limiting charge

(5) Limiting charges of nonparticipating physicians and suppliers (A) In general In the case of radiologist services furnished after January 1, 1989 , for which payment is made under a fee schedule under this subsection, if a nonparticipating physician or supplier furnishes the service to an individual entitled to benefits under this part, the physician or supplier may not charge the individual more than the limiting charge (as defined in subparagraph (B)). (B) “Limiting charge” defined In subparagraph (A), the term “limiting charge” means, with respect to a service furnished— (i) in 1989, 125 percent of the amount specified for the service in the appropriate fee schedule established under paragraph (1), (ii) in 1990, 120 percent of the amount specified for the service in the appropriate fee schedule established under paragraph (1), and (iii) after 1990, 115 percent of the amount specified for the service in the appropriate fee schedule established under paragraph (1). (C) Enforcement If a physician or supplier knowingly and willfully bills in violation of subparagraph (A), the Secretary may apply sanctions against such physician or supplier in accordance with section 1395u(j)(2) of this title in the same manner as such sanctions may apply to a physician.

Source

42 USC § 1395m(b)(5)

---

Scoping language

None identified, default scope is assumed to be the parent (part B) of this section.

---

Is this correct? or