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Make-up sessions for Online delivery were referenced in the CY 2026 PFS proposed rule (90 FR 32593) at 410.79 (f)(2)(i)(C), which states the Set of MDPP services, inclusive of make-up sessions, must be delivered to individual beneficiaries fully synchronously (that is, In-person, Distance learning, or In-person with a distance learning component) or fully asynchronously (that is, Online)

A commenter suggested that CMS consider a greater of approach, which would compare multiple methodologies and select the one that produced the highest estimate

Nutrient Deficiency Support: Ideal for individuals with low B12 levels or those seeking B12 deficiency treatment

Without this important nutrient, cellular function would cease, and energy would plummet

Response: We agree with commenters that teaching physicians should be allowed to determine when their virtual presence would be clinically appropriate, based on their assessment of the patient's needs and the competency level of the resident, and that this policy benefits teaching physicians, residents, and beneficiaries