Changes to Reciprocal Billing and Locum Tenens Arrangements

As a result of the “21st Century Cures Act” (P.L. 114-255), reciprocal billing arrangements and locum tenens arrangements will apply not only to physicians, but to physical therapists (specialty code 65) who work in certain health professional shortage areas. With the passing of this law, both reciprocal billing arrangements and locum tenens arrangements are applicable to Medicare-enrolled physical therapists who use substitute physical therapists to furnish outpatient physical therapy services.

To apply, the outpatient physical therapy services must be furnished in a health professional shortage area (HPSA), medically underserved area (MUA), or rural area.

The term “locum tenens” is being changed to “fee-for-time compensation arrangement.” The descriptions for modifiers Q5 (reciprocal billing arrangement) and Q6 (fee-for-time compensation arrangement) will be amended to include physical therapists in addition to physicians and the description for the Q6 modifier with replace the term “locum tenens arrangement” with “fee-for-time compensation arrangement.”

The guidelines for reciprocal billing and “fee-for-time compensation arrangements (formerly locum tenens arrangements) may be found in the Medicare Claims Processing Manual Internet-Only Publication # 100-04, Chapter 1, Sections 30.2.10 and 30.2.11, respectively.

These changes are effective July 13, 2017.

• About
• Latest Posts

Maryann Palmeter

Maryann C. Palmeter, CPC, CPCO, CPMA, CENTC, CHC, has more than 30 years of technical and executive level experience gained through her work on both the government payer and professional billing ends of the healthcare spectrum. She is director of physician billing compliance at the University of Florida Jacksonville Physicians, Inc., and is responsible for providing professional direction and oversight to the billing compliance program of the University of Florida College of MedicineJacksonville. Palmeter served on the AAPC’s National Advisory Board from 2011-2013 and was subsequently selected to serve as secretary for the 2013-2015 term. She was named the AAPC’s 2010 “Member of the Year” and is the vice president for the Jacksonville, Fla., local chapter.

Latest posts by Maryann Palmeter (see all)

• Primary Care Exception in Brief - February 8, 2019
• Coding Common Bedside Ultrasound Exams? Not so FAST! - January 2, 2019
• Don’t Chase Your Tail Over Medically Unlikely Edits - October 1, 2018