For a shared practice to apply under the Anti-Markup Rule, what percentage of services must the physician perform for the group?

For a shared practice to apply under the Anti-Markup Rule, what percentage of services must the physician perform for the group?

• A. 50%
• B. 60%
• C. 70%
• D. 75%

Answer: (D)

For a shared practice to comply with the Anti-Markup Rule, a physician must personally perform at least 75% of the services provided within the group. This requirement is in place to ensure that the services billed under shared practices are genuinely reflective of the physician's individual contribution to patient care. The Anti-Markup Rule is designed to prevent healthcare professionals from charging patients or insurers for services that are predominantly provided by other parties while taking a markup for themselves. By establishing a threshold of 75%, the regulation ensures that a substantial proportion of the billed services is rendered directly by the physician, thereby reinforcing the integrity of the billing process and promoting transparency in healthcare transactions. This standard is essential for maintaining compliance with federal regulations and ensuring that healthcare practices operate ethically within the healthcare system.

For a shared practice to comply with the Anti-Markup Rule, a physician must personally perform at least 75% of the services provided within the group. This requirement is in place to ensure that the services billed under shared practices are genuinely reflective of the physician's individual contribution to patient care.

The Anti-Markup Rule is designed to prevent healthcare professionals from charging patients or insurers for services that are predominantly provided by other parties while taking a markup for themselves. By establishing a threshold of 75%, the regulation ensures that a substantial proportion of the billed services is rendered directly by the physician, thereby reinforcing the integrity of the billing process and promoting transparency in healthcare transactions.

This standard is essential for maintaining compliance with federal regulations and ensuring that healthcare practices operate ethically within the healthcare system.