Understanding Locum Tenens for Your Medical Billing

Locum tenens is simply when one physician substitutes temporarily for another in the same capacity. There are some differences in billing for services performed by a locum tenens professional, however the 60-day time frame will apply.

First and foremost, be sure you are appending modifiers Q5 (Service furnished by a substitute physician under a reciprocal billing arrangement) and Q6 (Service furnished by a locum tenens physician) as appropriate to use.

The 60-day rule causes a lot of confusion. Basically, the clock starts ticking from the beginning of service and then runs for 60 consecutive days. It doesn’t matter whether the locum tenens or reciprocal billing physician provides services every day for 60 days, or once a week for 60 days–at the end of 60 days, the clock stops.

Don’t assume that a substitute physician falls under reciprocal billing rather than locum tenens just because he has a day job. Many physicians decide to moonlight as a locum tenens as a way to make extra money. Many residents often find time to work nights, weekends, or holidays as locum tenens providers.

Many people assume you can easily distinguish locum tenens from reciprocal billing by the type of payment arrangement or contract your practice has with the substitute physician. This is not exactly true. A practice is supposed to have a contract with any locum tenens physician but many locums do work without any contract whatsoever.

The bottom line is know for sure if your billing reciprocal or locum tenans and make sure you use the correct modifier to distinguish these service providers in your medical billing.

View all Articles by: Kathryn E, CCS-P - Retired