---
title: "Fee-Splitting Laws in Healthcare: Definition and Examples"
description: "Fee-splitting laws bar clinicians from sharing professional fees with unlicensed parties or referral sources. Four state rules, and how Cuvo Health prices."
canonical: "https://cuvo.co/glossary/fee-splitting"
last-updated: "Oct 26, 2026"
---
**Definition:** Fee-splitting laws are state statutes and medical board rules that bar a licensed clinician from sharing professional fees with an unlicensed person, or from paying part of a fee in return for patient referrals, outside the arrangements the law permits.

# What are fee-splitting laws in healthcare?

Fee-splitting rules decide whether a management fee, a marketing payment or a platform's percentage is lawful, and they differ sharply from state to state. Cuvo Health prices its platform with flat fees and no revenue share.

Published Oct 26, 2026. Facts reviewed Oct 26, 2026.

Fee-splitting laws are state statutes and medical board rules that bar a licensed clinician from sharing professional fees with an unlicensed person, or from paying part of a fee in return for patient referrals, outside the arrangements the law permits. They sit beside the corporate practice of medicine doctrine: one governs who owns the practice, the other who may share in what it earns. For a telehealth brand they shape three payments: the management fee the practice pays its MSO, marketing fees tied to patient sign-ups, and any percentage a platform takes. On Cuvo Health, the platform fee is flat, consults cost $25 each, and Cuvo takes no percentage of the brand's revenue.

**At a glance**
- What it is: State limits on sharing professional fees with unlicensed parties or referral sources
- Who it binds: Licensees under board rules, and in some states any person under criminal statutes
- What it reaches: Percentage fees, referral payments and split-fee arrangements
- Why it varies: New York bans percentage fees for space, equipment and personnel; California allows them if commensurate with value
- On Cuvo: Flat platform fee plus $25 per completed consult, no revenue share

**Fee-splitting rules in four states (statute text checked October 26, 2026)**

| State | Rule | What it reaches |
| --- | --- | --- |
| **New York** | Education Law 6530(19) | Sharing professional fees with anyone other than listed licensed colleagues, including payments for space, facilities, equipment or personnel services set as a percentage of, or dependent on, practice income |
| **Florida** | Statutes 458.331(1)(i) and 817.505 | Commissions, kickbacks and split-fee arrangements for patient referrals, by physicians and, under 817.505, by any person |
| **California** | Business and Professions Code 650 | Consideration for referrals; a percentage-of-gross-revenue fee for other services is lawful if commensurate with their value (650(b)) |
| **Texas** | Occupations Code 102.001 | Paying or accepting remuneration for securing or soliciting patients, except what federal anti-kickback law permits (102.003) |

## 01. Why do fee-splitting laws matter for a telehealth brand?

Because money moves between the professional entity and non-clinicians at several points. The practice pays the brand's MSO a management fee; the brand pays for marketing that brings in patients; a platform may charge a share of revenue. Counsel tests each payment against the rules of every state the practice serves, because a structure built for a permissive state can fail in a strict one.

## 02. Is a percentage-based management fee fee-splitting?

It depends on the state. New York Education Law section 6530(19) makes it professional misconduct for a licensee to let anyone outside listed licensed colleagues share in professional fees, and the prohibition expressly includes paying for space, facilities, equipment or personnel services as a percentage of, or dependent on, practice income, apart from facilities the statute exempts. California Business and Professions Code section 650(b) takes the opposite view for services other than referrals: a percentage of gross revenue is lawful if it is commensurate with the value of the services. That split is why counsel drafts the management fee against the strictest state the practice serves.

## 03. How is fee-splitting different from the Anti-Kickback Statute?

The federal Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b), reaches remuneration for referrals of items or services payable by a federal health care program. Fee-splitting and patient brokering laws are state law, and many are not limited to federal program business: California section 650 binds licensees whoever pays, and Florida section 458.331(1)(i) disciplines physicians for split-fee referral arrangements without a payer limit. A cash-pay program can sit outside the federal statute and still inside these.

## Frequently asked questions

**Q: What is fee splitting in healthcare?**

A: It is sharing a licensed clinician's professional fees with an unlicensed person or a referral source, which state fee-splitting laws restrict. On Cuvo, Cuvo charges the brand a flat platform fee and $25 per completed consult and takes no percentage of its revenue.

**Q: Is fee splitting illegal?**

A: Where a state prohibits it, yes, subject to the exceptions its statute lists: New York treats it as professional misconduct under Education Law 6530(19), and Florida makes split-fee arrangements to induce referrals a crime under section 817.505. Cuvo Health publishes flat pricing, so a brand can show counsel exactly what it pays.

**Q: Is a percentage management fee fee-splitting?**

A: It depends on the state: New York bars percentage payments for space, facilities, equipment or personnel services, while California allows a percentage for non-referral services if it is commensurate with their value. On Cuvo Health, the brand pays fixed fees rather than a percentage.

**Q: Fee splitting vs kickback: what is the difference?**

A: A kickback is a payment for a referral, and fee-splitting is sharing professional fees, though many state statutes cover both in one sentence. Cuvo Health takes no share of a brand's revenue; its pricing is a flat platform fee plus $25 per completed consult.

**Q: Do fee-splitting laws apply to telehealth?**

A: Yes. They bind licensed clinicians whatever the channel of care, and they reach the payments between a practice, its management company and its marketing. On Cuvo, the MSO structure and its agreement are built and maintained by Cuvo for the states each brand sells in.

**Related pages**

- [Corporate practice of medicine (CPOM)](/glossary/corporate-practice-of-medicine): The companion rule on who owns the practice
- [Management services agreement (MSA)](/glossary/management-services-agreement): Where the management fee is set
- [Revenue share (telehealth platforms)](/glossary/telehealth-platform-revenue-share): The pricing model fee-splitting rules test
- [Anti-Kickback Statute](/glossary/anti-kickback-statute): The federal referral-payment law
- [Add GLP-1, peptides and TRT to a gym or fitness brand](/blog/add-glp1-peptides-and-trt-to-a-gym-or-fitness-brand): Why referral fees to a clinic need counsel's review

Canonical page: https://cuvo.co/glossary/fee-splitting