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A few commenters recommended that CMS to apply the exemption by classifying the model as an advanced APM (AAPM) to enable ASM participants to meet QP thresholds, be exempt from MIPS, and receive the higher PFS conversion factor update

Individuals with digestive issues: B12 aids in maintaining a healthy digestive system

Therefore, we do not claim direct causality between an individuals prior B12 test and their hospitalization episode, although a significant correlation exists in large populational level between vitamin B 12 deficiency and hospital admissions for cardiovascular, hematological, neurological, psychological, and gastrointestinal diseases

Presence of comorbidities such as cardiovascular disease

People with specific gastrointestinal problems, such as Crohns disease or celiac disease, or those who have undergone gastrointestinal surgery may have difficulty absorbing B12 from food and supplements

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