What this site covers
Healthcare is the only major US industry where the person who owns the business often legally cannot be the person who owns the practice. That single constraint — the corporate practice of medicine doctrine — produces the MSO-PC structure, and the MSO-PC structure produces a long tail of consequences: two sets of books, one professional entity per state, payer enrollments that don’t travel, management fees that have to be simultaneously fair-market-value and investable, and a banking setup that no generalist bank understands. 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 actually lives.
Reference
Look up. Dry, complete, cited: 51 state CPOM pages, payer profiles, CARC codes, X12 anatomy, escheatment tables.
Who this is for
What this site is not
It is not product documentation. The MSO-PC Wiki is maintained by Lemma, which builds healthcare-focused banking for MSO-PC groups. Lemma is named on a handful of pages where it is genuinely relevant and disclosed as such; everywhere else — including vendor comparisons that cover Lemma’s own category — the wiki is written to be useful to readers who will never be customers. If it ever reads like a sales document, tell us, because that would be a bug.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 genuinely unsettled — and much of CPOM is — we say so rather than manufacturing false precision. See How we keep this current for our sourcing standards and how to report an error.Next
What is an MSO-PC?
The five-minute orientation: two entities, one business, and the doctrine that splits them.