The price of manual therapy, which had varied widely by hospital from 100,000 to 300,000 KRW, will be fixed at about 44,000 KRW starting next month, and the number of sessions will be capped at 24 per year.

On the 4th, the Ministry of Health and Welfare held the 10th meeting of the Health Insurance Policy Deliberation Committee (the committee) for 2026 and adopted these measures. At the meeting, the committee finalized manual therapy as a managed benefit item. Managed benefits are a system in which the government sets and manages prices and use criteria for non-covered items with high concern for overuse. Five percent of the medical fee is covered by National Health Insurance funds, and the remaining 95% is paid by patients.

The fee for manual therapy was set at 43,850 KRW per session (30 minutes). This is less than half the average manual therapy price of about 110,000 KRW at clinics nationwide. Currently, it can be provided without a limit on the number of sessions, but going forward it will be recognized only up to twice a week and 15 times a year. However, up to 24 sessions per year will be allowed if a physician judges high medical necessity, such as joint contracture due to surgery or fracture.

Basic physical therapy or simple rehabilitative therapy must be provided first before manual therapy, and the implementation requirements have also been strengthened to mandate recording of treatment details and effects when manual therapy is performed.

Managed benefits are a system the Ministry of Health and Welfare announced it would introduce in 2024 when it unveiled measures to manage non-covered services at the Special Committee on Medical Reform. This is because, for some non-covered items such as manual therapy, extracorporeal shock wave therapy, and percutaneous epidural neuroplasty, use has continued to grow even amid ongoing debate over treatment effectiveness. The government in particular sees that mixed billingreceiving covered and non-covered services together for private indemnity insurance claimsis increasing the burden on National Health Insurance finances.

Physicians’ groups are strongly opposing the managed benefits system. Although the Ministry of Health and Welfare last year selected manual therapy, radiative hyperthermia therapy, and percutaneous epidural neuroplasty as priority items for review under managed benefits through the Non-covered Services Management Policy Council, discussions have been delayed due to resistance from the medical community. At a press conference on the 27th of last month, the Korean Medical Association stated, “We refuse the forced implementation of managed benefits that represent only the interests of private indemnity insurers” and “It could seriously infringe the public right to choose treatment and access care, and it could shake the sustainability of the healthcare field.”

An official at the Ministry of Health and Welfare said, “Managed benefits are intended to resolve the issue of overuse in certain non-covered items and to guide appropriate care based on medical necessity,” adding, “Starting with manual therapy, we will gradually strengthen the management framework for non-covered services to reduce the public burden of medical expenses.”

At the same meeting, it was also decided to integrate the disease-specific home-based care pilot programs. Currently, seven separate pilots are operated for diabetes, home ventilator users, heart disease, tuberculosis, ostomy patients with cancer, and rehabilitation patients, among others, and there have been concerns that reimbursement criteria and copayment rates differ by disease and are complex. Going forward, these will be integrated into the ‘disease-specific home management pilot program’ to unify the reimbursement system and service standards, and the number of education and counseling service offerings will be increased.

A pilot project for reimbursement rates for rural health services will also be promoted. As the number of public health doctors has recently declined, widening the care gap at rural health subcenters, the government has decided to expand the role of public officials exclusively responsible for health services. At integrated health subcenters, when such officials provide care, the same reimbursement rates as health clinics will apply, and when a remote co-consultation is conducted with a physician, the consulting medical institution may be paid a consultation fee.