[Approval of additional management fee in medical insurance and its change]

An additional management fee was approved in 1996 due to the efforts of the Japanese Association of Clinical Pathology. This particular fee was increased after revisions, markedly contributing to the revenue of the departments of clinical laboratory in hospitals. In the revision of medical insurance fees, a marked reduction in medical costs with an increase in medical insurance for the elderly is performed. For this cost reduction, laboratory tests for which a reduction can be easily achieved may become targets. Regarding the activity of clinical laboratory physicians in terms of medical insurance fees, laboratory and physiological tests should be evaluated according to each item. The prospective payment system mainly employing diagnostic procedure combination (DPC) was introduced primarily at university and large hospitals.