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There is an alternative methyl-donation process involving Glycine Betaine (GB) in conjunction with the zinc requiring enzyme Betaine-homocysteine S -methyltransferase (BHMT)

[745] For the foregoing reasons and to assist these entities in completing the Form CMS-855A, we propose in this FY 2024 IPPS/LTCH PPS proposed rule that the aforementioned definitions of PEC and REIT would apply to all providers and suppliers completing the Form CMS-855A enrollment application

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Laura McCallister, from the Division of Periodontology (Ohio State University), for her contributions to the logistical support related to this study and for her expert editorial assistance