Getting paid: Avoid billing mistakes when dealing with locum tenens during physician absence

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews Medicare’s locum tenens framework for practices that use temporary physicians during a regular physician’s absence. It is aimed at billing and coding professionals, practice managers, and physicians who need to understand the general claim-filing process, documentation expectations, and the Medicare policy considerations that can affect extended coverage arrangements. The article also points readers to official Medicare resources for further guidance.

Why This Topic Matters

Locum tenens coverage can help practices maintain continuity of care and billing during physician absences, but Medicare requirements can create claim-processing problems if the arrangement is handled incorrectly. Understanding the policy scope and filing approach helps reduce denials, administrative issues, and compliance risk.

Article Sections

  1. How to file

    Overview of the claim-filing process for locum tenens coverage, including general Medicare claim handling and documentation expectations.

  2. The 60-day rule

    Discussion of Medicare’s time-related limits for locum tenens coverage and general considerations for longer absences.

  3. Official resources

    References to Medicare manuals and emergency-policy resources for additional background on locum tenens guidance.

What You Will Learn

  • How Medicare frames locum tenens coverage during physician absence
  • What general claim-filing and documentation topics are relevant to locum arrangements
  • What policy considerations arise when temporary coverage extends over time
  • Where to find official Medicare reference materials on locum tenens policies

Who Should Read This

  • Medical coders
  • Billing staff
  • Practice managers
  • Physician office administrators
  • Healthcare compliance staff
  • Physicians using temporary coverage

Modifiers Discussed


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