Locum tenens
Locum tenens physicians are temporary clinicians who cover for absent colleagues or fill vacancies, usually as independent contractors.
Locum tenens is Latin for holding the place of. A locum tenens physician, or locum, is a temporary physician who covers for a colleague who is away, or fills a vacancy while a group recruits. Advanced practice providers also take locum assignments. Locums usually work as independent contractors, often placed through a staffing agency, for anything from a few shifts to several months.
For Medicare, the regular physician can bill for a substitute's services under what CMS now calls a fee-for-time compensation arrangement, formerly a locum tenens arrangement. The regular physician must be unavailable, must pay the substitute on a per diem or similar fee-for-time basis, and adds the Q6 modifier to the claim. The substitute may not provide the services to Medicare patients over a continuous period of longer than 60 days, except for a physician called to active duty in the Armed Forces. A group can also use this for a physician who has left the group, for up to 60 days. In a hospital, the locum also needs privileges granted through the medical staff's credentialing process before the first shift.
Pitfalls: booking a locum before credentialing is complete, so the shifts stay uncovered anyway; leaving locums off the official schedule, so the paging list and payroll do not match who worked; and missing that the Medicare 60-day period runs continuously, including days the locum does not work.
Common questions
What does locum tenens mean?
Locum tenens is Latin for holding the place of. In US healthcare it means a physician or advanced practice provider who fills in temporarily, for a colleague on leave, during a vacancy, or when volume rises. Locums are usually independent contractors, often placed through an agency, rather than employees of the group they cover.
How long can a locum bill under the absent physician for Medicare?
Under the CMS rules for fee-for-time compensation arrangements, formerly called locum tenens arrangements, the substitute may not provide the services to Medicare patients over a continuous period of longer than 60 days, except for a physician called to active duty in the Armed Forces. Claims carry the Q6 modifier. The rules are in the Medicare Claims Processing Manual, chapter 1, section 30.2.11.
How is a locum tenens physician different from a PRN physician?
A PRN physician is usually an employee of the group or hospital who works extra shifts as needed. A locum tenens physician is usually an outside independent contractor brought in for a set period, often through an agency. Both need the same credentials and eligibility checks before they appear on the schedule.