"What are the facility standards for the function strengthening addition?" "If we've notified the comprehensive community care addition, can we bill it automatically?" "Did anything change in the FY2026 revision?" Because it is added on top of the initial consultation fee, clinic directors, office managers, and medical clerks often ask about it. Based on the March 5, 2026 facility-standards circular (Hoi-hatsu 0305 No. 7) and the Ministry of Health, Labour and Welfare (MHLW) revision overview, this article organizes the facility standards, key notification points, and the business continuity plan (BCP) requirement and transitional measure added in the FY2026 revision.
Disclaimer: This article provides general information based on publicly available information as of October 14, 2026. The MHLW's public notices and circulars, and the guidance of your regional bureau of health and welfare, are authoritative for points, facility standards, and notification handling. Always confirm the latest original text and your regional bureau before making a final decision on notification or billing.
For the prerequisite addition, see Comprehensive Community Care Addition: FY2026 Points, Eligible Patients, Facility Standards and Notification. The after-hours arrangement that can form part of the standards is covered in After-Hours Response System Addition: FY2026 Points, Requirements for Types 1–4, and Notification. For the overall revision, see Medical Fee Revision 2026: Changes Clinics Should Know.
Conclusion: five key points
| Item | Content |
|---|---|
| Points | 80 points added to the initial consultation fee (as stated in the MHLW revision overview) |
| Eligible providers | Clinics, or hospitals with fewer than 200 licensed beds |
| Prerequisite | Notification of the comprehensive community care addition, comprehensive community care fee, pediatric family-doctor fee, or home-care comprehensive management fee, etc. (with conditions on combinations) |
| New in FY2026 | Formulating a business continuity plan (BCP) and reviewing it regularly. Providers that had notified by March 31, 2026 are deemed to meet it until May 31, 2027 |
| Notification | Attachment 7, Form 1-3 |
- The addition evaluates initial consultations at institutions with family-doctor functions. It is described as recognizing appropriate diagnostic functions, including judging whether referral to a specialist institution is needed.
- Billing requires signage in the facility and on the website. The standards also require making a document with the posted content available for patients to take home.
Facility standards (organized from the circular)
The standards are set out as items (1)–(7) in Section 1-3 of the circular, and all of them must be met.
| No. | Requirement | Practical check |
|---|---|---|
| (1) | A clinic, or a hospital with fewer than 200 licensed beds | Ordinary clinics qualify |
| (2) | Meet any one of items A–G in the table below | Identify which category your clinic falls under |
| (3) | Employ a full-time physician who performs community health, welfare, or administrative activities | Any of items 1–7 below |
| (4) | Perform the five family-doctor functions as needed and post this information, including that patients can search via the medical functions information system | Check signage |
| (5) | Keep a document with the posted content in the facility for patients to take home, and provide it on request | Check where the document is kept |
| (6) | Formulate a business continuity plan (BCP), take necessary measures per the plan, and review it regularly | Added in FY2026; transitional measure applies |
| (7) | Not a clinic whose insurance-medical-institution designation carries a term of three years or less | New requirement on outpatient physician-oversupplied areas |
(2) Care-system requirements (A–G)
How you satisfy this depends on which category applies. The circular's wording is simplified below.
| Category | Content |
|---|---|
| A | Notification of comprehensive community care addition 1 |
| B | Notification of comprehensive community care addition 2, plus, in the most recent year, either 3 or more patients billed for addition 2, or a combined total of 3 or more patients billed for initial home-visit care (I) item 1, home-visit care (II) (case 1-a), or house calls |
| C | Notification of comprehensive community care fee 1 |
| D | Notification of comprehensive community care fee 2, plus the same patient-count requirement as B for the most recent year |
| E | Notification of pediatric family-doctor fee 1 or 2 |
| F | Notified for the home-care comprehensive management fee or the facility-resident equivalent, and qualifying as a home-care support clinic (hospital) under item 1(1) or (2) |
| G | Notified for the same management fees, qualifying as a home-care support clinic (hospital) under item 1(3) (cooperative type), and meeting the results requirement (e.g., 3 or more emergency house calls, or 1 or more home-based end-of-life cases / home care for children under 15 with severe disabilities) |
If you rely on addition 2, confirm the patient-count results for the most recent year (3 or more). Check how results are counted against the notification form's instructions.
(3) Full-time physician's community activity (any one)
A full-time physician must do at least one of the following (Form 1-3 asks for the physician's name):
- Handle consultations on using the long-term care insurance system and prepare physician opinion statements for care-need certification
- Cooperate as a police physician
- Conduct infant health checkups under Articles 12 and 13 of the Maternal and Child Health Act (18-month, 3-year checkups, etc.)
- Provide routine vaccinations under Article 5(1) of the Immunization Act
- Serve as a kindergarten doctor, nursery school consulting physician, or school doctor
- Attend community care meetings held by community comprehensive support centers
- Cooperate with general preventive care programs run by municipalities (community gathering spots, lectures, etc.)
Many clinics that handle infant checkups or routine vaccinations may already meet this item. For vaccination administration, see What Is Vaccine DX? Digitizing Immunization Administration and What Clinics Should Do; for digitizing infant checkups, see What Is Maternal and Child Health DX? Digital Maternal and Child Health Handbooks and Sharing Checkup Records.
(4) Five family-doctor functions and signage
Perform the following as needed and post that you do so in a visible place and on your website:
- Understand the patient's other medical institutions and prescribed drugs, manage medications as needed (and record it in the chart)
- Refer to specialist physicians or institutions
- Respond to health-management consultations, such as health checkup results
- Respond to consultations on health and welfare services
- Provide information on how to respond in emergencies, including outside clinic hours
You must also post that patients can search for institutions with family-doctor functions through the medical functions information system.
What changed in the FY2026 revision
The circular and the MHLW overview confirm two changes.
1. BCP formulation (facility standard (6))
Referring to the "Guide to Creating Disaster-Response BCPs for Medical Institutions (other than disaster base hospitals)", you must formulate a plan aimed at continuing care during disasters, resuming operations early under emergency arrangements, and ensuring patient and staff safety, and take the necessary measures under the plan. Regular review and revision as needed are also required.
Transitional measure: Providers that had notified the addition as of March 31, 2026 are deemed to meet the BCP requirement only until May 31, 2027. The circular's list of items with revised standards also notes the addition as applying "only when continuing to bill on or after June 1, 2027." In practice, to keep billing on and after June 1, 2027, the BCP must be in place by then. The transitional measure applies only to providers that had notified as of March 31, 2026.
For BCP design ideas, see BCP for Cyberattacks: Differences from Natural-Disaster BCPs and Care-Continuity Priorities and Connecting Business Continuity Plans (BCP) and ISMS.
2. Notifying the outpatient/home-care data submission additions is "desirable"
The MHLW overview states that it is desirable to have notified the outpatient data submission addition and the home-care data submission addition. This is wording in the overview; it does not appear in items (1)–(7) of the circular's facility standards. Check the latest original text to confirm whether it is mandatory. The outpatient data submission addition is summarized in the comprehensive community care addition article.
(Reference) Exclusion of clinics with a designation term of three years or less
In outpatient physician-oversupplied areas, clinics that did not respond to requests to provide medical functions lacking in the area, and whose designation carries a term of three years or less, cannot bill the function strengthening addition (or the comprehensive community care addition etc.). This is built into facility standard (7).
Notification steps
- Confirm which of A–G in (2) your clinic satisfies
- Identify the full-time physician and activity for (3)
- Prepare the posted notice and take-home document for (4) and (5), and publish it on the website
- Formulate the BCP (start early, even within the transitional period)
- Notify your regional bureau of health and welfare using Attachment 7, Form 1-3
For new notifications from June 2026 and handling of providers notified as of March 31, 2026 (including whether re-notification is needed), check the transitional provisions in the circular and your regional bureau's guidance.
In-house checklist
- We know which of A–G we meet and have supporting documents
- If relying on addition 2, we confirmed the most-recent-year patient counts (3 or more)
- We identified and recorded the full-time physician's community activity (any of the 7 items)
- Family-doctor functions are posted in the facility and on the website
- A document with the posted content is available to take home / provide on request
- We post that patients can search via the medical functions information system
- We have a BCP and a review process in place before May 31, 2027
- We still meet the facility standards of the prerequisite additions, such as the comprehensive community care addition
For operations that prevent missed billing, see Why Does Missed Billing Happen? A Cause-Based Checklist to Prevent Revenue Loss.
FAQ
Q. If we have notified the comprehensive community care addition, can we bill the function strengthening addition automatically? A. No. Notification of comprehensive community care addition 1 is one requirement (A), but you must also meet the full-time physician activity, signage and document, BCP, and other requirements, and notify using Form 1-3.
Q. Does comprehensive community care addition 2 qualify? A. Under the circular, it qualifies if you have notified addition 2 and also meet the most-recent-year patient counts (3 or more patients billed for addition 2, or a combined 3 or more for home-visit care or house calls).
Q. If we don't have a BCP yet, must we stop billing immediately? A. Providers that had notified as of March 31, 2026 are deemed to meet the requirement until May 31, 2027. New notifiers and those outside the transitional measure must meet the requirement. Confirm individual handling with your regional bureau.
Summary
- The function strengthening addition adds 80 points to the initial consultation fee for institutions with family-doctor functions.
- The standards span seven items: care-system requirements, full-time physician activity, signage and documents, BCP, and designation term.
- The FY2026 revision added BCP formulation, with a transitional measure until May 31, 2027 for providers that had notified as of March 31, 2026.
Pottech provides AI electronic medical records and billing-check features for clinics. If you need help checking billing status for additions or tallying the results needed for notification, please feel free to contact us.
References / Sources
- MHLW Health Insurance Bureau, Medical Care Division, "Handling of Facility Standards for Basic Medical Fees and Notification Procedures" (March 5, 2026, Hoi-hatsu 0305 No. 7) (Section 1-3 Function Strengthening Addition, Section 4 Transitional Measures, Attachment 7 Form 1-3) (published by the Kyushu bureau) https://kouseikyoku.mhlw.go.jp/kyushu/000476302.pdf
- MHLW, FY2026 Medical Fee Revision overview materials: II-3 Evaluation of Family-Doctor Functions (revision of the function strengthening addition) and II-8 Measures against Regional Maldistribution of Physicians (response to outpatient physician-oversupplied areas) https://www.mhlw.go.jp/content/12400000/001681336.pdf