The Central Social Insurance
Medical Council is responsible for establishing and monitoring reimbursement. All providers are reimbursed under an official
fee schedule, which allocates a certain amount of points for each diagnosis and procedure. Providers are reimbursed 10 yen
for each point.
3 Classes of Japanese Reimbursement
A class A device is one whose cost is included the
technical fee. A1 devices are usually supplies used in procedures and A2 often involves capital equipment with a disposable
component such as those used for diagnosis.
Includes implantable devices that already have an insurance
category, such as heart valves and stents.
New technologies, without an insurance category
Class C is
broken down into C1 which includes devices that are based on existing technology and C2 devices are ones for which there is
no preexisting technology to use as a basis.
Devices for which there is similar technology could get approved for reimbursement
in one of the following ways:
*Highly advanced medical technology (requires high level of physician skill)
insured medical materials (reviewed 4 times a year)
*Included in establishment of new technical fee
Every two years
medical device reimbursment is reviewed and can be reduced. The overall device reimbursement reductions vary from around
1% to as much as 7% or more. The reference price of equivalent medical devices in foreign markets seems to be a critical
factor in reimbursement reduction decisions.
Copyright © 2004 Kirk Zeller, All rights reserved