of such costs.

The first-half report, covering March treatment records, includes all medical institutions, including neighborhood clinics, while the second-half report, covering September, is conducted only among hospital-level institutions, excluding clinics.

By field, medicine accounted for the largest share of non-covered costs at 657.7 billion won (87.7 percent), followed by dentistry at 72.8 billion won (9.7 percent) and Korean medicine at 19.4 billion won (2.6 percent).

Across medicine, dentistry and Korean medicine combined, orthopedics recorded the highest non-covered treatment costs at 202.4 billion won. Neurosurgery followed at 100.5 billion won, internal medicine at 81.6 billion won, general surgery at 55.6 billion won and obstetrics and gynecology at 37.2 billion won. These departments, along with the rest of the top 10, accounted for 81.1 percent of total non-covered treatment costs.

Within medicine, the largest field, the top non-covered cost items were single-room upgraded ward fees at 56.1 billion won and manual therapy at 55.2 billion won. Soft-tissue reconstruction treatment materials followed at 28.1 billion won.

In dentistry, implants accounted for the highest non-covered costs at 35.2 billion won, while in Korean medicine, herbal medicine packets and herbal preparations led at 14.4 billion won.

Among the top non-covered cost items, treatment materials such as soft-tissue reconstruction materials and spinal epidural adhesion barriers saw substantial cost increases. Nursing hospitals and Korean medicine hospitals also reported growth in non-covered treatments related to cancer patients.

The Ministry of Health and Welfare converted manual therapy to a managed-benefit item starting in July. It also laid the groundwork for regulating extracorporeal shock wave therapy — including treatment frequency, intervals and indications — through voluntary corrective measures by the medical community.

The ministry expects these changes to be reflected in this year's non-covered treatment reporting system analysis, due for release next year.