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Common Clinical Use Cases: IM steroid injection (e.g., Depo-Medrol for bursitis or joint pain) Vitamin B12 injection for deficiency Testosterone therapy in male hypogonadism Naltrexone injection for alcohol or opioid use disorder Rocephin (ceftriaxone) for infections like gonorrhea or pneumonia These injections must be documented properly, including drug name, dosage, route, site, and medical necessity to justify the service

The WISeR (Wasteful and Inappropriate Services Reduction) model is a Medicare Part B prior authorization pilot running from January 2026 through December 2031 in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington

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The commenter indicated that the cardiac MRI procedures are more resource intensive because of stress protocols, continuous patient monitoring, specialized staff to care for patients undergoing these procedures, longer procedure room time, and post-stress observation time and many of the other procedures that are in these APCs are lower-acuity, non-cardiac tests

Ask about your plans benefits, any required documentation or preauthorization, and whether coverage differs for in-office administration versus self-injection at home