Medicare Compliance & Reimbursement

Medicare doesn't consider locum tenens an appropriate billing scenario for an uncredentialed physician. Myth: Tired of waiting for your new physician's Medicare credentialing to process? You can just report the new doctor's service under an existing physician's ID number and append the locum tenens modifier to it, right? Reality: No way. Locum tenens is designed to represent services performed "in the absence of the regular physician," according to Chapter 1 of the Medicare Claims Processing Manual. The scenario: Many practices have grown frustrated at wait times for Medicare credentialing when they hire a new physician, so they simply report the new physician's service as if it was performed by a locum tenens doctor, but that goes against the original intent of the locum tenens rules, says Quinten A. Buechner, MS, MDiv, CPC, ACS-FP/GI/PEDS, PCS, CCP, CMSCS, president of ProActive Consultants in Cumberland, Wis. "Some practices are billing this way and [...]