What is the maximum amount a physician may charge if they do not share a practice under the Anti-Markup Rule?

The correct answer is the lowest of the fee schedule amount or actual charge because this aligns with the guidelines established under the Anti-Markup Rule. The Anti-Markup Rule is part of the Stark Law provisions, which prohibit physicians from marking up the fees for services that they refer if those services are performed by others.

When a physician does not share a practice, they are restricted to charging an amount that does not exceed what they actually paid for the service or the fee schedule rate established by a third-party payer or the Medicare fee schedule. This provision ensures that the charges reflect the actual cost of the service or are compliant with set rates, preventing excessive billing practices that could exploit patients or payer systems.

In contrast, the other options focus on different pricing mechanisms that do not specifically consider the limits placed by the Anti-Markup Rule, which is fundamental in this context to ensure compliance and fairness in billing practices.