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Walston, K

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Commercial Insurance: The majority of commercial payers cover Depo-Provera as a preventive contraceptive service under the Affordable Care Act (ACA), which mandates coverage of FDA-approved contraceptive methods without cost-sharing for in-network providers

Response: While we note that APC geometric mean cost changes are expected under the current structure of the C-APCs and the complexity adjustments, we agree that a Level 3 Nerve Procedures APC is appropriate, in particular to resolve what would otherwise be a significant two times rule violation in the Level 2 APC