Physician in the group practice

Physician in the group practice means a member of the group practice, as well as an independent contractor physician during the time the independent contractor is furnishing patient care services (as defined in this section) for the group practice under a contractual arrangement directly with the group practice to provide services to the group practice's patients in the group practice's facilities. The contract must contain the same restrictions on compensation that apply to members of the group practice under 411.352 (or the contract must satisfy the requirements of the personal service arrangements exception in 411.357(d)), and the independent contractor's arrangement with the group practice must comply with the reassignment rules in 424.80(b)(2) of this chapter (see also Pub. L. 10004, Medicare Claims Processing Manual, Chapter 1, Section 30.2.7, as amended or replaced from time to time). Referrals from an independent contractor who is a physician in the group practice are subject to the prohibition on referrals in 411.353(a), and the group practice is subject to the limitation on billing for those referrals in 411.353(b).


42 CFR § 411.351

Scoping language

The definitions in this subpart apply only for purposes of section 1877 of the Act and this subpart. As used in this subpart, unless the context indicates otherwise:

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