We are extending the flexibility in the "close proximity of time" standard, as defined in two prior temporary final rules (TFR), through May 11, 2029. We issued a TFR providing the "close proximity of time" flexibility on July 23, 2021, because the COVID-19 national public health emergency (PHE) caused many individuals to experience barriers that prevented them from timely accessing in-person healthcare. On September 29, 2023, we extended the flexibility to evaluate evolving healthcare practices and consumption in a post-PHE environment. We determined that we need additional time to fully evaluate still-evolving healthcare practices after the PHE. We are therefore issuing this TFR to extend the "close proximity of time" flexibility until May 11, 2029, so we can continue to evaluate changes in healthcare practices and determine the proper "close proximity of time" standard for the musculoskeletal disorders listings.