As the Ministry of Health and Welfare (MOHW) began applying managed benefit coverage to manual therapy starting Tuesday, orthopedic and pain medicine clinics are increasingly discontinuing the treatment.
On Tuesday, Hospital A in Jongno-gu posted a notice at its entrance stating that "manual therapy will be discontinued as of July 1." Hospital B in Dongdaemun-gu, which had focused so heavily on manual therapy that it operated a separate manual therapy center, also decided to halt the treatment entirely.
The reason hospitals and clinics are rushing to abandon manual therapy is the government's system overhaul. The MOHW converted manual therapy into a managed benefit item as of that day. Managed benefit is a system that manages non-covered items within the health insurance framework when their medical necessity is recognized but there is concern over excessive use, controlling usage by applying a high patient co-payment rate.
Accordingly, the cost of manual therapy has been standardized at 43,850 won per session, with patients paying 95 percent of the treatment cost and health insurance covering the remaining 5 percent. Coverage is available up to twice a week and 15 times a year, and patients with joint contracture or stiffness from surgery or fractures may be recognized for up to 24 sessions based on medical judgment. In addition, manual therapy coverage is granted only when there is no improvement in symptoms even after basic physical therapy or simple rehabilitation treatment has been performed at least four times over two weeks or more. "As a result of analyzing private insurance data, more than 95 percent of patients receive treatment within 15 times a year, so the vast majority of patients will be able to receive treatment even under the new standards," an MOHW official explained.
The government expects the new system to serve as an opportunity to normalize manual therapy prices and reduce excessive treatment. Manual therapy has an average cost of about 110,000 won, with large price disparities among medical institutions, and because private insurance claims are easy to file, concerns over excessive treatment have been continuously raised. In fact, as of 2024, private insurance payouts related to manual therapy paid by domestic non-life insurers reached 1.3858 trillion won, accounting for the largest share of insurance payouts.
However, as the number of hospitals discontinuing manual therapy grows and coverage standards become stricter, patient anxiety is rising. A rehabilitation patient identified as C, who has consistently received manual therapy after undergoing knee surgery last year, expressed concern, saying, "Manual therapy is not a simple posture correction or massage concept but essential rehabilitation for walking recovery," and "I worry that I may not be able to receive enough of the treatment I need due to the uniform visit limits."
The medical community, on the other hand, argues that uniform standards that do not consider patient conditions fail to reflect the characteristics of rehabilitation treatment. The Korean Medical Association pointed out that hospitals and clinics specializing in manual therapy may face inevitable restructuring of therapists, and that patient access to care could also be weakened. The MOHW plans to gather opinions from the medical field after the system's implementation and review whether to supplement the system in the second half of this year.
