Group Practice (Stark)
A defined-term group of physicians who share specific operational characteristics making them eligible for certain Stark Law exceptions.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Compliance Program
- Primary sources
- 1
- Workspace handoff
- compliance binder →
Where this comes up
Compliance committees and practice managers operate at this level — written policy, workforce training, sanction policy, monitoring and auditing cadence, response and corrective action. The seven elements of an effective compliance program (OIG) are the scaffolding; this term lives somewhere on that scaffold.
Full definition
What it is in practice
42 CFR 411.352 defines group practice with criteria: single legal entity, ≥2 physicians, full range of services, substantially all services billed under the group, expense pooling, productivity bonuses formula constraints.
How it shows up in your practice
The group-practice definition affects whether arrangements qualify for the in-office ancillary services exception. Periodically re-test eligibility.
Sources
- 42 CFR Part 411 Subpart J — Starkhttps://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-411/subpart-J
Document group-practice eligibility in the Compliance Binder
Open compliance binder →Related terms
- Compliance ProgramIn-Office Ancillary Services ExceptionStark Law exception (42 CFR 411.355(b)) permitting referrals for designated health services furnished in the referring physician's office.
- Compliance ProgramStark LawFederal statute (42 USC 1395nn) prohibiting physicians from referring Medicare/Medicaid patients for designated health services to entities with which the physician has a financial relationship, unless an exception applies.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryIn-Office Ancillary Services ExceptionStark Law exception (42 CFR 411.355(b)) permitting referrals for designated health services furnished in the referring physician's office.
- GlossaryStark LawFederal statute (42 USC 1395nn) prohibiting physicians from referring Medicare/Medicaid patients for designated health services to entities with which the physician has a financial relationship, unless an exception applies.
- ComplianceStark Law (Physician Self-Referral): Compliance Basics for Designated Health ServicesThe Stark Law is strict-liability, civil-only, and triggers on Medicare claims for designated health services where a financial relationship exists. Here is what Stark actually prohibits, how the exceptions work, and where practices misread the in-office ancillary services exception.
- RegulationStark Law Overview (42 USC 1395nn)Strict-liability prohibition on physician referrals to entities for designated health services payable by Medicare when the physician (or immediate family member) has a financial relationship with the entity, unless an exception applies.
- GlossaryDesignated Health Service (DHS)Categories of services subject to the physician self-referral prohibition under the Stark Law.
- BillingWhat to Do When a Payer Says You're UnderbillingGot a letter saying you're underbilling? Here's what it actually means, whether you should worry, and what action to take.
- RegulationStark Group Practice Definition (42 CFR 411.352)Strict structural and operational definition of 'group practice' for purposes of the in-office ancillary services exception and physician services exception.
- ComplianceAmbulatory Surgery Center Compliance: CMS + State + Infection Control42 CFR Part 416 Conditions for Coverage, CMS State Operations Manual Appendix L, the ASC Infection Control Surveyor Worksheet, and where state ASC licensure tightens the standard.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.