Article 26Special Provisions on Calculation of Income from Social Insurance Medical Fees
第二十六条（社会保険診療報酬の所得計算の特例）
Where an individual engaged in medical practice or dental practice has, in any year, an amount to be received for social insurance medical care, if the amount to be received is 50,000,000 yen or less and the total of the amounts to be included in gross revenue pertaining to business income arising from the medical practice or dental practice engaged in by that individual is 70,000,000 yen or less, the amount to be included in necessary expenses as expenses pertaining to that social insurance medical care in calculating the amount of business income for that year is, notwithstanding the provisions of Article 37, paragraph (1) and Part II, Chapter II, Section 2, Subsection 4 of the Income Tax Act, the total of the amounts calculated by dividing the amount to be received into the amounts listed in the left-hand column of the following table and multiplying each of those amounts by the rate listed in the right-hand column of that table.
| The amount of 25,000,000 yen or less | 72 percent |
| The amount exceeding 25,000,000 yen but not exceeding 30,000,000 yen | 70 percent |
| The amount exceeding 30,000,000 yen but not exceeding 40,000,000 yen | 62 percent |
| The amount exceeding 40,000,000 yen but not exceeding 50,000,000 yen | 57 percent |
医業又は歯科医業を営む個人が、各年において社会保険診療につき支払を受けるべき金額を有する場合において、当該支払を受けるべき金額が五千万円以下であり、かつ、当該個人が営む医業又は歯科医業から生ずる事業所得に係る総収入金額に算入すべき金額の合計額が七千万円以下であるときは、その年分の事業所得の金額の計算上、当該社会保険診療に係る費用として必要経費に算入する金額は、所得税法第三十七条第一項及び第二編第二章第二節第四款の規定にかかわらず、当該支払を受けるべき金額を次の表の上欄に掲げる金額に区分してそれぞれの金額に同表の下欄に掲げる率を乗じて計算した金額の合計額とする。
| 二千五百万円以下の金額 | 百分の七十二 |
| 二千五百万円を超え三千万円以下の金額 | 百分の七十 |
| 三千万円を超え四千万円以下の金額 | 百分の六十二 |
| 四千万円を超え五千万円以下の金額 | 百分の五十七 |
The social insurance medical care prescribed in the preceding paragraph means the benefits or the medical care, long-term care, midwifery or services listed in the following items:
前項に規定する社会保険診療とは、次の各号に掲げる給付又は医療、介護、助産若しくはサービスをいう。
medical treatment benefits under the provisions of the Health Insurance Act (Act No. 70 of 1922), the National Health Insurance Act (Act No. 192 of 1958), the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982), the Mariners Insurance Act (Act No. 73 of 1939), the National Public Officers Mutual Aid Association Act (Act No. 128 of 1958) (including the cases where that Act is to be followed pursuant to Article 22, paragraph (1) of the Act on Remuneration, etc. of Ministry of Defense Personnel (Act No. 266 of 1952); the same applies hereinafter in this item), the Local Public Officers, etc. Mutual Aid Association Act (Act No. 152 of 1962), the Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953), the Act on Special Aid to the Wounded and Sick Retired Soldiers (Act No. 168 of 1963), the Maternal and Child Health Act (Act No. 141 of 1965), the Child Welfare Act (Act No. 164 of 1947), or the Atomic Bomb Survivors' Assistance Act (Act No. 117 of 1994) (including, out of the medical treatment for insured persons, members or subscribers, or dependents to whom hospitalization meal expenses, hospitalization living expenses, expenses for combined insured and uninsured medical treatment, family medical treatment expenses, or special medical care expenses (meaning special medical care expenses as prescribed in Article 54-3, paragraph (1) of the National Health Insurance Act or Article 82, paragraph (1) of the Act on Assurance of Medical Care for Elderly People; the same applies hereinafter in this item) are to be paid under the provisions of the Health Insurance Act, the National Health Insurance Act, the Act on Assurance of Medical Care for Elderly People, the Mariners Insurance Act, the National Public Officers Mutual Aid Association Act, the Local Public Officers, etc. Mutual Aid Association Act, or the Private School Personnel Mutual Aid Association Act, the part equivalent to the amount specified pursuant to the provisions of those Acts as the amount of the expenses required for that medical treatment in calculating the amount of those hospitalization meal expenses, hospitalization living expenses, expenses for combined insured and uninsured medical treatment, family medical treatment expenses, or special medical care expenses (for that part pertaining to special medical care expenses, limited to a part for which it has been certified, pursuant to the provisions of Order of the Ministry of Finance, that it is that part), and designated home-visit nursing for insured persons, members or subscribers, or dependents to whom home-visit nursing expenses or family home-visit nursing expenses are to be paid under the provisions of those Acts), benefits of medical care for rehabilitation, benefits of medical care for premature infants, benefits of medical care and education, or benefits of medical care;
健康保険法（大正十一年法律第七十号）、国民健康保険法（昭和三十三年法律第百九十二号）、高齢者の医療の確保に関する法律（昭和五十七年法律第八十号）、船員保険法（昭和十四年法律第七十三号）、国家公務員共済組合法（昭和三十三年法律第百二十八号）（防衛省の職員の給与等に関する法律（昭和二十七年法律第二百六十六号）第二十二条第一項においてその例によるものとされる場合を含む。以下この号において同じ。）、地方公務員等共済組合法（昭和三十七年法律第百五十二号）、私立学校教職員共済法（昭和二十八年法律第二百四十五号）、戦傷病者特別援護法（昭和三十八年法律第百六十八号）、母子保健法（昭和四十年法律第百四十一号）、児童福祉法（昭和二十二年法律第百六十四号）又は原子爆弾被爆者に対する援護に関する法律（平成六年法律第百十七号）の規定に基づく療養の給付（健康保険法、国民健康保険法、高齢者の医療の確保に関する法律、船員保険法、国家公務員共済組合法、地方公務員等共済組合法若しくは私立学校教職員共済法の規定によつて入院時食事療養費、入院時生活療養費、保険外併用療養費、家族療養費若しくは特別療養費（国民健康保険法第五十四条の三第一項又は高齢者の医療の確保に関する法律第八十二条第一項に規定する特別療養費をいう。以下この号において同じ。）を支給することとされる被保険者、組合員若しくは加入者若しくは被扶養者に係る療養のうち当該入院時食事療養費、入院時生活療養費、保険外併用療養費、家族療養費若しくは特別療養費の額の算定に係る当該療養に要する費用の額としてこれらの法律の規定により定める金額に相当する部分（特別療養費に係る当該部分にあつては、当該部分であることにつき財務省令で定めるところにより証明がされたものに限る。）又はこれらの法律の規定によつて訪問看護療養費若しくは家族訪問看護療養費を支給することとされる被保険者、組合員若しくは加入者若しくは被扶養者に係る指定訪問看護を含む。）、更生医療の給付、養育医療の給付、療育の給付又は医療の給付
medical care for medical assistance, long-term care for long-term care assistance (limited to home-visit nursing, home-visit rehabilitation, guidance on management of in-home medical care, outpatient rehabilitation, or short-term admission for recuperation prescribed in paragraph (2) of Article 15-2 of that Act, out of the in-home long-term care listed in paragraph (1), item (i) of that Article; preventive home-visit nursing, preventive home-visit rehabilitation, preventive guidance on management of in-home medical care, preventive outpatient rehabilitation, or preventive short-term admission for recuperation prescribed in paragraph (5) of that Article, out of the preventive long-term care listed in paragraph (1), item (v) of that Article; or long-term care health facility services or integrated facility for medical and long-term care services prescribed in paragraph (4) of that Article, out of the facility long-term care listed in paragraph (1), item (iv) of that Article), or midwifery for maternity assistance, under the provisions of the Public Assistance Act (Act No. 144 of 1950); benefits or medical care, long-term care, midwifery or services specified by Cabinet Order pertaining to medical care for medical support benefits or other support benefits under the provisions of the Act on Promotion of Smooth Return of Japanese Nationals Remaining in China, etc. and on Support for the Self-Reliance of Japanese Nationals Remaining in China, etc. Who Have Returned to Japan for Permanent Residence and Their Specified Spouses (Act No. 30 of 1994) (including as applied mutatis mutandis pursuant to Article 4, paragraph (2) of the Supplementary Provisions of the Act Partially Amending the Act on Promotion of Smooth Return of Japanese Nationals Remaining in China, etc. and Support for Self-Reliance after Permanent Return to Japan (Act No. 127 of 2007)); or benefits or medical care, long-term care, midwifery or services specified by Cabinet Order pertaining to medical care for medical support benefits or other support benefits under the provisions of the Act on Promotion of Smooth Return of Japanese Nationals Remaining in China, etc. and Support for Self-Reliance after Permanent Return to Japan prior to its amendment by the Act Partially Amending the Act on Promotion of Smooth Return of Japanese Nationals Remaining in China, etc. and Support for Self-Reliance after Permanent Return to Japan (Act No. 106 of 2013), for which the provisions then in force continue to govern pursuant to Article 2, paragraph (1) or paragraph (2) of the Supplementary Provisions of that amending Act;
生活保護法（昭和二十五年法律第百四十四号）の規定に基づく医療扶助のための医療、介護扶助のための介護（同法第十五条の二第一項第一号に掲げる居宅介護のうち同条第二項に規定する訪問看護、訪問リハビリテーション、居宅療養管理指導、通所リハビリテーション若しくは短期入所療養介護、同条第一項第五号に掲げる介護予防のうち同条第五項に規定する介護予防訪問看護、介護予防訪問リハビリテーション、介護予防居宅療養管理指導、介護予防通所リハビリテーション若しくは介護予防短期入所療養介護又は同条第一項第四号に掲げる施設介護のうち同条第四項に規定する介護保健施設サービス若しくは介護医療院サービスに限る。）若しくは出産扶助のための助産又は中国残留邦人等の円滑な帰国の促進並びに永住帰国した中国残留邦人等及び特定配偶者の自立の支援に関する法律（平成六年法律第三十号）の規定（中国残留邦人等の円滑な帰国の促進及び永住帰国後の自立の支援に関する法律の一部を改正する法律（平成十九年法律第百二十七号）附則第四条第二項において準用する場合を含む。）に基づく医療支援給付のための医療その他の支援給付に係る政令で定める給付若しくは医療、介護、助産若しくはサービス若しくは中国残留邦人等の円滑な帰国の促進及び永住帰国後の自立の支援に関する法律の一部を改正する法律（平成二十五年法律第百六号）附則第二条第一項若しくは第二項の規定によりなお従前の例によることとされる同法による改正前の中国残留邦人等の円滑な帰国の促進及び永住帰国後の自立の支援に関する法律の規定に基づく医療支援給付のための医療その他の支援給付に係る政令で定める給付若しくは医療、介護、助産若しくはサービス
medical care under the provisions of the Act on Mental Health and Welfare for Persons with Mental Disorders or Disabilities (Act No. 123 of 1950), the Narcotics and Psychotropics Control Act (Act No. 14 of 1953), the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (Act No. 114 of 1998), or the Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases Under the Condition of Insanity (Act No. 110 of 2003);
精神保健及び精神障害者福祉に関する法律（昭和二十五年法律第百二十三号）、麻薬及び向精神薬取締法（昭和二十八年法律第十四号）、感染症の予防及び感染症の患者に対する医療に関する法律（平成十年法律第百十四号）又は心神喪失等の状態で重大な他害行為を行った者の医療及び観察等に関する法律（平成十五年法律第百十号）の規定に基づく医療
out of the designated in-home services (limited to home-visit nursing, home-visit rehabilitation, guidance on management of in-home medical care, outpatient rehabilitation, or short-term admission for recuperation) for insured persons to whom in-home long-term care service expenses are to be paid under the provisions of the Long-Term Care Insurance Act (Act No. 123 of 1997), the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for those designated in-home services in calculating the amount of those in-home long-term care service expenses, out of the designated preventive long-term care services (limited to preventive home-visit nursing, preventive home-visit rehabilitation, preventive guidance on management of in-home medical care, preventive outpatient rehabilitation, or preventive short-term admission for recuperation) for insured persons to whom preventive long-term care service expenses are to be paid under the provisions of that Act, the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for those designated preventive long-term care services in calculating the amount of those preventive long-term care service expenses, or, out of the long-term care health facility services or integrated facility for medical and long-term care services for insured persons to whom facility long-term care service expenses are to be paid under the provisions of that Act, the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for those long-term care health facility services or integrated facility for medical and long-term care services in calculating the amount of those facility long-term care service expenses;
介護保険法（平成九年法律第百二十三号）の規定によつて居宅介護サービス費を支給することとされる被保険者に係る指定居宅サービス（訪問看護、訪問リハビリテーション、居宅療養管理指導、通所リハビリテーション又は短期入所療養介護に限る。）のうち当該居宅介護サービス費の額の算定に係る当該指定居宅サービスに要する費用の額として同法の規定により定める金額に相当する部分、同法の規定によつて介護予防サービス費を支給することとされる被保険者に係る指定介護予防サービス（介護予防訪問看護、介護予防訪問リハビリテーション、介護予防居宅療養管理指導、介護予防通所リハビリテーション又は介護予防短期入所療養介護に限る。）のうち当該介護予防サービス費の額の算定に係る当該指定介護予防サービスに要する費用の額として同法の規定により定める金額に相当する部分又は同法の規定によつて施設介護サービス費を支給することとされる被保険者に係る介護保健施設サービス若しくは介護医療院サービスのうち当該施設介護サービス費の額の算定に係る当該介護保健施設サービス若しくは介護医療院サービスに要する費用の額として同法の規定により定める金額に相当する部分
out of the designated medical care for independence support for persons with disabilities, etc. under a payment certification for which medical expenses for independence support are to be paid under the provisions of the Act on Providing Comprehensive Support for the Daily Life and Life in Society of Persons with Disabilities (Act No. 123 of 2005), the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for that designated medical care for independence support in calculating the amount of those medical expenses for independence support, or, out of the designated medical care in recuperative care (meaning medical care in recuperative care provided by a designated disability welfare service provider, etc. for recuperative care) for persons with disabilities under a payment decision for which medical expenses for recuperative care are to be paid under the provisions of that Act, the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for that designated medical care in recuperative care in calculating the amount of those medical expenses for recuperative care; or, out of the outpatient medical care for children with physical disabilities for children with disabilities under an outpatient benefit decision for which outpatient medical expenses for children with physical disabilities are to be paid under the provisions of the Child Welfare Act, the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for that outpatient medical care for children with physical disabilities in calculating the amount of those outpatient medical expenses for children with physical disabilities, or, out of the medical care for children with disabilities in residential facilities for children with disabilities under an admission benefit decision for which medical expenses for children with disabilities in residential facilities are to be paid under the provisions of that Act, the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for that medical care for children with disabilities in residential facilities in calculating the amount of those medical expenses for children with disabilities in residential facilities;
障害者の日常生活及び社会生活を総合的に支援するための法律（平成十七年法律第百二十三号）の規定によつて自立支援医療費を支給することとされる支給認定に係る障害者等に係る指定自立支援医療のうち当該自立支援医療費の額の算定に係る当該指定自立支援医療に要する費用の額として同法の規定により定める金額に相当する部分若しくは同法の規定によつて療養介護医療費を支給することとされる支給決定に係る障害者に係る指定療養介護医療（療養介護に係る指定障害福祉サービス事業者等から提供を受ける療養介護医療をいう。）のうち当該療養介護医療費の額の算定に係る当該指定療養介護医療に要する費用の額として同法の規定により定める金額に相当する部分又は児童福祉法の規定によつて肢体不自由児通所医療費を支給することとされる通所給付決定に係る障害児に係る肢体不自由児通所医療のうち当該肢体不自由児通所医療費の額の算定に係る当該肢体不自由児通所医療に要する費用の額として同法の規定により定める金額に相当する部分若しくは同法の規定によつて障害児入所医療費を支給することとされる入所給付決定に係る障害児に係る障害児入所医療のうち当該障害児入所医療費の額の算定に係る当該障害児入所医療に要する費用の額として同法の規定により定める金額に相当する部分
out of the designated specified medical care for patients with designated intractable diseases who have received a payment certification for which specified medical expenses are to be paid under the provisions of the Act on Medical Care for Patients with Intractable Diseases (Act No. 50 of 2014), the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for that designated specified medical care in calculating the amount of those specified medical expenses, or, out of the designated medical support for specified pediatric chronic diseases for children, etc. with specified pediatric chronic diseases under a medical expense payment certification for which medical expenses for specified pediatric chronic diseases are to be paid under the provisions of the Child Welfare Act, the part equivalent to the amount specified pursuant to the provisions of that Act as the amount of the expenses required for that designated medical support for specified pediatric chronic diseases in calculating the amount of those medical expenses for specified pediatric chronic diseases.
難病の患者に対する医療等に関する法律（平成二十六年法律第五十号）の規定によつて特定医療費を支給することとされる支給認定を受けた指定難病の患者に係る指定特定医療のうち当該特定医療費の額の算定に係る当該指定特定医療に要する費用の額として同法の規定により定める金額に相当する部分又は児童福祉法の規定によつて小児慢性特定疾病医療費を支給することとされる医療費支給認定に係る小児慢性特定疾病児童等に係る指定小児慢性特定疾病医療支援のうち当該小児慢性特定疾病医療費の額の算定に係る当該指定小児慢性特定疾病医療支援に要する費用の額として同法の規定により定める金額に相当する部分
The provisions of paragraph (1) do not apply if the final return does not contain a statement to the effect that the amount of business income has been calculated pursuant to the provisions of that paragraph.
Even if a final return is filed that is not filled out as referred to in the preceding paragraph, the district director may apply the provisions of paragraph (1) on finding there to be unavoidable circumstances for the failure to fill out the final return in that manner.