View all articles | Read the next article

The Centers for Medicare & Medicaid Services (CMS) has increased the annual cap on non-monetary compensation limits under the Physician Self-Referral Law (Stark Law) for the calendar year (CY) beginning January 1, 2026.1

CMS adjusts the non-monetary compensation limits each CY based on increases in the Consumer Price Index–Urban All Item (CPI–U) for the 12-month period ending the preceding September 30. As a result, compliance professionals should update organizational policies and procedures, as well as training and education on the new limits.

Annual limit

The CPI–U increase for the 12-month period ending September 30, 2025, was 3.0%, making the annual non-monetary compensation limit $535 for 2026. This means that:

• Non-monetary compensation for 2026 may not exceed an aggregate of $535 per physician and their immediate family members for the CY. Immediate family members are defined by the Internal Revenue Service and include a spouse, child, parent, brother, sister, grandparent, grandchild, stepparent, stepchild, stepbrother, or stepsister of the individual. 
• Non-monetary compensation cannot account for the volume or value of referrals or other business generated by the referring physician. 
• Non-monetary compensation also may not be requested by the physician, anyone affiliated with the physician’s practice, or the physician’s immediate family members. 

In accordance with the Physician Self-Referral Law, healthcare providers are required to maintain a physician gift log, which can be monitored throughout the CY. Compliance should monitor the gift log to ensure the non-monetary compensation does not exceed the annual cap. Results of the monitoring should be shared with the organization’s compliance committee and board to demonstrate that the caps have not been exceeded.

Corrective action for exceeding the cap

Exceeding the annual cap requires corrective action under the Physician Self-Referral Law. If the value of the excess non-monetary compensation is no more than 50% of the annual limit, the physician or the physician’s immediate family member may return the excess non-monetary compensation by the end of the CY in which the excess was received or within 180 consecutive calendar days following the date the excess non-monetary compensation was received.

Compliance professionals should note that repayment or return of the non-monetary compensation can only be used by the entity once every three years with respect to the same referring physician. In the event of such situations, it is always advisable to consult with the organization’s legal counsel.

More information

More information may be found on the CMS website: https://www. cms.gov/medicare/regulations guidance/physician-self-referral/

Endnotes

1. 42 C.F.R. § 411.357(k), https://www.ecfr.gov/ current/title-42/chapter-IV/subchapter-B/part411/subpart-J/section-411.357#p-411.357(k).

Compliance Today | March 2026

View all articles          Read the next article