Can a New York Therapist Pay a Biller a Percentage?

A New York therapist should not assume an outside billing company can be paid a share of clinical collections. New York’s professional-conduct rules raise a direct issue for income-linked administrative compensation. Bomi’s current standard agreement therefore uses its restricted-state per-claim arrangement for covered New York services.

What does New York’s fee-splitting rule say?

Regents Rule 29.1(b)(4) restricts sharing professional fees outside specified professional relationships. Its prohibition also addresses payments for space, facilities, equipment, or personnel services that depend on a licensee’s practice income or receipts, with stated statutory exceptions. That is why an ordinary outside billing contract should not be treated as equivalent to compensation within a professional practice.

The Office of the Professions separately explains that a management company can provide nonprofessional services such as scheduling or billing, while restricting its ability to share professional fees or profits. Outsourcing administrative work and choosing a permissible compensation method are separate questions.

How does Bomi price billing for covered New York services?

Bomi’s current standard agreement specifies $6 per original claim first submitted for services subject to its restricted-state clause. The fee replaces the percentage base fee for those services. It is earned at submission and is not conditional on the claim being paid.

For 80 original claims first submitted, the fee is $480; for 120, it is $720. These are simple examples of that claim fee, not estimates of reimbursement or the practice’s complete operating costs. Other expressly agreed charges and third-party costs need their own review.

Will a correction, appeal, or secondary claim cost another $6?

Under that clause, corrected and replacement claims, resubmissions, appeals, secondary or tertiary payer submissions, and follow-up on the same underlying claim do not trigger another per-claim fee. Ask for the counting rule in writing so the practice can reconcile the invoice to original submissions.

The agreement also excludes collections for these services from the percentage base fee, including patient and self-pay receipts. A patient statement alone is not a claim; a separate fee for standalone self-pay billing or other work without a payer claim requires prior written agreement when applicable.

What if the therapist or patient is in another state?

Bomi’s agreement applies its New York treatment when either the rendering professional or the patient is physically in New York when care is provided, or when the services are otherwise subject to New York restrictions. For example, a clinician outside New York treating a patient physically in New York should flag that encounter when reviewing the applicable Bomi arrangement.

That describes the contract’s scope, not a complete legal ruling on every telehealth fact pattern. Give counsel the actual clinician and patient locations, licenses, and services before using one pricing structure across the whole practice.

How can I keep a per-claim billing relationship accountable?

Ask who follows unpaid claims, how denials and missing payments are reported, and what information the practice must provide. Review one original claim through correction and appeal to confirm the service scope and fee treatment remain understandable.

A claim-based fee changes when the billing company earns compensation. Your practice should still have a clear owner for the agreed follow-up work. Sources checked October 23, 2026; this is educational information, not a practice-specific legal opinion.

Frequently Asked Questions

Can a New York therapist outsource billing?

Outsourcing administrative billing work and sharing professional fees are different issues. New York’s Office of the Professions recognizes nonprofessional management services, but the compensation structure must be permissible.

Is Bomi’s New York fee a percentage disguised as a claim charge?

The current standard clause sets $6 per original claim first submitted and makes it independent of the amount billed, allowed, reimbursed, or collected. Review the agreement applicable to your practice.

Sources and scope

Regents Rule 29.1(b)(4)

Office of the Professions: management services and professional entities

Related questions

How fee-splitting rules differ by state

Compare per-claim and percentage costs

See Bomi’s current pricing or talk through your practice’s billing needs.