For allergy, no significant specialty-specific change was identified. Revenue impact comes from the cross-specialty items — consultation fees, the inflation add-on, the wage increase evaluation fee, and the electronic clinical information coordination add-on.
That the rules did not move also means, conversely, that your own operations show up directly in the results.
1. What changed
| Item | Change | Old → New | Impact |
|---|---|---|---|
| Allergen immunotherapy (SLIT) — allergic rhinitis immunotherapy management fee (B001-35) | No change to points or requirements identified (the 280 pts first month / 25 pts thereafter structure appears to continue) | 280 pts / 25 pts (likely unchanged, verify) | Low |
| Pediatric food allergy challenge test (D291-2) | Points, age eligibility (under 16), and frequency (3 per year) all confirmed unchanged. Bundling of medication, injection and procedure costs, and the written explanation requirement, continue | 1,000 pts (unchanged), under 16, 3 per year (verify) | Low |
| Other | No other significant allergy-specific change identified (impact is from cross-specialty items) | — | Low |
The Japanese Society of Allergology conducted consultations ahead of the 2026 revision, but no new or increased specialty items were identified.
2. What it means for the practice
(1) Capturing the cross-specialty items is the main source of upside. Return visit fee +1, inflation add-on (2 pts initial, 2 pts return), wage increase evaluation fee (17–23 pts initial, 4–6 pts return). Allergy skews toward return visits — monthly visits for sublingual immunotherapy, for instance — so the return-side additions accumulate.
(2) Continuation rate is the revenue driver for sublingual immunotherapy. With the management fee static, results are decided by patient accumulation (staggering cedar and mite initiation across the year) and by continuation. SLIT presumes three to five years of treatment, so a dropout is not the loss of one patient but the loss of several years of remaining revenue.
(3) Judge food challenge testing by slot utilization. The 1,000-point fee is unchanged, and the structure allowing up to three per year for under-16s is established. Raise utilization of half-day admission and outpatient challenge slots, and make sure treatment costs for severe reactions — separately billable — are not missed.
(4) Posting for long-term prescriptions and refills is a cross-specialty requirement. Sublingual immunotherapy pairs well with long-term prescribing, so keep the required in-clinic posting current.
3. Practical checklist
- Have you confirmed the inflation add-on and wage increase evaluation fee are landing on return visit claims?
- Do you know your SLIT continuation rates at 1, 2, and 3 years?
- Are cedar and mite initiations concentrated in particular months?
- Do you know your challenge test slot utilization and cancellation rates?
- Are treatment costs for severe reactions during challenge testing being billed?
- Is the in-clinic posting for long-term prescriptions and refills in place?
4. Where an AI-native EMR fits — feature by feature
In a year when the rules do not move, differences in operations become differences in results. Here is how Pottech's AI-native EMR helps, feature by feature.
Feature 1: Patient PHR app integration — prevent sublingual dropouts
Prescription OCR capture, medication reminders, appointment booking, LINE login, and push notifications.
Sublingual immunotherapy only establishes its effect over three to five years, so a dropout means losing years of revenue. Daily adherence and monthly attendance together decide both the clinical result and the revenue. Medication reminders and appointment prompts reaching the patient are the most directly effective feature in this specialty.
Feature 2: Management analytics dashboard — watch continuation and utilization
Visit volumes, revenue per patient, and monthly trends are aggregated and visualized automatically.
The metric here is not new initiations but continuation rates at 1, 2, and 3 years. Adding new patients does not accumulate revenue if continuation is poor. For food challenge testing, the metric to follow is utilization per slot rather than raw case count. In a year with no upside from the rules, improving these operational metrics is what moves results.
Feature 3: Billing and claims management — close gaps on challenge testing
The automatic billing engine checks bundling, mutual exclusions, and frequency limits.
The pediatric food challenge test bundles medication, injection, and procedure costs — but treatment costs where a severe reaction occurs are separately billable. Because it is infrequent, this rule is easy to forget. Together with the three-per-year limit, having the system make the determination prevents quiet losses.
Also review what applies to every specialty
For allergy, capturing the cross-specialty items is the main source of upside. See "what applies to every specialty."
Sources (principal)
- MHLW, "About the FY2026 Fee Schedule Revision" https://www.mhlw.go.jp/stf/newpage_67729.html
- Credo Medical, "The allergic rhinitis immunotherapy management fee" https://www.credo-m.co.jp/column/detail/hosyu/7222/
- Knowlety, "Pediatric food allergy challenge test (FY2026 fee table)" https://knowlety.jp/ika/d291-2/
- Japanese Society of Allergology, "Consultation on FY2026 fee revision items" https://www.jsaweb.jp/modules/news_topics/index.php?content_id=886