CMS Updates Locum Tenens Policy

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  • August 1, 2017
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CMS Updates Locum Tenens Policy

Effective June 23, the Centers for Medicare & Medicaid Services (CMS) changed its locum tenens policy, and expanded it to include physical therapists.
Section 1842(b)(6)(D) of the Social Security Act allows payment for physician services provided by a physician other than the patient’s physician when the patient’s physician is unavailable. The policy covers both informal and reciprocal, or per diem or other fee-for-service compensation for such services. In the past, the term “locum tenens” was used to identify the paid services, and “reciprocal” identified a billing arrangement between covering physicians. To cover both under one policy, CMS has removed the term “locum tenens” and now refers to this as “fee-for-time.”
Modifiers Q5 Services provided by a substitute physician under a reciprocal billing arrangement and Q6 Services furnished under a locum tenens physician continue to be used, and will be allowed for physical therapists (the descriptors will be updated in a future quarterly update).
CMS also clarified that when a physician or therapist is called or ordered to active duty as a reserve member the Armed Forces for a continuous period of more than 60 days, payment may be made under reciprocal or fee-for-time arrangement for the entire period. Otherwise, the fee-for-time cannot extend past a continuous period of more than 60 days.
The official instruction, Change Request 10090, issued to your MAC regarding this change is available at

Certified Professional Medical Auditor

No Responses to “CMS Updates Locum Tenens Policy”

  1. Brenna Jordan says:

    Wondering if you can clarify the use of Q6 for procedures. I have used Q6 in the past for weekend rounding purposes, but am unsure of how to use it for Caths and Stents that might be done. exp: would I bill 93458(26) Q6? I have been unable to locate any information that is that specific. I would appreciate any addition information or if you have suggestions as to any other references other than CMS . Thank you.