Orthopedic Coding Alert

Do you know the new Medicare term for locum tenens?

When one of your physicians takes a leave of absence — be it for vacation, sabbatical, health reasons, etc. — your practice might consider hiring another physician temporarily to pick up the absent physician’s work.

All services for substitute physicians must be reported using locum tenens billing, a practice that allows your deserved reimbursement for your substitute physician’s services. You also need to know that locum tenens billing has a new name under Medicare guidelines, so don’t be caught off-guard when you see the new terms on policy pages.

Read on for a rundown on how to best utilize locum tenens billing in your practice.

Work From This Definition

“Locum tenens means ‘to hold the place of’ in Latin. When you bill for locum tenens, you are billing for a covering physician as if they were the regular physician. Medicare has certain parameters that need to be met in order to bill locum tenens, and many other insurance companies adopt similar policies,” explains Laureen Jandroep, CPC, COC, CPC-I, CPPM, founder/CEO of CCO.us.

Name change: The new Medicare-approved term for locum tenens billing is “fee for time compensation” (FTC), according to Jill Young, CPC, CEDC, CIMC, owner of Young Medical Consulting in East Lansing, Michigan. So although locum tenens might still be the way it’s referred to at your practice, you won’t likely see any reference to locum tenens in new Medicare guidance.

However, know that locum tenens and FTC are describing the same billing concept. (For the purposes of this article, we will refer to this billing practice as locum tenens/FTC.)

Best bet: Follow locum tenens/FTC rules for your Medicare providers, and check with private payers about best practices for billing a substitute physician’s services. They might follow Medicare’s lead on this issue, or they might have their own rules to follow for these physicians.

Extra Help? Don’t Employ Locum Tenens/FTC

Remember, locum tenens/FTC is only for physicians that are “holding the place of” another physician. If you’re hiring a physician on a temporary basis for any other reason, you can’t use locum tenens/FTC billing to report the physician’s services.

Also, your locum tenens/FTC claims should include modifier Q6 (Service furnished under a fee-for-time compensation arrangement by a substitute physician; or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area)); append it to every code on every claim you file for a locum tenens/FTC physician.