Key Takeaways
- The addition is 1 point under Note 11 of the follow-up visit fee (A001) and was not abolished in the FY2026 revision. Only clinics are eligible, and there is no equivalent on the first-visit fee.
- The facility standards are being a clinic, filing claims online or on optical disks, issuing detailed itemized statements free of charge, and posting this in the clinic and, in principle, on its website. No notification to the regional bureau is required.
- An institution that has notified the electronic clinical information coordination system addition cannot bill this addition; the public notice also states that the two cannot be billed together.
- It is not billed for the second department's same-day follow-up (39 points). It is not on Note 9's list of additions excluded for telephone follow-ups.
"Was the itemized statement issuance system addition abolished in the 2026 revision?" "If we notify the new medical DX addition, what happens to the 1-point statement addition?" With medical DX-related additions reorganized in the FY2026 revision, questions are increasing even about this small 1-point addition on the follow-up visit fee. This article summarizes its points, facility standards, notification and combination rules, based on the original texts of the FY2026 medical fee schedule (Public Notice No. 69), the implementation notice (Hoi-hatsu 0305 No. 6), the basic medical fee facility standards (Public Notice No. 70) and their handling notice (Hoi-hatsu 0305 No. 7).
Disclaimer: This article is general information based on publicly available information as of October 31, 2026. The MHLW public notices and notifications are the authoritative source for points and facility standards. Always confirm the latest original text and the handling of your regional bureau of health and welfare and review body before making billing decisions.
Overview of the itemized statement issuance system addition
The addition is defined in Note 11 of the follow-up visit fee (category A001). The public notice adds 1 point for patients who visit an insured medical institution (limited to clinics) that meets the facility standards designated by the Minister for issuing itemized statements listing each item used to calculate the fees.
Points and basic rules
| Item | Details |
|---|---|
| Points | 1 (added to the follow-up visit fee) |
| Basis | Follow-up visit fee (A001), Note 11 |
| Eligible institutions | Clinics only (hospitals cannot bill it) |
| First-visit fee | No equivalent addition |
| Notification | Not required (meeting the standards is sufficient) |
| Cannot be combined with | Electronic clinical information coordination system addition (first-visit fee Note 16, follow-up visit fee Note 19) |
Was it abolished or changed in FY2026?
The addition was not abolished in the FY2026 revision. Under the FY2026 public notice (effective June 1, 2026), it remains in Note 11 of the follow-up visit fee as a 1-point addition. The MHLW revision overview (individual revision items) does not list its abolition or a change in points.
What changed were the surrounding additions. The FY2026 revision reviewed the medical information acquisition addition and the medical DX promotion system addition and created the electronic clinical information coordination system addition. The public notice states that this addition and the itemized statement addition cannot be billed together (see below).
Facility standards (billing requirements)
The facility standards are set out in the basic medical fee facility standards (Public Notice No. 70) and their handling notice (Hoi-hatsu 0305 No. 7).
Requirements in the public notice
- The institution files claims using an electronic data processing system or on optical disks, as provided in the ordinance on claims for medical care benefits and publicly funded care
- It issues the itemized statements provided in the rules for insured medical institutions to patients free of charge (except for statements on publicly funded care where a "justifiable reason" under the supplementary provisions of the amending ordinance applies)
- It posts matters concerning the system in item 2 in a place easily visible in the institution
- It posts the matters in item 3 on its website, in principle
Requirements in the handling notice
| Requirement | Details |
|---|---|
| Institution | Must be a clinic |
| Claims | Files claims using an electronic data processing system or on optical disks |
| Statements | Issues detailed itemized statements, listing the fee categories, item names and points or amounts billed, to patients free of charge |
| Posting | Posts a notice to that effect in the clinic |
Clinics that file paper claims or charge for itemized statements do not meet the standards.
No notification required
The handling notice for the basic medical fee facility standards states that for this addition, meeting the standards is sufficient and no notification to the regional bureau of health and welfare is required.
Because no notification is needed, the clinic itself must manage whether it meets the standards. Periodically check the wording of posted notices, the website content and the statement issuance settings (whether statements are issued free of charge).
In-clinic posting and website posting
The public notice requires matters concerning the free issuance of statements to be posted in a visible place in the institution and those posted matters to be published on the website, in principle.
- In-clinic posting: post a notice that itemized statements are issued free of charge where patients can easily see it, such as at reception or in the waiting room
- Website: publish the same content, in principle, on the institution's website
The facility standards for the electronic clinical information coordination system addition also include posting matters on statement issuance in the institution and on its website (revision overview). Whichever addition you bill, posting about itemized statements is required.
Relation to the obligation to issue statements free of charge
Issuing itemized statements is itself required by the rules for insured medical institutions, regardless of the addition.
- Article 5-2, paragraphs 2 and 3: insured medical institutions designated by the Minister must, unless there is a justifiable reason, issue an itemized statement listing each item used to calculate the fees when issuing a receipt, and must do so free of charge
- Article 5-2-2: the same institutions must, unless there is a justifiable reason, issue itemized statements free of charge when providing designated publicly funded care for which the patient pays nothing
In other words, free issuance of itemized statements is an obligation under the rules, and this addition evaluates, at each follow-up visit, that a clinic has a system for electronic claims and free itemized statements.
Cases where it cannot be billed
| Situation | Handling | Basis |
|---|---|---|
| Hospitals | Not billable | Note 11 (clinics only) |
| First visits | No equivalent addition on the first-visit fee | Public notice |
| Institutions that have notified the electronic clinical information coordination system addition | Not billable | Notes 11 and 19, first-visit fee Note 16, implementation notice |
| Second department's follow-up on the same day (Note 3, 39 points) | Not billed | Note 3, implementation notice |
| Standards not met (paper claims, statements charged for, no posting, etc.) | Not billable | Public Notice No. 70, Hoi-hatsu 0305 No. 7 |
For telephone follow-ups, Note 9 lists the additions not billed as "Notes 8, 12, 13 and 15 to 20"; Note 11 (this addition) is not included.
Relation to the electronic clinical information coordination system addition
This is the point most in need of checking in FY2026.
- Follow-up visit fee Note 11: when this addition is billed, the electronic clinical information coordination system addition (first-visit Note 16, follow-up Note 19) cannot be billed separately
- Follow-up visit fee Note 19 and first-visit fee Note 16: when the electronic clinical information coordination system addition is billed, this addition cannot be billed separately
- Implementation notice: an insured medical institution that has notified the electronic clinical information coordination system addition cannot bill this addition
Because the notice refers to "an institution that has notified," a clinic that has notified the coordination addition appears unable to bill this addition even in months or for patients where the coordination addition is not billed. Make sure your notification status and billing system settings match.
| Itemized statement addition | Electronic clinical information coordination addition | |
|---|---|---|
| Basis | Follow-up visit fee Note 11 | First-visit fee Note 16, follow-up visit fee Note 19 |
| Points | 1 point per follow-up | First visit: 15 / 9 / 4 points once a month (additions 1 / 2 / 3); follow-up: 2 points once a month |
| Eligible | Clinics only | Notified institutions meeting the standards |
| Notification | Not required | Required |
| Combination | Not allowed (one or the other) | Not allowed (one or the other) |
For the facility standards and notification of the coordination addition, see Medical DX-Related Fees in the 2026 Revision.
Pre-billing checklist
- The institution is a clinic (not a hospital)
- Claims are filed online (electronic data processing system) or on optical disks
- Detailed itemized statements with categories, item names and points or amounts are issued to patients free of charge
- A notice that statements are issued free of charge is posted in a visible place in the clinic
- The same content is, in principle, published on the website
- The electronic clinical information coordination addition has not been notified (if it has, this addition is not billed)
- It is not attached to same-day second-department follow-ups (39 points)
- It is not attached to first visits
FAQ
Q. How many points is the addition? A. 1 point added to the follow-up visit fee, defined in Note 11 of the follow-up visit fee (A001).
Q. Was it abolished in the 2026 (FY2026) revision? A. No. It continues at 1 point under the FY2026 public notice. However, it cannot be combined with the newly created electronic clinical information coordination system addition, and institutions that notify that addition cannot bill it.
Q. Is notification required? A. No. Meeting the standards is sufficient, and no notification to the regional bureau is required.
Q. Can hospitals bill it? A. No. The public notice limits it to clinics.
Q. Can it be billed for telephone follow-ups? A. Note 11 is not among the additions Note 9 excludes for telephone follow-ups (Notes 8, 12, 13 and 15–20).
Q. What happens to the 1 point if we notify the electronic clinical information coordination addition? A. It can no longer be billed. The implementation notice states that institutions that have notified that addition cannot bill this addition. Review your billing system's automatic settings.
Summary
- The itemized statement issuance system addition is a 1-point addition under Note 11 of the follow-up visit fee and continues after the FY2026 revision
- Only clinics are eligible; there is no equivalent on the first-visit fee
- The standards are electronic claims (online or optical disk), free detailed itemized statements, in-clinic posting and website posting (in principle); no notification is required
- It cannot be combined with the electronic clinical information coordination system addition, and institutions that notify that addition cannot bill it
- It is not billed for second-department follow-ups (39 points); it is not on the list of additions excluded for telephone follow-ups
Related articles
- Follow-up Visit Fee Additions List: FY2026 Points, Outpatient Management Addition Rules and Combination Limits
- Initial Consultation Fee Additions List
- Medical DX-Related Fees in the 2026 Revision
- What Is the Outpatient Management Addition?
- Why Billing Is Missed: A Cause-by-Cause Checklist
- Medical Fee Revision 2026
Pottech provides AI electronic medical records and billing check functions for clinics that reflect billing requirements. If you have questions about setting additions to match your notification status or checking billing rules after a revision, please feel free to contact us.
Frequently Asked Questions
- Q. How many points is the addition?
- A. 1 point added to the follow-up visit fee, defined in Note 11 of the follow-up visit fee (A001) in the FY2026 medical fee schedule (Public Notice No. 69).
- Q. Was it abolished in the FY2026 revision?
- A. No. It remains in Note 11 at 1 point. However, it cannot be combined with the newly created electronic clinical information coordination system addition, and institutions that notify that addition cannot bill it.
- Q. Is notification required?
- A. No. The facility standards notice states that meeting the standards is sufficient and no notification to the regional bureau is needed.
- Q. What are the requirements?
- A. Being a clinic, filing claims online or on optical disks, issuing detailed itemized statements with fee categories, item names and points or amounts free of charge, and posting this in the clinic and, in principle, on its website.
- Q. Can hospitals bill it?
- A. No. The public notice limits it to clinics.
- Q. Which should we bill, this or the electronic clinical information coordination addition?
- A. They cannot both be billed; once you notify the electronic clinical information coordination addition, this addition can no longer be billed. Check whether you meet that addition's standards and that your notification status matches your billing system settings.
参考・出典
- 厚生労働省「診療報酬の算定方法の一部を改正する件」（令和8年厚生労働省告示第69号）医科診療報酬点数表（A000 初診料 注16、A001 再診料 注3・注9・注11・注19） https://www.mhlw.go.jp/content/12400000/001686842.pdf
- 厚生労働省保険局医療課「診療報酬の算定方法の一部改正に伴う実施上の留意事項について」（令和8年3月5日保医発0305第6号、1007訂正後）別添1（A000 初診料(30)、A001 再診料(4)(15)） https://www.mhlw.go.jp/content/12400000/001757385.pdf
- 厚生労働省「基本診療料の施設基準等の一部を改正する件」（令和8年厚生労働省告示第70号）（明細書発行体制等加算の施設基準） https://www.mhlw.go.jp/content/12400000/001675854.pdf
- 厚生労働省保険局医療課「基本診療料の施設基準等及びその届出に関する手続きの取扱いについて」（令和8年3月5日保医発0305第7号、1007訂正後）別添1 第2の2 明細書発行体制等加算 https://www.mhlw.go.jp/content/12400000/001757361.pdf
- 厚生労働省「令和8年度診療報酬改定について」個別改定事項（電子的診療情報連携体制整備加算の新設） https://www.mhlw.go.jp/content/12400000/001681336.pdf
- 保険医療機関及び保険医療養担当規則（昭和32年厚生省令第15号）第5条の2、第5条の2の2（e-Gov法令検索） https://laws.e-gov.go.jp/law/332M50000100015
- 厚生労働省「令和8年度診療報酬改定について」（告示・通知・疑義解釈資料の掲載ページ） https://www.mhlw.go.jp/stf/newpage_67729.html