This wiki covers healthcare MSOs only. Healthcare lawyers are welcome to forward it to their clients, but it does not document the MSO structure for businesses buying law firms.
What this site covers
In much of US healthcare, the person who owns the business cannot legally own the practice. That constraint is the corporate practice of medicine doctrine, and it is why the MSO-PC structure exists. The structure then shapes everything downstream: two sets of books, one professional entity per state, payer enrollments that do not transfer between entities, management fees that must be both fair market value and investable, and a banking setup that most generalist banks do not support. This wiki documents all of it, at four levels of depth:Start Here
Learn. Guided, sequential tutorials with a guaranteed outcome. Start with a fictional practice and go from idea to first paid claim.
Guides
Do. Task recipes for a competent reader with a specific goal: form a PLLC, enroll in Medicare, fight a chargeback, set a management fee.
Concepts
Understand. The mental models and the why: CPOM, fee-splitting, the claim lifecycle, where MSO profit comes from.
Reference
Look up. Cited: state CPOM pages, payer profiles, CARC codes, X12 anatomy, escheatment tables.
Who this is for
How we source
Every legal claim on this site carries a citation to a primary source: a statute, a regulation, a court opinion, an agency manual, or a payer’s own documentation. Case law gets full citations. Legislation gets bill numbers and effective dates. Where a rule is unsettled, and much of CPOM is, we say so rather than implying more precision than exists.Who maintains the MSO-PC Wiki
The MSO-PC Wiki is a neutral resource maintained by Lemma who builds healthcare-focused banking for MSO-PC groups. Lemma’s healthcare banking product is documented in getlemma.com/docs. See How we keep this current for our sourcing standards and how to report an error.Next
What is an MSO-PC?
A short orientation to the two entities, the one business they make up, and the doctrine that requires them to be separate.