What resource is essential for determining if procedures are subject to the multiple procedure payment reduction?

The National Physician Fee Schedule Relative Value File is the essential resource for determining if procedures are subject to the multiple procedure payment reduction. This file provides detailed information on the valuation of services, including specific coding and payment guidelines that inform whether certain procedures billed together reduce their combined payment amount.

Understanding the structure of the National Physician Fee Schedule allows medical auditors and providers to ascertain reduced payments for multiple procedures performed during the same session. The file outlines which codes are impacted by the policy, ensuring compliance with Medicare payment regulations.

Other resources, while useful in certain contexts, do not provide the specific payment reduction guidelines as effectively as the Relative Value File. The provider's office policy manual may contain policies for practice operation but does not encompass federal payment guidelines. The CPT codebook provides definitions and descriptions of procedures but lacks payment policy details. The Medicare Claims Processing Manual, while comprehensive regarding claims submission and processing, does not specifically detail the multiple procedure payment reduction like the Relative Value File does.