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Again, notwithstanding the temporary measures implemented in response to the PHE for COVID-19 and extended thereafter, we have historically established this “immediate availability” requirement to mean in-person, physical, not virtual, availability (see the April 6, 2020 IFC (85 FR 19245) and the CY 2022 PFS final rule (86 FR 65062))

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Who should check with a provider first If you are pregnant, nursing, have kidney disease, or take medications that interact with B12 metabolism (such as metformin), discuss this with a provider before starting