Under the multiple procedure rule, how is the highest value code reimbursed?

The correct answer is that under the multiple procedure rule, the highest value code is reimbursed at 100%. This means that when multiple procedures are performed during the same session, the procedure with the highest relative value is fully reimbursed at the established rate.

The multiple procedure rule is designed to address the efficiencies gained when procedures are performed together, as it acknowledges that the total cost of providing these services is often lower than if performed independently. Therefore, the highest value code receives its full payment. Subsequent codes, which are typically of lower value, receive reduced reimbursement rates to reflect the bundled nature of the service delivery.

This approach helps to promote the provision of comprehensive care while ensuring that healthcare providers are incentivized for delivering multiple services effectively within a single patient encounter.