The Korean government has moved to rein in the country's largely unregulated non-covered medical service market, starting with manual therapy, a 1.5 trillion won industry.
A new managed benefit system that allows the government to directly set manual therapy prices and limit treatment frequency will take effect on July 1. The measure goes beyond lowering treatment costs, partially reclaiming the pricing authority hospitals have held over non-covered services, a shift expected to send significant ripples through the medical community.
According to the Ministry of Health and Welfare on the 14th, the government is accelerating efforts to establish detailed standards for converting manual therapy into a managed benefit. The fee currently under consideration is in the low 40,000 won range per 30-minute session. Given that the average price of manual therapy at clinic-level medical institutions nationwide is around 110,000 won, this represents a reduction of more than half. The government plans to convene the Health Insurance Policy Review Committee in May to finalize the fee at either 40,000 won or 43,000 won.
The managed benefit at the heart of this measure is a hybrid form between covered services, which qualify for health insurance, and non-covered services, which patients pay for in full. Patients bear 95 percent of the cost while health insurance covers only 5 percent. However, it functions as a powerful control mechanism, as the government can directly set price and frequency caps.
The government aims to correct practices in which some hospitals checked whether patients held private indemnity insurance before charging high fees of 100,000 to 300,000 won, or recommended unnecessary long-term treatments.
Treatment frequency will also be strictly limited. For general patients, the government plans to allow manual therapy only twice a week, with a maximum of 15 sessions per year. For patients requiring rehabilitation after surgery, an additional nine sessions will be permitted, allowing up to 24 sessions per year.
If treatment exceeds these limits, the hospital enters an arbitrary non-covered status, meaning it cannot collect payment from either the patient or health insurance. The aim is to effectively block "shopping-style treatment" that goes beyond medical necessity.
Behind the government's strong regulatory push lies the judgment that manual therapy has contributed to the collapse of essential medical care. As an environment took shape in which non-covered services generated easy profits, medical personnel who should have remained at demanding posts such as emergency rooms or pediatrics shifted into the manual therapy market. Through this policy, the government hopes to reduce the profitability of manual therapy and redirect medical resources back to essential care.
The medical community immediately pushed back. The Korean Association of Clinic Doctors criticized the move, saying that pricing a medical procedure requiring physicians' specialized knowledge and treatment responsibility at the low 40,000 won range, lower than commercial massage rates, seriously undermines the value of medical care. The association argued that the price cannot even cover operating expenses such as labor and rent, and will ultimately shrink the manual therapy market itself, reducing patients' treatment options.
Civil society, by contrast, is largely supportive of the reform.
The civic group People's Solidarity for Building a Welfare State said moral hazard at some medical institutions has triggered surges in private indemnity insurance premiums and expanded medical spending waste across society, adding that this conversion to managed benefit should mark the beginning of medical normalization. The group also stressed that the scope of management should be quickly expanded beyond manual therapy to other excessive non-covered items such as nerve plasty and extracorporeal shock wave therapy.
The government is treating the managed benefit conversion of manual therapy as a test case for reforming the non-covered services market.
"Manual therapy prices have been set excessively high relative to their effectiveness, which has largely encouraged overtreatment," a Ministry of Health and Welfare official said. "We will minimize confusion in medical settings ahead of the July rollout and sequentially introduce reasonable management measures for other non-covered items as well."
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