Physician Independent Contractor Agreement Template

PHYSICIAN INDEPENDENT CONTRACTOR AGREEMENT

This Physician Independent Contractor Agreement (the "Agreement") is made and entered into as of this ______ day of __________________, 20____ (the "Effective Date"), by and between:

PRACTICE/ENTITY: __________________________________________________, a __________________ [State] professional corporation/entity, with its principal place of business located at __________________________________________________ ("Company"),

AND

PHYSICIAN: __________________________________________________, an individual, with a principal address of __________________________________________________ ("Physician").

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1. SERVICES

The Company hereby engages the Physician, and the Physician hereby agrees to perform professional medical services as a(n) __________________ [Specialty] (the "Services"). The Physician shall perform the Services at the following locations: __________________________________________________ (the "Facilities").

2. TERM AND TERMINATION

2.1 Term: This Agreement shall commence on the Effective Date and shall continue for a period of ______ year(s), unless terminated earlier pursuant to this Section. 2.2 Termination for Cause: Either party may terminate this Agreement immediately upon written notice if the other party breaches any material term of this Agreement or if the Physician loses their medical license or hospital privileges. 2.3 Termination Without Cause: Either party may terminate this Agreement without cause by providing ______ days' prior written notice to the other party.

3. INDEPENDENT CONTRACTOR STATUS

The Physician is an independent contractor, not an employee, partner, or joint venturer of the Company. The Physician shall be solely responsible for the payment of all federal, state, and local taxes, including self-employment taxes, and shall not be entitled to any employee benefits, including, but not limited to, health insurance, retirement plans, or paid leave.

4. COMPENSATION

In full consideration for the Services provided, the Company shall pay the Physician as follows:

• Base Compensation: __________________ per [Hour/Day/Procedure].
• Payment Schedule: Payments shall be made [Monthly/Bi-weekly] within ______ days following the submission of an invoice.

5. LICENSURE AND COMPLIANCE

The Physician represents and warrants that they hold a valid, unrestricted license to practice medicine in the State of __________________, possess a valid DEA registration, and maintain eligibility to participate in federal and state healthcare programs. The Physician agrees to comply with all applicable laws, including HIPAA and the Anti-Kickback Statute.

6. MALPRACTICE INSURANCE

The Physician shall maintain professional liability (malpractice) insurance in the minimum amount of __________________ per occurrence and __________________ in the aggregate. [The Company/The Physician] shall be responsible for the cost of such premiums.

7. CONFIDENTIALITY

The Physician acknowledges that they may have access to proprietary information, trade secrets, and patient records (collectively, "Confidential Information"). The Physician agrees to hold all such Confidential Information in strict confidence and not to disclose it to any third party during or after the term of this Agreement.

8. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of __________________.

9. ENTIRE AGREEMENT

This Agreement constitutes the entire understanding between the parties and supersedes all prior agreements, oral or written, regarding the subject matter herein. Any modifications must be made in writing and signed by both parties.

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IN WITNESS WHEREOF, the parties have executed this Agreement as of the Effective Date first written above.

COMPANY:

Signature: __________________________________ Name: ______________________________________ Title: ______________________________________ Date: ______________________________________

PHYSICIAN:

Signature: __________________________________ Name: ______________________________________ NPI Number: ________________________________ Date: ______________________________________