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Candida overgrowth affects people of all ages and backgrounds, but certain groups carry significantly higher risk: women (particularly those who use oral contraceptives or have experienced multiple pregnancies), individuals who have completed one or more courses of broad-spectrum antibiotics, people with diabetes or insulin resistance (elevated blood glucose directly feeds yeast proliferation), those taking corticosteroids or other immunosuppressive medications, and individuals under chronic psychological stress

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In response, as we summarized in the CY 2024 PFS final rule (88 FR 78977), commenters stated that the methods used do not lead to accurate valuation and that the problems lie with the nature of E/M services and the PFS's budget neutrality adjustment