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As we previously stated in the CY 2016 PFS final rule with comment period (80 FR 70897), we do not believe the annual maintenance factor for all equipment is precisely 5 percent, and we concur that the current rate likely understates the true cost of maintaining some equipment

The question that matters clinically is whether a given patient is a good candidate, what the right protocol looks like for their specific goals and lab results, and whether they have access to a supervised framework that can catch the small number of patients for whom these compounds are not appropriate before they start rather than after