Medical Office Building (MOB) CAM Reconciliation Guide for Landlords
Typical CAM pools, billing errors, gross-up mechanics, and BOMA standards for medical office building (mob) properties.
Benchmark CAM per SF
$9.00 – $17.00 / SF
Source: Revista / BOMA Medical Office 2024
Gross-Up Applicability
Relevant — MOBs near hospitals may have uneven occupancy as practices consolidate. Enhanced HVAC and janitorial standards mean variable expenses are higher per SF and should be grossed up at standard occupancy.
Typical CAM Pools
- Janitorial (medical-grade)
- HVAC maintenance (enhanced)
- Elevator maintenance
- Security
- Utilities (common area)
- Medical waste management (shared)
- Insurance
- Property taxes
- Management fees
- Parking maintenance
Standard Exclusions
- Tenant-specific medical equipment
- Individual suite build-out
- Capital improvements
- Leasing commissions
- Tenant medical waste (individual)
Common Lease Structures
Common Billing Errors
- Passing through medical-grade HVAC costs to non-medical tenants in mixed buildings
- Including after-hours HVAC charges in base CAM rather than billing individually
- Misallocating parking structure costs between medical and non-medical tenants
Relevant BOMA Standards
- ANSI/BOMA Z65.1-2024 (Office Buildings)
- Special provisions for medical suites requiring higher ventilation
Medical Office Building (MOB) CAM Context
Medical office buildings command premium CAM charges due to enhanced HVAC (fresh air requirements, negative pressure rooms), medical-grade janitorial services, and specialized common areas (waiting rooms, imaging suites). After-hours usage is a frequent billing dispute.
Related Resources
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