Knowing how to bill for locum tenens services

If you are looking into using a locum tenens staffing company for temporary physician or nurse practitioner staffing support, obtaining a return on your investment is likely among your primary concerns. When you understand how to properly bill for locum tenens services provided, you’ll find that locum tenens staffing is an effective way to generate revenue while ensuring patient access and continuity of care.

The locum’s role and the duration of the assignment will dictate which billing method you should use to bill for locum tenens professional services.

Holding the place of a physician who is returning within 60 days

If you need a locum tenens physician for the traditional “holding one’s place” type of scenario (e.g., coverage for vacations, illness/medical leave, continuing education, etc.), The Medicare Claims Processing Manual allows you to bill for locum tenens professional fees using the absent physician’s billing information as long as the following conditions are met:

•  The regular physician is unavailable to provide the visit services.
•  The patient has arranged or seeks to receive the visit services from the regular physician.
•  The locum tenens provider is paid for his/her services on a per diem or similar fee-for-time basis.
•  The substitute physician does not provide services to Medicare patients over a continuous period of longer than 60 days.

If these conditions are met, you can bill for the locum’s professional services using the absent provider’s national provider number (NPI) in box 24 of the CMS-1500 form. You must also use modifier –Q6 (Service furnished by a locum tenens physician) in box 24d of the CMS-1500 form for each line item service on the claim to indicate the service was provided by a locum.

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