Policy: Understand This Medicare Update on Locum Tenens

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

Article Overview

This article reviews a Medicare policy update affecting temporary substitute physician coverage. It is aimed at practices, billers, and coders who need to understand the current terminology, claim reporting basics, and related documentation considerations for substitute physician services under Medicare and similar payer policies.

Why This Topic Matters

Practices often rely on temporary physician coverage during absences, and Medicare’s updated wording and billing expectations can affect how those services are reported. Understanding the policy helps reduce claim errors and supports consistent handling of substitute physician billing across payers.

Article Sections

  1. Introduction

    Introduces the topic of substitute physician billing and notes that Medicare guidance uses updated terminology. It frames the article as a practical overview for practices planning temporary coverage.

  2. Latin Definition Epitomizes Locum Tenens

    Explains the general concept behind locum tenens and discusses how the Medicare-related terminology is described in the article. It also notes that other payers may follow Medicare or maintain separate policies.

  3. Don’t Employ Locum Tenens/FTC As Extra Help

    Covers the circumstances under which temporary substitute physician billing is and is not appropriate. It also discusses claim identification and reporting considerations associated with substitute physician services.

  4. Observe Locum Tenens/FTC Time Limit

    Summarizes the duration limit for substitute physician coverage and mentions what happens when coverage extends beyond that period. It also addresses documentation expectations tied to the temporary coverage arrangement.

What You Will Learn

  • How Medicare’s terminology for temporary substitute physician billing is described in the article
  • What general situations involve substitute physician coverage
  • What broad claim-reporting and documentation issues are associated with this billing topic
  • How the article addresses time limits for temporary coverage

Who Should Read This

  • Medical coders
  • Billing staff
  • Practice managers
  • Physician office administrators
  • Compliance personnel

Modifiers Discussed


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