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Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final rule (83 FR 59654 through 59661), creating the CQ and CO payment modifiers for services provided in whole or in part by PTAs and OTAs, respectively

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The absence of effects on IGF-1, glucose metabolism, and tissue growth reduces concerns about long-term hormonal consequences, but prudent medical oversight remains appropriate for any extended peptide use