Fee-For-Service Time Compensation (Previously known as Locum Tenens)

No, it is not appropriate to bill as Fee-For-Service Time Compensation for longer than 60 days, even if a different substitute physician is providing the service. Group practices may bill for a temporary replacement under the exiting physician’s NPI for up to 60 days. This information is available on the CMS website (PDF) in Publication 100-04, Chapter 1, Section 30.2.10 and 11.

Exception

A physician or physical therapist called to active duty in the Armed Forces may bill for services furnished under a reciprocal billing arrangement for longer than the 60-day limit providing all other requirements are met.

Last Reviewed: 9/12/2023

• This arrangement can only exist between physicians, not nonphysician practitioners (e.g., PAs, SPs and CRNAs) and in the case of outpatient physical therapy services furnished by physical therapists in a HPSA, an MUA or a rural area
• When a physician or physical therapist needs to take a leave of absence for any reason, another physician or physical therapist can fill his or her duties for up to 60 days
• HCPCS modifier Q6 should be used, and all claims should be billed under the NPI of the physician or physical therapist on leave
• After 60 days, the substituting physician or physical therapist must begin submitting claims under his or her own NPI

Resource: The CMS Medicare Claims Processing Manual (Pub. 100-04), Chapter 1 (PDF), Section 30.2.1 - 30.2.11.

Last Reviewed: 9/12/2023

Enter the regular physician's (absent) NPI in box 24J of the CMS-1500 form or electronic equivalent.

Last Reviewed: 9/12/2023

No. It appears the physician is regularly scheduled for one shift a month. Physicians may retain substitute physicians to take over their professional practices when they are absent for reasons such as illness, pregnancy, vacation or continuing medical education. It is not appropriate to bill Fee-For-Service Time Compensation for longer than 60 days.

Last Reviewed: 9/12/2023

If a Fee-For-Service Time Compensation service was rendered and the Q6 HCPCS modifier was appended to the claim, we would need to see documentation (would not be within the progress note) that substantiates a Fee-For-Service Time Compensation Arrangement has occurred. This may be a contract, etc.

Last Reviewed: 9/12/2023

We would need to see documentation indicating he/she was called to military duty.

Last Reviewed: 9/12/2023

No. Services of nonphysician practitioners (e.g., CRNAs, NPs and PAs) may not be billed under the Fee-For-Service Time Compensation or Reciprocal Billing reassignment exceptions. These provisions apply only to physicians.

Last Reviewed: 9/12/2023

Group practices may bill for a temporary replacement under the exiting physician’s NPI for up to 60 days.

Last Reviewed: 9/12/2023

No. Physicians may retain substitute physicians to take over their professional practices when they are absent for reasons such as illness, pregnancy, vacation or continuing medical education. It is not appropriate to bill Fee-For-Service Time Compensation for longer than 60 days.

Last Reviewed: 9/12/2023

No. The service is billed under the regular physician’s NPI. If the regular physician or a provider in the group of the same specialty has seen the patient in the past three years, it is considered an established patient.

Last Reviewed: 9/12/2023