Don’t get too creative with 60-day locum tenens limit

Why This Topic Matters

Locum tenens arrangements can affect how services are billed, who may be paid under a practice’s arrangement, and whether a practice stays within Medicare policy expectations. Understanding the scope of the rule helps practices avoid compliance risk when staffing gaps last longer than expected.

Article Sections

1. Locum tenens use in Medicare practices

   Introduces why practices rely on temporary physician substitution during absences or staffing changes. It frames the policy issue in the context of Medicare enrollment and practice coverage needs.

2. CMS clarification on the 60-day limit

   Summarizes the reported CMS clarification regarding the duration of substitute coverage and the need for attention to how long a temporary arrangement continues. The section also notes compliance and audit concerns raised by billing consultants.

3. Alternative approach: credentialing the locum

   Describes an alternate administrative approach for practices anticipating longer-term coverage needs. It outlines the kinds of practice and enrollment considerations associated with using a credentialed physician.

4. Official resources

   Lists referenced CMS and DecisionHealth resources for readers seeking the source materials and related educational content.

5. CMS Q&As: Locum time limit; using locum to replace a departed physician

   Presents CMS questions and answers addressing extended absence scenarios and a physician leaving a group practice. It provides policy clarification and administrative context for locum billing arrangements.

6. Quick review of Medicare's locum rules

   Reviews the main policy points excerpted from the Medicare manual, along with form and recordkeeping references used in locum billing workflows.