Locum

Fee-For-Service Time Compensation Update

Fee-For-Service Time Compensation Update

Locum tenens, now termed Fee-For-Service Time Compensation, involves contracted physicians who substitute for a physician who has left the practice or is temporarily unavailable (e.g., on medical leave, vacation, etc.). CMS allows payment for their services, requiring modifier Q6 for proper billing.

Effective June 23, 2017, CMS expanded this policy to include physical therapists, replacing "locum tenens" with "fee-for-time."

Billing Guidelines

  • Use modifier Q6 when billing for locum tenens services under the regular physician's name.
  • Billing period is maximum 60 days.
  • No need for locum tenens physician credentialing.
  • The regular physician cannot bill for any other claims without Q6 modifier for a period of 60 days within the group.
  • If services exceed 60 days, the regular physician bills the first 60 days with Q6, and the substitute physician bills the remaining.
  • Nonphysician Practitioners (e.g., CRNAs, NPs, and PAs): exceptions apply only to physicians, not nonphysician practitioners.

Clerical Reminders

  • Claims must contain the regular physician's NPI in block 24J.
  • Modifier Q6 must be appended to CPT/HCPCS codes in box 24D.
  • The 60-day count starts on the first day the locum tenens physician sees a patient.
  • Maintain a record of each service by the substitute physician or physical therapist, along with their NPI.
Billing for locum tenens or Fee-For-Service Time Compensation services ensures continued outstanding care without revenue loss. Providers need not fear billing for locum tenens physician services. Organizations planning for services beyond 60 days should initiate payer enrolment in advance.
Disclaimer: This update is for informational purposes only and not intended as legal or billing advice. Providers should confirm current CMS and payer guidelines before submitting claims.