decisionhealth Newsletters, Part B News - 2009 Issue 8 (August)
Be mindful of '60-day clock' when hiring locum tenens
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Article Overview
This article discusses Medicare locum tenens policy for practices that need temporary physician coverage, especially when a regular provider will be absent for an extended period. It summarizes CMS guidance from the Medicare Claims Processing Manual and notes practical compliance considerations such as credentialing, enrollment, recordkeeping, and claim submission requirements. The piece is relevant to physician practices, coders, billers, and compliance staff working with Medicare claims.
Why This Topic Matters
Understanding locum tenens rules helps practices maintain compliant billing when physician coverage changes for an extended period. The article highlights CMS-based requirements that affect claim handling, provider enrollment, and documentation workflows.
Article Sections
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Locum tenens coverage and the 60-day limit
Introduces the timing issue that arises when a regular physician will be absent for an extended period. It explains the broad CMS policy context for temporary replacement coverage.
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CMS guidance and billing setup
Summarizes the CMS position on claim submission options and enrollment-related considerations for locum tenens services. It also references the Medicare Claims Processing Manual as the source of guidance.
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Credentialing and compliance reminders
Discusses practice-level planning for temporary physician coverage and notes documentation and credentialing considerations. It also outlines several compliance limitations associated with locum tenens arrangements.
What You Will Learn
- The general Medicare framework for locum tenens physician coverage
- Why extended absences require advance planning
- What documentation and provider information should be maintained
- How CMS-related guidance affects billing workflow and enrollment considerations
- Which compliance limitations are commonly associated with locum tenens arrangements
Who Should Read This
- Medical coders
- Medical billers
- Physician practice managers
- Compliance staff
- Revenue cycle professionals
- Health care administrators
Modifiers Discussed
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