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For the Enhanced Communications Opportunities APCM service element, we proposed to incorporate access to CTBS services, including remote evaluation of pre-recorded patient information and interprofessional telephone/internet/EHR referral service(s), to maintain ongoing communication with the patient, as well as access to patient-initiated digital communications that require a clinical decision, such as virtual check-ins and digital online assessment and management and E/M visits (or e-visits) (see section II.G.2.c.(8) of this final rule)

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Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa