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Factors Considered As discussed in the FY 2021 IPPS/LTCH PPS final rule (85 FR 58873 through 58892), to reduce the Medicare program's reliance on the hospital chargemaster and to support the development of a market-based approach to payment under the Medicare FFS system, we finalized our proposal to require that hospitals report certain market-based payment rate information on their Medicare cost report for cost reporting periods ending on or after January 1, 2021

Bioavailability limitations require 2-3x higher doses for nasal versus injectable delivery , creating corresponding 2-3x cost increases that make nasal spray primarily appropriate for needle-phobic individuals or peptides specifically designed for nasal use

Ideally, ventilation should be supplied only to maintain indoor air quality