Is the term locum tenens familiar to you as a practicing physician? It means “to hold the place of or to substitute.” This applies to a physician who temporarily takes over a practice or fills in for a partner for Medicare patients. This may occur for several reasons, such as vacation, maternity leave, or illness.
Using locum tenens allows a practice to continue receiving reimbursement from Medicare under an absent physician’s name and provider number. Medicare has very specific rules on how to submit claims for practices that are using locum tenens. The submission guidelines are:
- A practice can only employ locum tenens for 60 days or less. Claims must be submitted under the absent physician’s National Provider Identifier (NPI) number and name. The covering physician is to be reimbursed by the practice.
- There is no extension for the 60-day maximum. If a physician will be out for more than 60 days, there are two alternatives:
- Employ a new locum tenens to take over; or
- The physician will need to return to work for a small amount of time and start the 60-day time limit over.
- Locum tenens must be credentialed by Medicare and have a NPI number on file with Medicare, even though they will bill under the absent physician name and NPI number.
- The Q6 modifier must be placed in Box 24D on the HCFA 1500 form. This signifies to Medicare that a locum tenens performed the service, in case of an audit.
As long as claims are submitted correctly, there will be no change in the practice reimbursement from Medicare when using locum tenens.
If a rheumatology practice is looking to replace a retiring partner, using locum tenens is a great way to try out new candidates and allow a practice time to make staff changes. Accessing physicians in this manner can save a practice a lot of time, headaches, and money.
Many physicians find it advantageous to act as locum tenens when they are trying to make a decision as to where and what size practice they may want to join. For physicians interested in finding locum tenens job opportunities, there are recruiting agencies and job boards available.
Physicians who are considering hiring a locum tenens from an agency should understand that Medicare will only reimburse the practice and not the locum tenenss directly. Locum tenens will receive payment from their local hiring agency and will be paid on a per-diem or fee-for-time basis. All payment arrangements should be decided before the locum tenens physician begins work.
Contracting with locum tenens can be a win-win situation for both the practice and the locum tenens. If you develop a good working plan you can keep your staff and patients happy and your bottom line productive. If you have questions, contact Melesia Tillman, CPC, CRHC, CHA, at [email protected] or (404) 633-3777, ext 820.