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We also reiterated, as we stated in the CY 2025 OPPS/ASC final rule with comment period (89 FR 93957), that there could be potential value in the use of ASP data for payment purposes for diagnostic radiopharmaceuticals when reported correctly and by all manufacturers who manufacture a product that is described by a given HCPCS code

Also, insurance companies typically do not cover off-label drugs such as Mounjaro prescribed for weight loss

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[DOI] [PMC free article] [PubMed] [Google Scholar] 7.Chen Y., Han M., Matsumoto A., Wang Y., Thompson D.C., Vasiliou V