Not much has changed, although COVID has sped up the transition away from cash a bit and these days you can withdraw cash from almost any major Japanese bank ATM.  But the short answer is, **you will need to carry cash (Japanese yen)**, many restaurants, shops, taxis etc still accept nothing else and credit cards will not solve this problem.

PASMO/Suica can generally speaking only be topped up with cash, although there are various tourist versions with preloaded value that you can pay for with cards at the airport and major train stations, and residents can recharge automatically from Japanese bank accounts etc.