Dermatology's revision took the shape of "points held, requirements added."
No point change was identified for the dermatology specific disease guidance fee, but the billing criteria now include capacity for long-term prescriptions and refill prescriptions, along with in-clinic posting to that effect. Requirement-driven revisions matter because continuing to bill without complying creates rejection and audit exposure.
1. What changed
| Item | Change | Old → New | Impact |
|---|---|---|---|
| Dermatology specific disease guidance fee | Billing criteria revised toward long-term prescribing and refill prescriptions: capacity for 28+ day prescriptions, capacity to issue refill prescriptions, in-clinic posting to that effect, and appropriate response when patients request them | No point change identified (current (I) 250 pts / (II) 100 pts likely unchanged, verify) | Medium |
| Home visit nursing for intractable skin disease | Patients covered by the home intractable skin disease procedure guidance fee (pemphigus, pemphigoid, epidermolysis bullosa and similar) formally added to the group eligible for 4+ visits per week under the home visit nursing basic fee | Scope expansion (not a new fee, verify) | Low–Medium |
| Biologics and home self-injection for atopic dermatitis | No significant dermatology-specific change identified (the home self-injection guidance framework and covered drugs continue) | — | Low |
2. What it means for the practice
(1) Sort out posting and charting rules immediately. With points held, the guidance fee tightened on requirements instead. In-clinic posting that long-term prescriptions and refills are available, and a record of how requests were handled. This is June-effective compliance that should already be in place — if not, address it now.
(2) Recalculate margins on biologics. Home self-injection of dupilumab and similar for atopic dermatitis remains a management-fee-based revenue pillar. No direct change was identified, but recalculate margins alongside the drug price revision (▲0.86%).
(3) Facilities treating severe blistering disease can make home capacity visible. Pemphigus, pemphigoid, and epidermolysis bullosa joined the 4+ visits per week group for home visit nursing. Establishing coordination with home visit nursing agencies clarifies your role in the community.
(4) Capturing the cross-specialty items is the main source of upside. Dermatology sees high volume with fast return-visit turnover, so return-side additions (2 points inflation, 4–6 points wage increase) accumulate readily.
3. Practical checklist
- Have you posted in the clinic that long-term prescriptions and refills are available?
- Is there capacity for prescriptions of 28 days or longer?
- Are patient requests for refill prescriptions recorded in the chart?
- Have you recalculated biologics margins after the drug price revision?
- Have you established coordination with home visit nursing for intractable skin disease patients?
- Have you confirmed the inflation add-on and wage increase evaluation fee land on return visit claims?
4. Where an AI-native EMR fits — feature by feature
In 2026 this specialty is asked not about points but about whether operations meet the requirements. Here is how Pottech's AI-native EMR helps, feature by feature.
Feature 1: Charting and orders — record the newly codified response
AI generates SOAP notes from the consultation audio, and set orders enter tests and prescriptions in one action.
Long-term prescribing and refills require not only that the capacity exists but that an appropriate response was made when the patient asked. Dermatology sees high daily volume with limited documentation time per encounter. Generating the note from audio is what keeps a newly codified requirement from becoming "we did it but there's no record."
Feature 2: Billing and claims management — verify guidance fee criteria mechanically
The automatic billing engine checks bundling, mutual exclusions, and frequency limits.
The dermatology guidance fee is monthly and requires eligible condition, billing frequency, and requirement compliance to line up. Right after a requirement is added is exactly when clinics keep billing on the old workflow. Holding the billing conditions in the system lowers audit risk.
Feature 3: Patient PHR app integration — keep contact under long-term prescribing
Prescription OCR capture, medication reminders, appointment booking, LINE login, and push notifications.
Promoting long-term prescriptions and refills means, in effect, longer intervals between visits. For conditions requiring long-term management such as atopic dermatitis and psoriasis, longer intervals make it harder to know how the patient is doing in between. Adherence reminders and next-visit prompts reaching the patient support continuity in a long-prescription era.
Also review what applies to every specialty
Consultation fees, the inflation add-on, the wage increase evaluation fee, the electronic clinical information coordination add-on, and the increase in patient cost-sharing on long-listed drugs are collected in "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, "FY2026: billing criteria for the dermatology specific disease guidance fee" https://www.credo-m.co.jp/column/detail/hosyu/7248/
- Care Team, "Home visit nursing for intractable skin disease: 4+ visits per week now billable" https://careteam.jp/column/column066
- Tokyo Association of Medical Practitioners, "FY2026 revision: Chuikyo report (excerpt)" https://www.hokeni.org/docs/2026021200012/