Korea will cease to cover lower abdominal and urinary ultrasonography costs by 2024.
Ultrasonography Test Price: 80.08 Billion Won
Beginning in the following year, the government announced that it would no longer cover lower abdominal and urinary ultrasound exams under health insurance. The purpose of this project is to stop overtesting and stop money from health insurance from being misappropriated.
The government cut reimbursements for brain and cerebrovascular MRI exams, as well as upper abdominal and multisite ultrasounds, earlier this year.
There isn’t currently a set reimbursement guideline for lower abdominal and urinary tract preoperative ultrasounds. As a result, preoperative ultrasound examination costs have been reimbursed to some medical facilities.
As a result, from 50.35 billion won in 2019 to 80.08 billion won in 2022—a 60.6 percent increase—the cost of lower abdominal and urinary ultrasound examinations to the Health and Welfare Ministry.
According to the ministry, this sum is expected to be more than 1.6 times higher than the projected cost of lower abdominal and urinary ultrasonography in 2022, which is estimated to be 49.9 billion won.
However, starting in the next year, only cases that are judged medically necessary will be covered for lower abdominal and urinary ultrasounds performed for preoperative risk assessment purposes, according to the ministry.
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Payment for ultrasounds performed the day of the exam that were previously invoiced consistently without explanation will only be accepted if a specific explanation is provided, such as the rationale behind the treating physician’s medical judgment.
Director general of the Ministry of Health and Welfare’s Health Insurance Innovation Division Kang Joon stated, “By clarifying We try to stop financial leakage by basing MRI and ultrasound reimbursement standards on medical necessity.
He also stated that the money saved by taking this action will be used for basic medical needs, guaranteeing that health insurance dollars are spent where they are most required.
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