New Stark regs refine "same building" rules

Contract Language. By Steven M. Harris, AMNews contributor. July 5, 2004.

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In its second phase of Stark II self-referral regulations, due to take effect July 26, the Centers for Medicare & Medicaid Services included new "same building" tests that physicians must meet in order to receive reimbursement for designated health services.

The new Stark II regulations modify the previous same-building test for designated health services such as lab work, imaging and various therapies by establishing three alternative tests, each of which requires the referring physician or group practice to maintain an office in the building where the services are provided and satisfy parameters relating to hours and physician services. Physicians have to satisfy the requirements of one of the three tests to meet the same-building requirement.

The first test generally applies when the building in which the physicians are practicing and providing services is the principal place of practice for the physicians and their group. A designated health service is considered to be furnished in the same building under the first alternative test if the building is one in which the referring physician or his or her group practice has an office that is normally open to their patients at least 35 hours per week, and the referring physician or one or more members of his or her group regularly practices medicine and furnishes physician services to patients in that office at least 30 hours per week.