Locum tenens Q & A
15 August 2006
You can use locum tenes physicians for up to 60 days at any time to fill in for physicians who are out of the office.
The term locum tenes is Latin for "holding the place of" and describes a process that allows you to bring in another physician not affiliated with your practice to temporarily bill for services under the PIN of an absent physician.
The locum, who usually has no practice of his or her own, is then paid by arrangement with your practice.
Basic rules of billing for a locum tenes physician:
- Use the Q6 modifier in box 24d of the CMS-1500 form.
- Enter the regular physician's PIN in box 24k of the CMS-1500 form.
- Keep track of the locum's PIN and his/her services in your files in case your carrier requests them.
Q: I know Medicare allows a locum to stay for up to 60 days, but what do we do if a physician will be gone for 90 days?
A: Each locum tenes physician can work for up to 60 days. After 60 days, another locum can be used for an additional 60 days. You could also credential the original locum for your practice if you want the physician to keep seeing patients beyond the 60-day limitation.
Q: If the regular physician comes back after 60 days, stays for a few days, then leaves again, can we use the same locum?
A: Yes. A "continuous period" starts on the first day the substitute doctor provides service to patients of the regular doctor and continues until services are provided to patients by the regular physician, according to Chapter 1, section 30.2.10 of Medicare's Claims Processing Manual.
Q: Can a locum be used to help temporarily at a busy practice?
A: No. A locum must fill in for an absent doctor and can't substitute for hiring an extra doctor at a growing practice.
Q: If a doctor leaves a clinic, can the clinic bill a temporary replacement as a locum tenes until a permanent replacement can be found?
A: Yes. A locum can be used for up to 60 days and those services may be billed using the Q6 modifier and the departed physician's PIN. Locums should not be used to fill staffing shortages however, and in this case a second locum shouldn't be hired if the position is open longer than 60 days.
Copyright 2006 DecisionHealth. Reprinted by permission of PartBNews.