Forum - Questions & Answers

Jun 29th, 2011 - JULIA7014 8 

Locum Tenens vs Reciprocal Billing

In simple terms, can someone please summarize the difference between Locum Tenens billing vs Reciprocal billing? As I've read the information downloaded from CMS they both seem so similar.

Your response is appreciated.

Jun 30th, 2011 - Codapedia Editor 1,399 

re: Locum Tenens vs Reciprocal Billing

Locum is for when your physician goes away for an extended period of time: 3 weeks in Europe, maternity leave. You hire another physician and pay them on a per diem basis to care for your patients. You bill and collect the money.

Reciprocal billing is for coverage. Physician A covers for Physician B over July 4, and Physician B bills for the services, even though Physician A did the work. Then, over Labor Day, Physician B covers for Physician A, but Physician A bills for it. Frankly, I never recommend reciprocal billing. I strongly prefer everyone billing for the services provided.

There's an article in Codapedia on locums which you read here:

http://codapedia.com/article_192_Locum-tenens-billing.cfm

Jul 7th, 2011 - JULIA7014 8 

re: Locum Tenens vs Reciprocal Billing

Going back to this subject...how do we bill for a Locum Tenens who is covering for a physician on maternity leave? Example...Provider A covering for Provider B using office visit code 99213. Would the claim have Provider B's information with CPT® code 99213- Q6 modifier?

Jul 8th, 2011 - rphelps 615  1 

re: Locum Tenens vs Reciprocal Billing

Yes. Also you will need to keep up the amount of time provider b is covering for provider A.



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