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Similarly, in proposed 428.202(c)(4), CMS proposes that for a subsequently approved drug for which there are no quarters during the first calendar year ( beginning after the drug's first marketed date for which AMP has been reported under section 1927(b)(3), the payment amount benchmark period would be the first calendar year in which such drug has at least 1 quarter of AMP reported

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The behavior management/modification CTS themselves need to be congruent with the treatment plan and designed to effectuate the desired patient outcomes