Multiple operations assessing rules in Medicare 011-42060060
Expand allThis document outlines information and processes relating to the multiple operation assessing rule (MOR) in Medicare.
Multiple operation rule
A 'multiple operation' is when more than one procedure in Group T8 is performed:
- on the same patient, and
- on the same occasion, and
- by the same health professional
Multiple operations are treated as one service for payment purposes.
The Medicare benefit for multiple operations is based on a total fee for the procedures involved.
Where 2 or more operations (other than amputations) are performed on a patient on the one occasion, the fees are calculated according to the MOR as follows:
- 100% of the fee for the item with the highest schedule fee
- 50% of the fee for the item with the next highest schedule fee plus
- 25% of the schedule fee for all other surgical items
When the results of these calculations are added together, the total becomes the schedule fee for the multiple operation. This fee is used to calculate the Medicare benefit payable.
The Resources page contains examples where the MOR is applied and how the fee is calculated.
Related links
Therapeutic procedures assessing rules in Medicare