Will there be fewer doctors treating developmental disorders in children? Medical field alarmed by reimbursement revision

From The Mainichi Shimbun via Yahoo! Japan

June 1 2026

TOKYO – Confusion and concern are spreading among families of children with developmental disabilities and medical professionals over the revision to Japan’s medical fee schedule that took effect on June 1.

For fees billed under Outpatient and Home Psychiatric Therapy—a service routinely claimed when examining children with developmental disorders—payments to physicians who do not hold the national qualification of Designated Mental Health Physician will, in principle, be reduced by 40%.

Many pediatricians and child psychiatrists who treat children with developmental disorders do not hold this qualification. There are growing fears that the reimbursement cuts will make it financially unsustainable to continue providing such care.

What does the revision change?

“If this continues, the number of hospitals treating children with developmental disorders will plummet, leading to the collapse of medical services.”

When the Association of People with Developmental Disabilities posted this warning on X in early May, it spread rapidly.

Comments from users included:

• “There are already too few clinics as it is.”
• “Even now, people wait months for appointments. Won’t this make things even worse?”

Social media was flooded with posts expressing alarm.

The reimbursement category affected, Outpatient and Home Psychiatric Therapy, refers to treatment in which physicians work with patients in outpatient settings under a structured treatment plan to improve interpersonal relationships and social adaptation skills.

From June 1, reimbursement for physicians without the Designated Mental Health Physician qualification was reduced as follows:

• Initial consultations (60 minutes or more): from ¥5,500 to ¥3,300.
• Follow-up consultations (more than 5 minutes but less than 30 minutes): from ¥2,900 to ¥1,740.

By contrast, for physicians who hold the qualification, reimbursement for initial consultations increased from ¥6,000 to ¥6,500.

Impact on children was not discussed

Why was this reimbursement category targeted for revision?

In recent years, concerns have arisen—particularly in urban areas—about psychiatrists opening clinics and diagnosing patients with insufficient experience after completing residency training, sometimes making overly casual diagnoses or prescribing psychotropic medications excessively.

The Ministry of Health, Labour and Welfare says it is drawing a distinction in reimbursement based on whether physicians hold the Designated Mental Health Physician qualification, which requires practical clinical experience, in order to ensure the quality of psychiatric care.

However, the qualification is intended for physicians who make legally authorized decisions that can restrict a patient’s rights, such as involuntary hospitalization or the use of physical restraints.

Doctors who treat children with developmental disorders on an outpatient basis generally have no need for this qualification in their daily practice.

Advocates warn of “collapse of medical care”

In response to the revision, some clinics are considering charging patients private reservation fees, while others are considering reducing developmental-disability services and shifting toward general pediatric practice.

Tomoko Katsuyama, secretary-general of the Association of People with Developmental Disabilities, criticized the change:

“There is already a shortage of medical institutions that diagnose developmental disorders, and waiting times for initial consultations are a serious problem. This revision will only make the situation worse. It runs counter to the principle of early detection and early support.”

The Japan Autism Society also issued a statement expressing concern that people in rural areas, where physician shortages already exist, may find it even harder to access necessary medical care.