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These payment rates reflect the cost of services provided and are in line with services in other comparable settings

By supporting tissue remodeling, encouraging blood vessel growth, and speeding up wound healing, these therapies can address postpartum injuries like anal sphincter tears or vaginal tissue damage

These variances can lead to inconsistent patient outcomes

Response: In response to commenters indicating it was unclear from the discussion in the proposed rule our considerations for determining if an improper payment is of sufficient magnitude to reopen a payment determination, for one, we note that in the CY 2025 PFS proposed rule (89 FR 61896) we specified that we would be highly unlikely to exercise our discretion to reopen a payment determination to address particular instances of low-value improper payments which, in an individual case may be to the benefit of either the ACO or CMS and in the aggregate are likely to have a de minimis net effect on program expenditures in the long run