Support for Temporary Emergency Care Fees Funded by Health Insurance to End

Additional Fees for Emergency Room Specialists and Critical Surgeries Become Regular Rates
Support for 23 Designated Regional Emergency Medical Centers Extended Until Year-End
Initial Consultation Fees at Clinics and Medication/Dispensing Fees at Hospitals to Increase

The temporary fee measures implemented under the name of emergency care to prevent medical service gaps caused by last year's mass resignation of medical residents will be terminated. However, the additional fees for emergency room specialists’ consultations and for emergency and critical surgeries will be institutionalized and applied on a regular basis going forward. Temporary support for maintaining a stable emergency medical system, such as emergency medical facilities and personnel, will also be gradually phased out.

At the "20th Health Insurance Policy Deliberation Committee Meeting of 2025" held on the 31st, Lee Hyun-hoon, the Second Vice Minister of Health and Welfare, is speaking. Ministry of Health and Welfare

The Ministry of Health and Welfare announced on the 31st that it had approved these measures at the "20th Health Insurance Policy Deliberation Committee Meeting of 2025."

Since February 20 of last year, the government has continued to provide financial support through health insurance to allow medical institutions to maintain and operate emergency care systems, in line with the declaration of a public health crisis alert and the announcement of emergency care measures. However, with the recent recovery of the overall healthcare system, the public health crisis level has been downgraded from "severe," and the pan-government emergency response system has been lifted. Taking these changes into comprehensive consideration, the government decided to end "emergency care health insurance support."

Accordingly, at the committee meeting, it was decided to end support for four items: separate compensation for local emergency room consultations, compensation for the allocation of patients with severe conditions who are difficult to accommodate, temporary increases in referral fees, and temporary and expanded incentives for rapid response teams. However, two items-additional fees for emergency room specialists’ consultations and increased and expanded fees for emergency and critical surgeries-were converted into regular fees to help maintain the emergency medical system.

Previously, out of ten items supported by health insurance to maintain the critical and emergency medical system and minimize care gaps, several-such as post-compensation for emergency admissions of patients with severe conditions, policy support funds for emergency admissions of patients with severe conditions, policy support funds for emergency admissions of inpatients, and temporary additional fees for emergency medical actions within emergency rooms-have already either been converted to regular fees or had their support ended, in connection with the 2025 adjustment of relative value scores for hospitals and clinics, pilot projects for restructuring advanced general hospitals, and comprehensive support projects for secondary general hospitals.

Incentives that evaluated and supported the contribution of regional emergency medical centers, regional trauma centers, and pediatric emergency medical centers to emergency care will also end this month. The period from September to October, including the Chuseok holiday, has been set as the final evaluation period, and after reviewing performance, support funds will be paid in December.

The 23 designated regional emergency medical centers, which have been temporarily operated since September last year to treat critical emergency patients, will remain in place until the end of this year and then be discontinued. After designation, the average number of critical emergency patients (KTAS 1-2) at these centers increased from 8.7 to 12.1, and the regional share of critical emergency patients rose from 120.7% to 136.7%. In response, the government plans to continue policies such as additional designation of emergency medical institutions and strengthening compensation to further enhance the regional capacity for critical and emergency care, which is essential to core medical services.

At the committee meeting, it was also decided to increase the initial consultation fees for clinics, which have been undercompensated, as well as the medication and dispensing fees for hospitals. In line with the "Second Comprehensive National Health Insurance Plan (2024-28)," the government is using the financial resources secured by linking conversion indices and relative value scores to raise the relative value scores for undercompensated services, thereby addressing imbalances between different medical services. To this end, 0.1% of the 2026 increase in conversion indices for hospitals and clinics will be allocated, injecting 19 billion won into clinic consultation fees and 32.5 billion won into hospital medication and dispensing fees.

As a result, from next year, the initial consultation fee for all clinics will increase by 140 won (0.76%), from 18,700 won to 18,840 won. For hospitals, four items will see increases of 30-50%: discharge patient dispensing fees (up by 200 won), outpatient and inpatient dispensing and medication guidance fees (up to 820 won), and aseptic preparation fees for injectable drugs (up to 3,770 won).

In addition, the Ministry of Health and Welfare will expand coverage for home care equipment needed by children with severe illnesses who are mainly managed at home, such as pulse oximeters, suction machines, and enteral feeding pumps. Previously, support was provided only for ventilators and oxygen generators. The Ministry stated, "By expanding coverage for home care equipment, we expect to contribute to the growth, development, and health improvement of children with severe illnesses through appropriate home treatment and disease management, while also alleviating the financial burden on their families."

This content was produced with the assistance of AI translation services.