Urologists: Enjoy your vacation but be careful with locum tenens limit

Why This Topic Matters

Locum tenens arrangements can help practices stay staffed, but Medicare billing and enrollment rules can affect how services are reported and paid. Understanding the policy boundaries helps practices reduce audit exposure and avoid claim-processing problems when physician absences last longer than expected.

Article Sections

1. Locum tenens coverage and the 60-day limit

   Introduces Medicare locum tenens arrangements and the time limitation that applies to substitute physician coverage. Discusses why longer physician absences create operational and billing concerns for practices.

2. CMS clarification on extended absences

   Summarizes CMS guidance on what happens when a physician is absent longer than expected. Covers the general approach CMS says practices should use for additional coverage periods.

3. Practice approaches and audit considerations

   Describes how some practices manage longer-term coverage discussions with contractors and the general compliance concerns raised by extended use of substitute coverage. Notes the risk of increased review activity.

4. Alternative: Get the locum credentialed

   Reviews an alternative staffing approach for longer absences and the related practice-enrollment considerations. Outlines broad limitations associated with using substitute physicians in this setting.

5. Official resources

   Lists source materials and related reference items cited in the article. Provides readers with pointers to CMS and other informational resources.

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

   Presents CMS question-and-answer guidance on substitute coverage when an absence lasts longer than expected and when a physician has left a group practice. Addresses the broader billing framework discussed by CMS.

7. Quick review of Medicare's locum rules

   Provides a condensed review of the Medicare Claims Processing Manual guidance relevant to locum tenens billing. Summarizes documentation and claim-processing topics covered in the source.