Health Insurance Affairs Committee, Japan Society for Thermal Medicine Proposal for Appropriate Medical Reimbursement:

Hyperthermia therapy was incorporated into the medical reimbursement system in 1990 as a treatment used in conjunction with radiation therapy (code: M003, Electromagnetic Wave Hyperthermia Therapy). At that time, reimbursement was set at 9,000 points for deep-seated treatments and 6,000 points for superficial treatments per session. Originally, only one session was reimbursed under the set point value, and any additional sessions were included in this initial reimbursement and could not be billed separately. However, in the 2020 revision, it was announced that in cases of medical necessity, hyperthermia therapy could be reimbursed again after the initial course, with a maximum of two sessions every two months. Despite this change, the concept of a “single course” of treatment has largely remained unchanged for over a quarter century. The “Proposal by the Japan Surgical Society (JSS)” was developed with the guiding principle of establishing a consistent and evidence-based method to determine surgical fees, adapting to advancements in medical science. Since the 2010 revision, this proposal has been adopted as a foundational resource for revisions in surgical treatment reimbursement and remains an essential document for these revisions today. In the Health Insurance Review Committee, we established a working group to formulate the JSS proposal, carefully examining appropriate reimbursement rates.