How Medical Practices Can Dispute CAM Charges
Medical office tenants often overpay thousands in CAM and NNN charges due to improper admin fees, capital expense misclassification, and incorrect cost allocation. Most leases grant audit rights — but only within strict time windows.
In medical office buildings, CAM disputes often involve high-voltage electrical loads, generator redundancy systems, infection-control HVAC infrastructure, and healthcare compliance costs. These technical components make operating expense audits more complex than traditional retail or general office leases.
What a CAM Dispute Can Actually Recover
8,000 SF practice × $3 PSF improper allocation = $24,000/year
10,000 SF imaging center × $4 PSF misclassification = $40,000/year
Over a 5-year term, unresolved CAM errors can exceed $150,000.
Step 1: Review the Lease Language Carefully
Confirm CAM definitions, admin fee caps, capital expenditure exclusions, amortization rules, audit rights, notice requirements, and reconciliation timelines. Medical leases often contain narrow dispute windows (commonly 12 months). For deeper context, review our Medical Office CAM Reconciliation Guide and Medical Office NNN Expense Breakdown.
Step 2: Request Supporting Documentation
Request invoices, vendor contracts, allocation schedules, and supporting reconciliation detail. Tenants are generally entitled to review backup documentation supporting CAM charges.
Step 3: Identify Healthcare-Specific Overcharges
- Generator replacements passed through as operating expense
- Parking structure repairs classified as CAM
- HVAC upgrades tied to imaging load treated as tenant expense
- Admin fees exceeding stated percentage caps
- Capital improvements amortized improperly
How to Structure a CAM Dispute Letter
Medical tenants typically structure disputes by:
- Referencing the specific lease section governing CAM
- Identifying the disputed category or calculation
- Requesting detailed backup documentation
- Preserving audit rights in writing
- Reserving all contractual rights pending review
Why Timing Matters
Most medical office leases require formal notice within a defined audit window. Failure to dispute within that period may waive recovery rights for that reconciliation year.
Related Medical Lease Resources
Frequently Asked Questions
Can medical tenants legally dispute CAM charges?
Yes. Most medical office leases include audit rights allowing tenants to review and challenge CAM reconciliations within defined timeframes.
What CAM charges are most commonly disputed?
Admin fee cap violations, capital improvements improperly passed through, reserve fund allocations, and incorrect pro-rata share calculations.
How long do medical practices have to dispute charges?
Many leases provide a 12-month audit window after reconciliation delivery, though timelines vary by agreement.
Do medical office leases typically include CAM caps?
Some medical office leases include caps on controllable CAM expenses or administrative fees, but many exclude taxes and insurance from caps. Lease language must be reviewed carefully.
Need help reviewing your reconciliation before the audit window closes? Our medical lease auditidentifies improper allocations, admin fee violations, and capital expense misclassification while preserving your dispute rights.