The FY2026 fee revision substantially reorganized the add-ons related to medical DX. The former Medical DX Promotion System Development Add-On and others were consolidated into the Electronic Clinical-Information Coordination Add-On, shifting the axis of evaluation from “developing” a system to actual “usage results.” This article outlines the essentials.
The reorganization and its timing
In the FY2026 revision, the former Medical DX Promotion System Development Add-On and the Medical Information Acquisition Add-On were abolished and consolidated into the new Electronic Clinical-Information Coordination Add-On, with full enforcement reported to begin on June 1, 2026.
Overview of points
The add-on to the initial-visit fee (once per month) is reported as 15 points for tier 1, 9 for tier 2, and 4 for tier 3. The add-on to the re-visit / outpatient fee is 2 points once per month regardless of tier. Tiers are separated by the level of medical-DX capability and usage in place.
Core requirements
- Tier 1: an electronic-prescription issuing capability plus actual use of the Electronic Health Record Information Sharing Service
- Tier 2: an electronic-prescription issuing capability (may include being in the adoption process)
- Tier 3: online eligibility verification via My Number insurance cards, plus standard DX readiness and public disclosure
- Common: the recent My Number insurance-card usage rate must meet the defined threshold
Note that if the My Number insurance-card usage rate does not meet the threshold, the add-on reportedly cannot be claimed even if the system capability is in place.
Relationship to the EHR
This add-on is closely tied to DX readiness of in-hospital systems including the EHR — such as support for the information-sharing service and electronic prescriptions. An EHR that conforms to standards and updates continuously is advantageous for keeping up with regulatory changes like these.
Summary and caveat
The Electronic Clinical-Information Coordination Add-On signals a shift toward evaluating actual medical-DX usage. Because details such as points, requirements, and transitional deadlines can change with revisions and notices, always confirm against official sources such as MHLW notifications before claiming.
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