As discussed in the proposed rule (90 FR 33799), we believe the inclusion of the name of a hospital senior official will provide CMS actionable and enforceable certainty, and MRF users additional assurance, including in situations where the hospital's payer-specific negotiated charge is based on a contractual algorithm, percentage, or formula by which a hospital genuinely cannot specify a dollar amount, that the data were reviewed and verified by the ( hospital's leadership, and would expedite our ability to quickly identify an individual at the hospital to obtain, where necessary, further clarity regarding the MRF data
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Tesamorelin & CJC-1295 (Mod GRF 1-29) & Ipamorelin Blend (12mg) $109.00 Tesamorelin & CJC-1295 (Mod GRF 1-29) & Ipamorelin peptide blend is Synthesized and Lyophilized in the USA
For CY 2026, we believed these were still appropriately assigned to APC 5361 (Level 1 Laparoscopy and Related Services), which had a proposed payment rate of $6,228.97
We did not receive public comments on this provision, and therefore, we are finalizing our proposal regarding APC 8010 without modification
