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Implementation of Managed Care Benefits for Manual Therapy: 43,850 won per session; Summary Based on 15 Sessions Per Year

Published 2026-07-20 Views 106 7 min read KO EN JA ES

Patient and therapist in a rehab clinic with spine, joint, cost, insurance, and schedule icons — The illustration links manual therapy care with pricing, coverage, and annual visit scheduling.

Key Summary

With the government’s introduction of “managed benefits” for manual therapy, the cost per session will be standardized at 43,850 won starting on the 1st of this month. In the past, manual therapy was primarily provided as non-covered services, resulting in significant price variations among medical institutions; the average cost per session was reportedly around 110,000 won.

The key to this reform is not simply a price reduction, but the combined application of a standard price, a high patient copayment rate, limits on the number of sessions, and mandatory treatment records. The government explains that the background for this reform stems from the fact that manual therapy is highly elective and supplementary in nature, and there were concerns about increased usage and potential misuse.

What Is Manual Therapy?

Manual therapy is a treatment performed at medical institutions using the hands or physical contact to address musculoskeletal pain, restricted joint movement, and functional recovery. Although it is classified as a type of physical therapy, not all procedures aimed at pain management or posture correction are covered by health insurance.

A key aspect of this new system is that insurance coverage for manual therapy depends on whether the treatment is medically necessary, within established clinical guidelines and frequency limits, and supported by an evaluation and documentation of treatment effectiveness.

What Is “Managed Coverage”?

Managed coverage is a new category established within “Selective Coverage.” It is a system for separately managing items where the need for treatment is recognized but which carry a high risk of misuse or require strict cost management. Unlike general health insurance benefits, which apply a low copayment rate, managed coverage combines a high copayment rate with clear eligibility criteria.

The main features of managed benefits for manual therapy are as follows:

A uniform per-session fee applies to all medical institutions
A 95% copayment rate applies
Weekly and annual usage limits
Clarification of grounds for exceptions
Mandatory evaluation of treatment effectiveness and maintenance of medical records
Introduction of procedures for medical institutions to verify the number of sessions per patient

What Will Change?

Category	Existing	After Implementation of Managed Benefits
Price	Varies by hospital with significant discrepancies	Standardized at 43,850 won per session
Insurance Classification	Primarily non-covered services	A type of managed care benefit within the selective benefits category
Copayment Rate	Non-covered services require full out-of-pocket payment	Managed care benefits require a 95% copayment
Basic Usage Limit	Weak unified management standards	Principle of 2 sessions per week and 15 sessions per year per person
Exceptions	May vary by medical institution	Up to 24 sessions per year permitted for medical reasons such as surgery or fractures
Billing Procedure	Primarily non-covered service claims	Claims submitted after the system verifies the number of sessions used
Treatment Records	Management standards may vary	Mandatory effectiveness evaluation and treatment records

Per-Session Cost and Copayment Rate

According to the official notice, the per-session cost for manually administered therapy under managed benefits is 43,850 won. The copayment rate is set at 95%. In other words, while manually administered therapy is being incorporated into the national health insurance system, the portion borne by patients remains very high.

This structure does not mean that manual therapy is fully covered at low costs like general benefits; rather, it signifies an intent to manage the service by standardizing prices and usage volumes. While patients will no longer have to bear the burden of comparing prices that varied significantly from hospital to hospital, they must still be aware that the copayment rate remains high.

Usage Criteria: 2 Sessions per Week, 15 Sessions per Year as a General Rule

Manual therapy recognized as managed benefits generally follows the criteria below.

Item	Criteria
Weekly Limit	Up to 2 sessions per person per week
Annual Limit	Up to 15 sessions per person per year
Exception Criteria	Cases where joints have become stiff or rigid due to surgery, fractures, etc.
Number of Exception Sessions	Up to 24 sessions per year, subject to a physician’s medical judgment

Exceptions are not automatically applied to all patients. They may be granted based on a physician’s judgment in cases where a medical need for additional treatment is confirmed, such as joint contractures, stiffness, or functional limitations following surgery or a fracture.

What Happens If the Limit Is Exceeded?

Before providing manual therapy, medical institutions must verify the patient’s remaining session limit through the Manual Therapy Management System or the Health Insurance Review and Assessment Service (HIRA) portal. If the criteria are met, they bill for the treatment according to established procedures.

Manual therapy sessions that exceed the approved limit cannot be billed as managed benefits, and there are restrictions on billing the excess medical costs to either the National Health Insurance or the patient. However, if the treatment itself is for personal purposes not covered by National Health Insurance, the patient may opt to receive the service separately at their own expense without insurance coverage.

Cases Where Health Insurance or Out-of-Pocket Expense Insurance Coverage Is Unlikely

Manual therapy for the following purposes differs from the intent of managed care benefits and is therefore unlikely to be covered by health insurance or out-of-pocket expense insurance.

For the purpose of recovering from fatigue
For the purpose of body contouring
For purposes focused on cosmetic enhancement or posture improvement
Repeated use without confirmed medical necessity
Use not supported by an evaluation of treatment effectiveness or medical records

Whether out-of-pocket expense insurance provides coverage may vary depending on the enrollment date, policy terms, and the insurer’s underwriting criteria. However, it is important to note that manual therapy for personal purposes, as specified by the government, is subject to coverage restrictions not only under National Health Insurance but also under out-of-pocket expense insurance.

Treatment Standards Are Also Being Strengthened

It is not just the price and frequency that are changing; the management of medical care at healthcare facilities is also being strengthened. The government has made the evaluation of manual therapy effectiveness and the maintenance of treatment records mandatory, and has tightened standards to require that simple rehabilitation therapy or basic physical therapy be administered first.

This measure is intended to ensure that manual therapy is not used as a high-cost treatment applied immediately to all musculoskeletal symptoms, but rather is used only on a limited basis when necessary following basic treatment and medical evaluation.

Points for Patients to Check Before Visiting a Hospital

If you plan to receive manual therapy, it is advisable to check the following items.

Check with your healthcare provider to see if your symptoms qualify for manual therapy covered by managed care benefits.
Check how many manual therapy sessions you have already received this year.
Check to ensure you do not exceed the limit of twice a week or 15 sessions per year.
If there are exceptional circumstances, such as joint restrictions following surgery or a fracture, verify that you have the relevant medical records.
Be aware that insurance coverage may not be available if the treatment is intended solely for recovery from fatigue or body contouring.
If you plan to file a claim under your out-of-pocket expense insurance, review your policy terms and your insurer’s guidelines separately.

Significance of the System’s Introduction

This reform is not so much a policy to unconditionally expand coverage for manual therapy, but rather a measure to manage high-frequency, high-cost treatments—which were previously in the non-covered category—within the national health insurance system. For patients, this increases price predictability, while medical institutions will face greater responsibilities regarding billing and record-keeping.

The government plans to evaluate the performance of the manual therapy program every three years and refine detailed criteria—such as reimbursement categories and transition principles—based on monitoring results. Therefore, the actual implementation methods may be further adjusted depending on the outcomes of on-site operations.

Images

Healthcare management illustration with hospital, insurance shield, dashboard, calendar and joint check icons — The graphic visualizes managed coverage and visit tracking for manual therapy.

FAQ

How much will the cost per manual therapy session be?

Following the implementation of managed care, the cost per manual therapy session will be standardized at 43,850 won. This measure is intended to reduce the wide variation in prices between hospitals that existed in the past.

If manual therapy becomes covered by health insurance, will patients' out-of-pocket costs decrease significantly?

It is difficult to say for certain that costs will decrease significantly. Since a 95% copayment rate applies to manual therapy under the managed care program, although it is covered by the health insurance system, the patient’s out-of-pocket costs remain relatively high.

How many times a year is manual therapy covered?

As a general rule, coverage is provided for up to twice per week per person, for a total of 15 times per year. However, in cases where a joint has become stiff or rigid due to surgery or a fracture, coverage may be extended to up to 24 times per year based on a doctor’s medical judgment.

If I exceed 15 sessions per year, am I no longer eligible for additional manual therapy?

Manual therapy covered under managed care generally follows a limit of 15 sessions per year. Unless there are exceptional circumstances, treatments that exceed this limit are unlikely to be covered under the National Health Insurance system or billed to the patient.

Does the manual therapy coverage limit change after surgery or a fracture?

In exceptional cases where a medical necessity is confirmed—such as joint stiffness or limited mobility following surgery or a fracture—up to 24 sessions per year may be approved. In such cases, the doctor’s assessment and relevant medical records are crucial.

Is manual therapy for fatigue recovery or posture correction covered by insurance?

Manual therapy for personal needs, such as fatigue recovery or posture correction, is not covered by health insurance or out-of-pocket expense insurance. Treatment for these purposes may be billed entirely to the patient.

How does the hospital track the number of manual therapy sessions a patient receives?

Medical institutions check the number of visits per patient through the manual therapy management system or the Health Insurance Review and Assessment Service (HIRA) portal, and bill for the services if the criteria are met.

Do I need to undergo basic physical therapy before starting manual therapy?

The government has tightened treatment guidelines to require that simple rehabilitation therapy or basic physical therapy be administered first. Manual therapy is regulated as a treatment to be applied only when its medical necessity has been confirmed through an evaluation.

What is the biggest difference between manual therapy covered by insurance and existing out-of-pocket manual therapy?

The biggest difference is that pricing and eligibility criteria are standardized. For managed care benefits, the per-visit amount, copayment rate, annual limit on the number of visits, exceptions, and mandatory treatment records all apply.

How do I check the status of my out-of-pocket medical insurance claim?

Whether out-of-pocket medical insurance covers a particular treatment may vary depending on the policy terms, the date of enrollment, and the insurer’s underwriting criteria. In particular, manual therapy for personal purposes—such as fatigue recovery or body contouring—may be subject to coverage restrictions under out-of-pocket medical insurance.

Sources

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#Manual therapy #Managed benefits #Health insurance #Medical indemnity insurance #Medical expenses