US · guidance
CMS Pub. 100-04, ch. 6, § 80.6
Indirect Contractual Arrangement
SNF-510.3
The necessary contractual arrangement between physicians and the facility in which they
perform their services may exist indirectly by reason of the terms of their relationship
with an employer and the employer’s contractual arrangement with the facility.
EXAMPLE
A professional corporation enters into a contractual arrangement with an SNF to provide
physician services for it. Under this arrangement, the SNF alone bills and receives
payment for the physician services and pays the corporation a percentage of the charges.
The corporation, in turn, employs several physicians to provide the services, and under
the terms of their employment, is entitled to any fees payable for the services (other than
the portion of the fees retained by the SNF). The combination of the two arrangements -
between the SNF and the corporation and the corporation and the physicians - constitutes
an indirect contractual arrangement between the SNF and the physicians. For the SNF to
bill and receive payment for the physician services furnished in the SNF, the SNF must
also enter into a direct contractual arrangement with the physicians for this purpose.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
61d20c13a062f4fbf972243f246f5124494a6f99b20e97dbe9cd5012fbbee1da
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