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In a 2018 report developed under contract with CMS, RAND noted that operating from the perspective of paying for the `typical' instance of a procedure, these analyses suggest that the current system could be improved by shifting more of the allocation of PE RVUs to the physician office setting

Extra caution is appropriate in patients with active cancer, recent cancer, unexplained masses, unexplained weight loss, pregnancy, breastfeeding, known allergy to peptide products, active infection, immune compromise, significant liver or kidney disease, active inflammatory or autoimmune disease flares, unusual clotting history, uncontrolled cardiovascular disease, use of chemotherapy or immune-modifying biologic therapy, and competitive athletes subject to anti-doping rules