Medical Group Management Association
Join Now

Government Advocacy

The voice of medical practices in Washington

Engage with a team that advocates on your behalf and translates complex regulations into focused updates on the latest health issues from Washington.

In-office ancillary services exception

Physicians and medical practices rely on the Stark law’s in-office ancillary services exception and physician services exceptions to allow “within-practice” referrals of designated health services. Of these, the in-office ancillary services exception is used most frequently as it allows physicians in medical practices to:

  • Make referrals for certain designated health services within the medical practice;
  • Furnish those designated health services to practice patients;
  • Bill Medicare and Medicaid for the services;
  • Retain and use the revenues earned from providing the services within the group practice for payment of practice expenses and physician compensation

The in-office ancillary services exception has several essential requirements and restrictions relating to:

  1. The designated health services that can be provided in the medical practice (because only certain specific types of designated health services are allowed to be furnished under this exception) – referred to here as “   Service Restrictions”;
  2. Who provides or supervises the services in the practice -- the “Performance and Supervision Test”;
  3. Where the services are furnished -- the “Building” or “Site-of-Service” Test;
  4. How the designated health services are billed -- the “Billing Test”; and
  5. The additional requirement that any medical practice other than a true solo physician practice must qualify as a bona fide “Group Practice” for Stark law purposes -- the “Group Practice Requirements”.

Shopping Cart

Your cart is empty

Click here if your organization is tax exempt

A State Sales tax exempt certificate must be on file and taxable items cannot be ordered online. For immediate assistance during normal business hours of 7:00am to 5:00pm MT M-Th and 7:00 am to Noon MT on Friday, please call toll-free: 877-275-6462, ext. 1888



Use two letter code for US states
Use three letter code for country
Use two letter code for US states
Use three letter code for country
Use two letter code for US states
Use three letter code for country

Grand Total:
Saved credit card is required for opt-in to autorenew.

Questions? Contact the MGMA Service Center for assistance during checkout or review our return policy for more information.




Thank you for your purchase! If you purchased an event, you will be receiving a follow-up email from our Learning Management System regarding the product/event purchased and no further action is required.