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RCM Advisor

Quarter 2 2026 - Volume 31, ISSUE 2

Percentage-Based Medical Billing

Why It’s a Compliance Trap for Medicare, Medicaid, and Many Commercial Plans

By Laureen Murphy, CPC, CPC-I, RH-CBS, CAH-CBS, CH, CBS, CH, CS / Printed with Permission by MedCycle Solutions


Percentage-based billing (charging a percent of collections or revenue) can be prohibited for Medicare and Medicaid payment arrangements and can violate state fee-splitting rules for commercial claims. Learn what’s risky, what’s illegal in certain contexts, and how to structure compliant billing fees.

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