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The "rapid reversal" group (approximately 10-15% of users) experiences concerning quick benefit loss within weeks of discontinuation, typically involving users who applied very high concentrations creating dependency-like patterns, possessed severe underlying skin conditions requiring ongoing treatment, experienced significant lifestyle or environmental stressors overwhelming skin resilience, discontinued abruptly without tapering from high-dose protocols, or had unrealistic perception inflation during treatment leading to exaggerated reversal perception

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Reporting Separately Identifiable E/M Services However, if the physician provides a medically necessary, unrelated E/M service (codes 9920299215), then Q0091 may be billed separately with modifier 25 on the E/M code

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