Locum Tenens Misuse

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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 locum tenens billing and compliance issues in anesthesia practices. It discusses when temporary physician coverage is appropriate, common misuse patterns, claim submission handling, and the role of CMS guidance and carrier policy. The content is aimed at coders, billers, compliance staff, and practice administrators who need to understand the general boundaries of locum tenens arrangements.

Why This Topic Matters

Misuse of locum tenens arrangements can create billing errors and compliance exposure for physician groups. Understanding the general policy framework helps practices avoid improper claim handling and staffing arrangements that may trigger payment problems or penalties.

Article Sections

  1. Introductory compliance concerns

    Introduces the topic of locum tenens use in physician practices and frames the article around billing and compliance concerns.

  2. Common billing irregularities

    Summarizes recurring locum tenens billing issues identified by the article and discusses why temporary coverage arrangements can become problematic.

  3. When locum tenens use is appropriate

    Describes general situations in which temporary physician coverage may be considered under Medicare policy and mentions limits discussed in the article.

  4. Handling extended absences

    Addresses longer-term physician absences and the article’s discussion of serial temporary coverage arrangements and compliance concerns.

  5. LTs and the CMS 1500 form

    Explains claim form handling for temporary physicians and the broader administrative issues involved in submitting Medicare claims.

  6. Have black bag, will travel

    Discusses broader industry trends in locum tenens staffing and the changing profile of physicians working in temporary roles.

What You Will Learn

  • The general Medicare policy concerns surrounding locum tenens arrangements
  • Common locum tenens billing and staffing mistakes discussed in anesthesia practice settings
  • How temporary physician coverage interacts with claim submission and recordkeeping
  • Why extended absences and long-term staffing shortages raise compliance questions
  • What broader staffing trends are affecting locum tenens use

Who Should Read This

  • Medical coders
  • Medical billers
  • Compliance staff
  • Anesthesia practice administrators
  • Physician group managers

Codes Discussed

Code Ranges Discussed

  • MEDICARE: 1842(B)(6)(D)

Modifiers Discussed


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