decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Locum Tenens, Reciprocal Billing / Substituting for a Physician Who has Left the Practice
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Article Overview
This article covers Medicare billing considerations for locum tenens and reciprocal billing when a physician is no longer in the practice, including temporary substitution scenarios, coverage timing, and references to CMS guidance. It is intended for coders, billing staff, compliance personnel, and physician practice administrators who need a general understanding of how these situations are discussed in Medicare policy context. The article focuses on the broad billing framework and related administrative communication with the Medicare carrier.
Why This Topic Matters
Coverage arrangements after a physician departure can affect how a practice continues to bill Medicare and document temporary staffing. Understanding the policy context helps practices evaluate whether the situation falls within locum tenens or reciprocal billing concepts and when to seek carrier guidance.
What You Will Learn
- How Medicare locum tenens coverage is discussed for a physician who has left a practice
- What general temporary staffing situations are addressed in the article
- How CMS guidance is presented in relation to time-limited substitution arrangements
- Why practices may communicate with a Medicare carrier about temporary coverage
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice administrators
- Physician office managers
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