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. 2021 Sep 13;4(4):311–320. doi: 10.31662/jmaj.2021-0011

Table 1.

The Reimbursement and Pricing Categories for Medical Technologies in Japan and South Korea (41), (42).

Category South Korea Japan
Coverage Reimbursed Comparing the technologies with those already listed and placed in the same “functional category,” which has similarity in material, feature, size, etc. B1 category: placed in the existing functional classification
B2 category: placed in the existing functional classification with definition change
B3 category: placed in the existing category with improvement premium with conditional period
If the new technology is considered superior to the listed technologies, “Value Appraisal Standard” Innovation Track and Technology Improvement Track are applied for premium pricing and a new functional category is created C1 category: premium pricing with new functional category creation
C2 category: new functional category with new procedure code or only new procedure code
R category: evaluation of remanufactured technologies (reprocessed technologies with new functional category)
Funded under the procedure (technical) fee (integrated fee schedule of hospital and physician fees) Low-cost disposable and reusable instruments are paid under procedure fees A1 category: placed in the existing technical fees that are not linked to the specific procedure fee codes
A2 category: placed in the existing technical fees that are linked to the specific procedure fee code
A3 category: placed in the existing procedure fees, but change the condition of the fees
Noncoverage Cosmetic, not cost-effective or not clinically essential technologies F category: Not suitable for reimbursement coverage