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Research has investigated the mechanisms by which NNMT inhibition might increase energy expenditure, potentially through effects on mitochondrial function or uncoupling protein expression

Vitamin B 12 can also be absorbed by passive diffusion, but this process is very inefficient only about 1% to 2% of the oral vitamin B 12 dose is absorbed passively (2)

Response: Regarding the commenter's concern about low case volumes, we refer readers to the CY 2026 OPPS/ASC proposed rule (90 FR 33771) for discussion of our consideration of low case volumes prior to proposing this measure for adoption in the REH setting