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Thread: Billing for a physician that is not longer employed

  1. #1
    Join Date
    Apr 2007
    Nashville, TN

    Default Billing for a physician that is not longer employed

    AAPC: Back to School
    I have a clinic that is billing for a physician that is no longer employed at that clinic. Can someone give me the link on CMS or any other site that states you cannot bill for a physician that is no longer employed by that clinic.

  2. #2


    I don't have the link but I can tell you that if the physician has any lingering billing out there from when he was there then it can be bill. If the dates of the billing is happening after the physician left then this is clear fraud.

  3. #3
    Join Date
    Apr 2007


    Is there a locum provider covering until they find a replacement? If so, they can continue to bill under the previous provider for up to 60 calendar days. You use the credentialed providers billing information and add a Q6 modifer to the cpt codes.

    Look up locum tenens on CMS for the guidelines.


    Hopefully this will cover your situation. If not, it would be fraud.

    Laura, CPC

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