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Verify the current MAC LCD for the most recent coverage determination before billing semaglutide or tirzepatide for non-diabetes indications Source: CMS LCD Database RCM teams managing injection billing must verify that their billing software reflects the April 2026 quarterly MPFSDB update

This ongoing care ensures lasting results and continued wellness support

[585] The Shared Savings Program's existing financial methodology does not fully account for actions taken to protect the integrity of the Medicare program, or address the impact of improper payments, including improper payments resulting from fraud or similar fault on program calculations

Following this, the most likely course of action will be to complete a prescription of antibiotics