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Saravanan et al., 2023

Another commenter recommended that CMS include a measure on physical therapy referrals to incentivize access to high value services for patients with low back pain

The more specific the code, the stronger the medical necessity behind the services on the claim

They described a system where manufacturers can launch new, clinically undifferentiated products at inflated prices and offer deep discounts to providers, who then profit from the spread between their acquisition cost and the high Medicare reimbursement rate