Locum Tenens, Fee for Time and Reciprocal Billing – Differing Options for Billing

Locum Tenens, Fee for Time and Reciprocal Billing are options for the billing of services when a substitute provider sees patients. The definition of these three types of services is important when a provider is not able or chooses, like for a vacation, to be gone from the practice.  What type of provider (physician, nurse practitioner, physician assistant, or other) can utilize which of the concepts of billing is important to understand in compliant billing.

Locum tenens is Latin word that means “to hold the place.”  There was confusion because the concept of Locum Tenens as a substitute physician was also a concept of how to bill for the services.  Medicare made a change and the billing concept’s name was changed to “fee for time compensation”.  This name did not help lower the confusion.  The facts of billing for a substitute physician didn’t change:  Reciprocal Billing has definitions that can include physical therapists.

The webinar by industry expert Jill M. young will go into the details of who can use locum tenens or fee-for-time arrangements and reciprocal billing.  How long they can last, how to bill for the services, what documentation is needed and other details of this unique arrangement that Medicare allows providers to utilize.

Webinar Objectives

Medicare provides the most comprehensive guidance on billing for substitute providers. This session will use the Medicare Claims Processing Manual as the foundation to explain the key rules governing substitute provider billing. Building on this base, we will also explore how other major payers interpret and apply these rules, offering a broader understanding of the billing landscape for substitute services across various insurance providers.

Webinar Agenda

• Overview of substitute provider billing scenarios
• Medicare’s rules and definitions (based on the Medicare Claims Processing Manual
• Billing processes under the reciprocal billing and locum tenens arrangements
• Comparison of substitute provider policies across other major payers
• Common billing challenges and compliance pitfalls
• Q&A and practical guidance for implementation

Webinar Highlights

• What types of providers can be locums?
• What is the fee for time compensation model of billing?
• Who can use this methodology when billing for locums services of a provider?
• How long can a physician act as a substitute ?
• Are there any exceptions to this duration?
• What information goes on a claim form to identify the situation?
• What documentation needs to be kept for these services?
• What is reciprocal billing ?
• What types of providers can use reciprocal billing?

Who Should Attend

Coders, Billers, Administrators, Physicians