Part B Insider - 2024 Issue 7
Fee-For-Time Billing: 7 Myths and 1 Truth About Fee-for-Time Billing
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Article Overview
This article explains the general topic of fee-for-time billing for temporary physician coverage and why it matters to practices that use fill-in doctors during absences. It summarizes common myths and practical reporting considerations discussed in guidance from CMS and Medicare Administrative Contractor sources, with emphasis on who the guidance applies to and the kinds of billing situations that may be misunderstood.
Why This Topic Matters
Practices that use temporary physician coverage need to understand how fee-for-time billing is discussed in Medicare guidance so they can recognize when the topic applies and avoid confusing it with other staffing or billing arrangements.
Article Sections
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Truth 1: FFT Billing Applies to Temporary Doctors
Introduces the core fee-for-time billing concept and the type of temporary coverage arrangement the article is addressing. Also references CMS guidance and the related Medicare context.
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Myth 1: You’ll Use the Fill-in Doctor’s NPI
Discusses billing identity and claim-submission issues associated with temporary physician coverage. Mentions payer-specific handling and form-related considerations.
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Myth 2: You Can Bill Fee-for-Time Before Your Doctor Is Credentialed
Covers a common misuse of fee-for-time billing involving newly hired physicians and delayed credentialing. Includes discussion of federal oversight concerns and Medicare provider-number reporting.
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Myth 3: In Some Cases, You Can Skip Modifier Q6
Addresses incorrect claim-reporting practices in temporary coverage situations and the importance of consistent claim preparation. Focuses on compliance concerns tied to substitute physician billing.
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Myth 4: You Can Use FFT for “Extra Help”
Explains that the article distinguishes temporary replacement coverage from short-term staffing used to support higher patient volume. Highlights the difference between substitute coverage and supplemental help.
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Myth 5: There’s No Time Limit on FFT
Describes timing limits associated with fee-for-time billing and notes that special circumstances may affect coverage duration. Also touches on what happens when longer-term coverage is needed.
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Myth 6: You Can Use FFT for Nonphysician Providers
Reviews whether fee-for-time billing applies to nonphysician clinicians and cites Medicare contractor guidance. Also mentions the special physical therapy-related context referenced in the article.
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Myth 7: FFTs Can Bill for Services Normally Included in Global Period
Addresses how fee-for-time billing relates to services that may otherwise be bundled into global surgery or postoperative payment structures. Focuses on the article’s discussion of substitute physician billing boundaries.
What You Will Learn
- What fee-for-time billing is generally about in temporary physician coverage
- How the article distinguishes true substitute coverage from other staffing arrangements
- Which Medicare-related sources are referenced in the discussion
- What kinds of billing misunderstandings commonly arise in fee-for-time scenarios
- How the article frames claim submission, credentialing, timing, and provider-type issues
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician office administrators
- Emergency medicine practices
- Compliance teams
Modifiers Discussed
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