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This raises further questions about the utility of reopening payment determinations versus maintaining administrative finality of initial determinations

Hoffmann, D., Raineri, R., Hecht, S

We are proposing the RUC-recommended work RVU of 0.24 for CPT code 96380 ( Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional ) and the RUC-recommended work RVU of 0.17 for CPT code 96381 ( Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection )

We discuss and seek comment on the circumstances in which we would exercise our discretion to reopen a payment determination and issue a revised initial determination to account for the impact of identified improper payments on Shared Savings Program calculations (as described in section III.G.7.c.(2).(b) of this proposed rule)