When multiple procedures are performed during the same surgical session under ASC PPS, what is the reimbursement rate for the highest level group?

Prepare for the RHIA Reimbursement Test with multiple choice questions, each accompanied by hints and explanations. Ace your exam with confidence!

In the context of Ambulatory Surgical Center (ASC) Payment System (ASC PPS), when multiple procedures are performed during the same surgical session, the reimbursement structure is designed to incentivize the efficiency of providing surgical care. The correct answer indicates that the reimbursement rate for the highest level group of procedures is set at 100%.

This means that for the primary procedure, the ASC receives the full payment, reflecting the policy's focus on compensating the center fully for the first and often most resource-intensive procedure conducted.

Subsequent procedures performed during the same session may incur reduced rates, as policies generally include reductions or adjustments to the payment for each additional procedure. However, the initial reimbursement for the highest level procedure remains at the full rate, which helps ensure that centers continue to offer a wide range of surgical services without financial disincentives for more complex cases.

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