As of Jan. 1, ASCs, hospitals, physician groups and other DHS entities may provide non-cash compensation to physicians up to an aggregate total of $535 per physician, according to a blog post from law firm Hall, Render, Heath and Ryman.
As of Jan. 1, ASCs, hospitals, physician groups and other designated health services entities may provide non-monetary compensation to physicians up to an aggregate total of $535 per physician for calendar year 2026, according to a blog post from law firm Hall, Render, Heath and Ryman.
Here are seven things to know:
1. Non-monetary compensation that does not exceed $535 can be provided as long as it doesn’t take into account the volume or value of referrals or other business generated by the physician and is not solicited by the physician or the physician’s practice. That includes requests from staff or employees acting on the physician’s behalf.
2. The $535 cap is an annual aggregate limit, meaning it applies to the total combined value of all qualifying items or services provided to a physician over the entire year, not a per-occurrence or per-benefit cap. The compensation also cannot include cash or cash-equivalents such as gift cards or prepaid cards, which do not qualify under the non-monetary compensation exception.
3. If an entity inadvertently exceeds the $535 cap, the compensation may still be treated as compliant if the excess value is no more than 50% of the cap and the physician returns the excess non-monetary compensation, or an amount equal to its value, according to the post.
4, The physician must return the excess compensation by the earlier of the end of the calendar year in which the excess was received, in this case Dec. 31, 2026, or within 180 consecutive days of receiving the excess.
5. The 2026 update also adds a major operational constraint: the “return” option may be used by an entity only once every three years with respect to the same referring physician.
6. Hospitals, and certain other facilities with bona fide medical staffs, can provide medical staff incidental benefits only if each occurrence is of low value, meaning less than $46 per occurrence, according to the post. This limit is per occurrence, unlike the $535 annual aggregate limit.
7. The Stark limited remuneration exception, which was finalized in 2021, allows compensation, including cash and cash-equivalents, up to an annual cap that adjusts for inflation. For 2026, the limit increases to $6,237, up from $6,055 in 2025. The exception does not include writing, signature or set-in-advance requirements, but the compensation must still be fair market value and commercially reasonable.
