What payment percentage is assigned to each additional code under the multiple procedure rule?

The multiple procedure rule is an important aspect of reimbursement policies in healthcare. When multiple surgical or procedural codes are billed on the same day for a patient, the primary procedure is typically reimbursed at 100% of the allowable payment, while subsequent procedures are reimbursed at a reduced percentage to account for the efficiencies of performing multiple procedures during the same encounter.

In this context, each additional code after the primary procedure is typically assigned a percentage rate that reflects this reduction. The correct answer—25%—indicates that subsequent procedures are reimbursed at a quarter of the payment for the primary procedure. This approach encourages the efficient use of resources while ensuring that providers are compensated for the multiple services they deliver.

Understanding the multiple procedure rule and the associated payment reductions is essential for coding and billing processes, as it affects how a provider sets their billing practice and how healthcare organizations manage their financial operations.