How Much Does a Friendly PC Owner Cost?
The short answer: it depends. Here is why that is the right answer — and what drives pricing.
The Short Answer: It Depends. Here Is Why That Is the Right Answer.
Physician PC ownership is not a commodity service. The cost varies based on the complexity of your structure, the states you operate in, your timeline, and the ongoing scope of the arrangement. Any service quoting you a flat fee without understanding your situation is selling you something that may not fit your needs.
What Drives the Cost
Number of States
Each state where you operate and serve patients may require its own PC structure or at minimum its own state-specific documentation. Multi-state operators pay more than single-state operators.
New Formation vs. Transfer
Forming a brand new PC involves state filing fees, registered agent setup, EIN, and formation documents. Transferring an existing PC involves share transfer mechanics, title search, and review of existing agreements.
Business Type and Complexity
A single-location medspa in one state is simpler than a multi-state telehealth platform with complex payer relationships. Complexity drives documentation scope, which drives cost.
Urgency and Timeline
Standard timelines allow for deliberate document drafting. Expedited arrangements — driven by deal closings, regulatory deadlines, or launch dates — command a premium for attorney time and physician availability.
Ongoing vs. One-Time Arrangement
Some operators need a PC owner for a defined project period. Others need a permanent ongoing arrangement. Ongoing arrangements typically involve an annual retainer or periodic renewal fee.
Legal Counsel Involvement
If you already have engaged healthcare counsel, attorney costs may be limited. If we are referring and coordinating counsel, that adds to the total engagement. Attorney fees are separate from our placement and coordination fees.
What Is Typically Included
Standard scope of our physician PC owner arrangements
- Formation or transfer of the PC in applicable state(s)
- Coordination of MSA, PC Operating Agreement, and Stock Restriction Agreement drafting with counsel
- Physician signature on required state regulatory and formation documents
- Physician signature on Medicare/Medicaid enrollment documents where applicable
- Coordination on state-specific compliance requirements (e.g., California SB 351)
- Ongoing physician-of-record availability for required functions
- Regulatory change monitoring and proactive notification
- Annual document review for continued compliance
What Is Typically Separate
- Legal fees for counsel drafting or reviewing the MSA, Operating Agreement, and Stock Restriction Agreement
- State formation fees, registered agent fees, and state filing costs
- Payer credentialing and enrollment fees
- Any malpractice insurance premium adjustments related to the arrangement
Putting Cost in Context
Cost of Non-Compliance
- Voided management agreements — losing your MSO economics retroactively
- State Medical Board regulatory action — license suspension or revocation
- Deal failure — PE transactions fall apart when diligence uncovers CPOM defects
- Payer contract termination — Medicare/Medicaid can terminate enrollment
- Civil liability to investors, partners, and employees who relied on compliance
- Retroactive fines under California SB 351 (effective Jan 1, 2026)
Cost of Proper Structure
- One-time formation or transfer costs (legal + physician placement fees)
- Modest ongoing annual arrangement fee
- Clean diligence in M&A and investment transactions
- Defensible regulatory posture for state Medical Board review
- Stable foundation to grow, raise capital, and scale
The Honest Calculation
For most MSO operators, the cost of a properly structured friendly PC arrangement is a fraction of the annual revenue generated by the businesses it enables. The question is not whether you can afford a compliant structure — it is whether you can afford to operate without one.
Healthcare investors and acquirers routinely walk away from deals — or significantly reprice them — when they find CPOM defects in diligence. Operators who structured correctly face no such friction.
Disclaimer: This page provides general pricing context and does not represent a binding offer. Actual fees depend on the specific scope of your engagement. All fees are discussed and agreed upon in writing before engagement begins.
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