A medical fee schedule shows the amount an insurer will pay for a given procedure. This amount is considered to be the _______.

• A. Negotiated Amount Payable
• B. Average Amount Payable
• C. Lowest Amount Payable
• D. Highest Amount Payable

Answer: (D)

A medical fee schedule defines the ceiling for how much the insurer will reimburse for a given service. The amount shown is the maximum the insurer will pay for that procedure under the plan, so it’s the highest payable amount. In practice, the actual payment can be lower due to patient cost-sharing and network rules, but the schedule sets the reimbursement ceiling. It isn’t describing an average, the lowest, or a separate negotiated amount—the fee schedule’s role is to cap what’s payable.