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As this is above the threshold of 10 claims and below the threshold of 100 claims for a service within a year, we proposed to apply our universal low volume New Technology APC policy and use the highest of the geometric mean cost, arithmetic mean cost, or median cost based on up to 4 years of claims data to assign CPT codes 0890T and 0891T to the appropriate New Technology APCs

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L-carnitine (free form), Bulking agents (microcrystalline cellulose, dicalcium phosphate), Anti-caking agents (vegetable stearic acid, silicon dioxide, vegetable magnesium stearate), Coating agents (hydroxypropylmethylcellulose, vegetable glycerin, camauba wax), Stabilizer (interlaced cellulose gum)