However, to explore the potential impacts more generally, in the CY 2026 OPPS/ASC proposed rule we explained that we conducted a literature search to compare the payment rates of Medicare FFS, MA organizations, and other commercial payers, which is discussed in section XX.B
Items included in the packaged payment provided in conjunction with the primary service also include all drugs, biologicals, and radiopharmaceuticals, regardless of cost, except those drugs with pass-through payment status and SADs, unless they function as packaged supplies (78 FR 74868, 74869, and 74909 and 79 FR 66800)
Healthcare providers often need to reduce the doses of these concurrent antidiabetic medications when starting semaglutide therapy, with subsequent adjustments based on glucose monitoring results and clinical response
and CPT code 75563( Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences
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