Kompanie Healthcare Partners LLP

Diagnostic Imaging Center & Radiologist Group PC-MSO Deal Structuring

Structure capital-efficient MRI/CT equipment leasing safe harbors, separate technical facility fees from professional radiologist interpretations, and capture 10x–13x platform valuations.

Diagnostic imaging centers require massive capital equipment outlays (high-field 3T MRIs, 128-slice CT scanners, digital PET/CT) while navigating strict Corporate Practice of Medicine (CPOM) and anti-markup rules. Payers strictly scrutinize technical component (TC) facility fees and professional component (PC) reading fees. Non-physician private equity sponsors cannot own radiologist practices or mark up professional interpretations. Kompanie LLP architects dual-tier imaging MSOs: the MSO owns and leases advanced imaging equipment, facilities, and AI-enabled PACS software to the physician-owned Professional Corporation under certified Fair Market Value (FMV) safe harbors.

Deliverables

  • Equipment Lease Safe Harbor drafting compliant with 42 CFR § 1001.952(b) and Stark Law equipment lease rules.
  • Turnkey Friendly Radiologist PC corporate governance charters with stock restriction agreements.
  • Technical Component (TC) facility fee optimization and commercial payer global billing carve-outs.
  • Teleradiology credentialing and interstate medical licensing network infrastructure.

Frequently asked questions

How can an MSO legally earn revenue from an imaging center without violating Stark Law?

The MSO earns revenue by leasing capital equipment, real estate, and non-clinical administrative staff to the physician PC at certified Fair Market Value (FMV) fixed rental rates that are set in advance and do not fluctuate based on the volume or value of imaging referrals.

What is the multiple spread between independent imaging centers and regional imaging MSOs?

Independent standalone imaging centers typically trade at 4x to 6x EBITDA due to single-site capital risk. Regional networks with 6+ locations, centralized PACS reading, and in-network hospital contracts command 10x to 13x EBITDA at institutional exit.