Skip to main content
This page condenses the 51 state pages into one table so you can see the map before reading the detail. Each row links to the state’s full reference page, which carries the citations, the profession-by-profession caveats, and the verification checklist. The tier labels are this wiki’s editorial classification, not legal categories; commentators disagree on roughly eight jurisdictions and the CPOM concept page explains why. Every row must be verified against the state page and with counsel licensed there before you rely on it.

​
How to read the tiers

“Is my state a CPOM state?” is the wrong question. The question that actually decides your structure has four parts, and a state can answer them differently:
  1. Who may own the professional entity? Almost every state limits this to licensees through its professional corporation act, whether or not it “has CPOM.”
  2. Who may employ the clinicians? In strict states, only the professional entity (plus hospitals and other statutory exceptions).
  3. Which decisions must remain with the clinician? The control prong, now enumerated by statute in Oregon, California, and Vermont.
  4. What may the MSO be paid, and how? Fee-splitting and anti-kickback rules, which exist in states with no CPOM doctrine at all.
The “Ownership” and “Fee-splitting” columns below answer parts 1 and 4 in shorthand. Parts 2 and 3 are on each state page.

​
Strict

​
Moderate

​
Nuanced

​
Permissive / none

​
Reading the fee-splitting column

“Permitted” means the state has no rule that categorically bars a management fee calculated as a percentage of practice revenue; it does not mean any percentage is safe. Every state’s anti-kickback, patient-brokering, or referral-fee statute still reaches a fee that varies with referrals rather than with services. “Not specified” means no statute or regulation squarely addresses percentage management fees and the analysis proceeds from general principles. New York is the canonical jurisdiction where percentage fees are materially risky; Florida and California have explicit statutes that shape the analysis. See Fee-splitting rules and the California page.

​
What this table does not tell you

  • Other professions. The tiers are for medicine. Dentistry, optometry, physical therapy, chiropractic, veterinary medicine, and behavioral health each sit on a different map: Mississippi is permissive for physicians and strict for optometrists. Section 2 of each state page covers this.
  • Officer and director requirements. Several states restrict who may serve as a director or officer of the professional entity, not only who may own shares. See Who can own a professional entity.
  • Transaction notice and MSO registration. A growing set of states require notice of healthcare transactions or disclosure of MSO and private-equity ownership regardless of tier. See the legislation tracker.
  • Noncompetes. Governed by separate state law that moved substantially in 2025–2026. Section 5 of each state page.

​
Sources

Each state page carries its own citations to the professional corporation act, medical practice act, board rules, attorney general opinions, and case law. For the national picture, the secondary surveys this wiki cross-checks against are Epstein Becker Green’s Corporate Practice of Medicine 50-State Survey and MedPath’s CPOM Across the 50 States and D.C.; they do not agree on every state, which is itself the point of the “Nuanced” tier. Primary sources on the state page control where they conflict with a survey.
Last modified on August 27, 2026

Related topics

The corporate practice of medicine doctrineFee-splitting rules, explainedWho can own a professional entityRun a CPOM self-auditForm a professional corporation (PC)CPOM & MSO legislation trackerCPOM case law