Whose Tax ID Number Should be Used to Bill for Services Under the Stark Personal Services Exception?

Can a physician group continue to bill under its tax identification number if it is providing patient services to hospital patients under a personal services arrangement with a hospital? According to CMS, the answer is yes. The services do not have to be billed under the hospital’s tax identification number.
CMS expressed the opinion that it did not matter which entity did the billing. Under the revised definition of entity, the arrangement must satisfy the personal services exception regardless of whether the group continues to do the billing under its tax identification number or whether it bills for the services on behalf of the hospital under the hospital’s tax identification number. The billing tax identification number is not relevant to whether the elements of the Stark personal services exception are met.

CMS noted, however, that if the group did the billing under its tax identification number and the proceeds were deposited into a lock box account, the group must control the lock box account. If the group does the billing on behalf of the hospital under the hospital’s tax id number, then the lock box can be controlled by the hospital.

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