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Wiki PA Locum Tenes

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VickieArballo

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Fresno, CA
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Good Afternoon. We had a NP who was part of our surgical hospitalist program. She rounded on patients and was credentialed as a surgical assist. She left for greener pastures and now we have 2 PA's on the team with Locum Tenes status while we look for a replacement. I would appreciate any guidance on how to bill for these providers. I have found instruction for billing for a Locum physician, but not a lower level provider.

Vickie
 
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The locum tenens guidelines only apply to physicians (MD, DO, MBBS) and not NPPs (PA, NP, etc). In order to bill services under the PAs name, they should be credentialed with insurances. There are some services NPPs can provide that may be billed under the supervising physician. For example, incident-to outpatient visits and split/shared hospital services. This would not apply to surgical assists. The PAs could be used to round and bill under the physician IF the physician also sees the patient the same day. Some practices may have the noncredentialed PAs do only specific work, or decide it's best (for patient care and physician convenience) to have the PAs provide those services and not bill for them, or decide to bill those services out of network after informing the patient. There is a huge difference between being trained, capable, and legally permitted to provide medical services vs expecting payment for those services. In my opinion, this decision should have been made before hiring the PAs about how to handle/distribute/bill the work. At this point, they are already working and will only be with you a short time. I suggest having them provide as much work as possible that may be billed under the supervising physician and not billing for services that cannot.
 
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I have a question that I cannot find the answer to on the internet but do you know if a resident can be a locum tenen? He is licensed in our state but is in his 3rd year of residency? Any clue?
 
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I agree with Sharon that the resident can likely provide locum tenens services (assuming you meet the other requirements).
I will add that the work must not be part of the residency training program, and rather the resident is "moonlighting" for the locum tenens work. And as noted by Sharon, have a license that allows him to practice independently.
 
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