On January 22, 2009, CMS issued a Q&A stating that in certain

circumstances physician-owned lithotripsy companies can continue to use a

percentage-based or per-use payment structure when providing lithotripsy

services "under arrangements" to hospitals.

CMS had previously announced in its August 19, 2008 Stark final rules that

use of per-service or percentage-based compensation would be prohibited for

equipment leases effective October 1, 2009. This Q&A clarifies that the

provision of lithotripsy services "under arrangements" to a hospital, which

includes both the provision of a technician and the lithotripsy equipment, can

continue to be treated as a service (rather than an equipment lease) and billed

on a per-service basis under the new rules. Ober|Kaler's Julie Kass and Kristin Cilento discuss the Q&A.