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As indicated in the CY 2025 PFS proposed rule, and as discussed above, CMS will monitor the extent to which manufacturers obtain a new NDC-9 for the same Part D rebatable drug in a manner that could result in inappropriately resetting the payment amount benchmark period or otherwise affect the calculation of the benchmark period manufacturer price
We expect that this code will be billed once during that timeframe when the patient is seen for an office/outpatient (O/O) evaluation and management (E/M) visit that is related to the recent surgical procedure
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doi: 10.1210/jcem.74.2.1730807 131 PopovicVLealAMicicDKoppeschaarHPTorresEParamoCet al
