Which statement is true regarding the payment methodology for multiple procedures?

The statement that the highest valued procedure is always paid first accurately describes a common payment methodology for multiple procedures. In many reimbursement models, including Medicare and private payers, the payment structure often involves a hierarchical system. This means that when multiple procedures are performed during a single patient encounter, the highest valued procedure—generally defined by Relative Value Units (RVUs) or other valuation metrics—is typically reimbursed in full. Subsequent procedures may then be reimbursed at a reduced rate, often reflecting a discount or a percentage of their usual fee. This method encourages efficiency in delivering care while acknowledging the complexity of higher-value services.

By structuring payments this way, payers can manage costs effectively while still compensating providers for a range of services rendered. Therefore, recognizing the highest valued procedure as the primary source of reimbursement helps maintain fairness and fosters appropriate levels of service delivery in a healthcare setting. This methodology supports the sustainability of the healthcare payment system, ensuring that providers are incentivized to perform comprehensive care without overburdening the reimbursement structure.