News & Views

Perspectives on the locum tenens industry

How Hospitals Can Bill for Locum Tenens

As the need for locum tenens continues to increase, it is important for health care facilities to understand how to properly bill for locum tenens services. A practice may need to take on a locum tenens physician or advanced practitioner for a variety of reasons, ranging from the temporary leave of a permanent physician, to covering for an explosive summer influx of patients, to filling in until a permanent physician can be hired for a position. As the industry grows, professional and facility fee billing becomes increasingly complex.

The first question you must determine is why you are using a locum tenens. If you seek a locums physician or advanced practitioner to provide coverage while searching for a permanent staff member, to provide a broader range of services, or to supplement your current staff, then your next step would be to determine if the locum tenens provider is enrolled in Medicare. A locum tenens physician must go through the Medicare credentialing process and be accepted as a credentialed Medicare provider before seeing any Medicare patients.

If the physician is already credentialed with Medicare, the process is simple. At this point, the locums physician will be linked to the group and then the provider’s NPI number can be used.  If the physician is not enrolled in Medicare, the locums provider must enroll and use the NPI number once approved.

But, not all locums physicians are being used on a long-term basis.  What if you, as a facility, seek a locums physician simply to provide vacation coverage or maternity leave?  In fact, true to it’s Latin definition, locum tenens actually means “holding one’s place”, alluding to vacation or this type of short-term coverage. Assuming that the locums physician will not be needed for more than 60 days, billing can be carried out using the absent doctor’s NPI and Q6 modifier.  The locum tenens physician’s services must be billed using the modifier Q6 to show that a locum tenens physician provided care, and a record of the services provided to your patients by the locum tenens physician must be kept on file.