The fiscal 2026 revision fundamentally reorganized the structure of medical DX-related fees. The previously central medical DX promotion system development fee and medical information acquisition fee were abolished and consolidated into the newly established electronic clinical information coordination fee.
Institutions that had filed for the old fees are not migrated automatically and must file again.
Disclaimer: This article provides general information. Point values, facility standards, and transitional measures are set by official notices and are subject to change. Always verify against current primary sources.
What Changed
| Item | Before | After |
|---|---|---|
| Medical information acquisition fee | Existed | Abolished |
| Medical DX promotion system development fee | Existed | Abolished |
| Electronic clinical information coordination fee | — | Newly established |
The old fees were abolished as of May 31, 2026, and the new fee became billable from June 1, 2026.
The reorganization is explained as shifting the axis of evaluation from per-patient information acquisition status toward the institution's overall level of DX capability—a move from encouraging adoption to evaluating utilization.
Overview of the New Fee
Point structure
According to reporting, points are structured as follows.
| Applies to | Tier | Points |
|---|---|---|
| Initial consultation | Tier 1 | 15 |
| Initial consultation | Tier 2 | 9 |
| Initial consultation | Tier 3 | 4 |
| Follow-up / outpatient | Uniform | 2 (monthly) |
| Inpatient | Tier 1 | 160 (first day) |
| Inpatient | Tier 2 | 80 (first day) |
Always confirm specific point values in the official notices.
Facility standards
Standards are tiered according to support for electronic prescriptions and the EMR information sharing service.
Requirements reported as common to all tiers include:
- Submitting claims online
- Having arrangements to issue itemized statements free of charge
- Having arrangements for online eligibility verification
- Meeting a standard regarding My Number Card utilization rate
Higher tiers additionally require support for electronic prescriptions and the EMR information sharing service.
This structure inherits the thinking of the former medical DX promotion system development fee. For institutions that had already built those arrangements, what is required has not fundamentally changed—what changed is the fee framework and the need to re-file.
Most Important: Filing Must Be Redone
Even institutions that had filed for the old fees must file again to bill the new fee. Prior filings do not carry over.
Forgetting to file leaves you unable to bill despite having the arrangements in place. Verify your filing status immediately.
- Has the new filing been submitted?
- Is the tier appropriate for your arrangements?
- Does your My Number Card utilization rate continue to meet the standard?
- Have posting requirements been updated to the new fee?
Do Not Forget to Update Postings
Postings are easily overlooked. If in-clinic notices and website text were written using the old fee's name, they must be updated.
Website text especially is reviewed less often than in-clinic postings, so old names tend to linger.
Also Reorganized
According to reporting, the medical record management system fee was also reorganized, consolidating from three tiers into two.
Overall revision changes are covered in Medical Fee Revision 2026.
My Number Card Utilization Rate
The new fee also incorporates a utilization rate standard. As with the old fee, it must continue to be met after billing begins; falling below the standard means the fee cannot be billed for that period. Building a monthly check into operations is effective.
Policy background is covered in The Policy Behind the My Number Insurance Card.
Building the Arrangements
Higher tiers hinge on electronic prescriptions and the EMR information sharing service.
- Electronic prescriptions: What Is an Electronic Prescription?
- EMR information sharing service: The Complete Guide to the EMR Information Sharing Service
- Online eligibility verification: What Does Mandatory Online Eligibility Verification Mean?
AI Karte, developed by Pottech, is an integrated-rececon cloud EMR designed so that online eligibility verification, electronic prescriptions, and the EMR information sharing service advance on one foundation, with system updates aligned to fee revisions.
Response Checklist
| Item | What to check |
|---|---|
| Filing | Submitted for the new fee? Old filings do not carry over |
| Tier | Appropriate to your arrangements? |
| Utilization rate | Continuing to meet the standard? |
| Posting (in-clinic) | Updated to the new fee? |
| Posting (web) | Website updated? Any old fee names remaining? |
| Electronic prescriptions | Status confirmed if targeting a higher tier |
| Information sharing service | Status confirmed if targeting a higher tier |
| Billing status | Confirmed on claims that billing actually occurred from June |
Conclusion
- The fiscal 2026 revision abolished the medical information acquisition fee and the medical DX promotion system development fee
- The electronic clinical information coordination fee replaced them, billable from June 1, 2026
- Evaluation shifted from per-patient acquisition toward institution-wide DX capability
- Re-filing is required even if previously filed; migration is not automatic
- Facility standards inherit the old framework, so required arrangements have not fundamentally changed
- Posting updates, especially on websites, are easily missed
- Higher tiers hinge on electronic prescriptions and the EMR information sharing service
- Always confirm specific values in the official notices
For details on AI Karte or to request a demo, please contact us.
References / Sources
- Ministry of Health, Labour and Welfare, "About the FY2026 (Reiwa 8) Medical Fee Revision" https://www.mhlw.go.jp/stf/newpage_67729.html
- Ministry of Health, Labour and Welfare, "About Explanatory Materials for the FY2026 Medical Fee Revision" https://www.mhlw.go.jp/stf/newpage_71068.html