Locum Tenens – The Rules and Paperwork Required!

Jill M. Young

Jill M. Young

Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working...
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Pre-recorded
60 Mins
Jill M. Young

The concept of Locums or Locum Tenens involves physicians substituting or filling in for other physicians on a temporary basis. This practice is prevalent for various reasons and allows for patient care without the need for extensive credentialing.

When considering the rules and regulations surrounding Locum Tenens, Medicare serves as an important reference point. In recent years, Medicare has implemented significant changes to the Locum Tenens section of its Manual. It is crucial to understand these changes, as well as the complex billing and documentation requirements for Medicare patients. This understanding forms the foundation for compliant practices.

In addition to Medicare, it is necessary to research and implement the policies of other insurance carriers. Ensuring compliant documentation in patients' charts, as well as meeting any additional documentation requirements of various carriers, is essential. It is important to note that utilizing Locum Tenens involves more than simply adding a modifier to a claim when another physician provides care in the office. Compliant documentation, proper tracking, and understanding the qualifications of individuals authorized to deliver substitute provider services are vital aspects that will be covered in detail during the webinar.

Given the increasing demand for Locum Tenens providers by national agencies, it is crucial for healthcare providers to be well-informed about the rules governing such arrangements. By adhering to these rules, healthcare providers can avoid engaging in non-compliant relationships and ensure the delivery of quality patient care.

Webinar Objectives


The objective of this session is to provide a comprehensive understanding of the concept of Locum Tenens, which involves the substitution of a physician. The focus will be on the billing aspect, specifically the Medicare modifier that recognizes this substitution on claims. Participants will also gain insights into the potential payment challenges that may arise when other insurance carriers do not recognize this modifier. 

Additionally, the session aims to educate participants on the rules and guidelines related to Locum Tenens, including the maintenance of specific lists and adherence to timelines for substitute services. Understanding these rules is essential for compliant utilization of the Locum Tenens concept, ensuring proper billing and adherence to regulatory requirements. 

Moreover, the session will address the importance of researching other insurance payers to navigate potential payment issues effectively. Participants will receive practical tips on how to conduct this research and learn about the necessary documentation that should be maintained for proper claims submission and reimbursement.

Webinar Agenda


  • Length of the life of a Locum physician
  • What paper trail Medicare mandates be kept  
  • Identifying any restrictions placed on your “substitute” physician by the insurance carriers. This will avoid jeopardizing their work or your payment for those services will ensure a smooth transition into and out of their time with your practice.
  • Documentation of services provided under the Locum Tenens concept is an important step in the compliance process
  • The technical aspects of how to bill for their services from carriers is next. What numbers go in which boxes and which modifiers are appropriate
  • FAQ from Medicare MAC’s to address common questions

Webinar Highlights


  • Who can be a locum tenens provider?
  • Length a locum’s physician is allowed to provide services per Medicare
  • there exceptions?
  • other carriers have restrictions?
  • Medicare specific rules
    • Documentation guidelines
    • Master list of patients
    • Incident to services
    • Claim specific information
  • Other insurance carriers
    • How to research
    • What do to if there are not answers

Who Should Attend


Practice Managers, Office Managers, Coders and Billers

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