Forum - Questions & Answers

Sep 27th, 2012 - diannew 1 

billing for temporary provider

We are a small physical therapy practice, only one therapist and one assistant. Our therapist is about to go on maternity leave and has had no luck hiring another therapist. She has found a therapist willing to cover for her on a part time temporary basis. Can the locum tenens situation be used? Everything I've read so far talks about physicians only for that. Any help is much appreciated.

Sep 27th, 2012 - nmaguire   2,606 

re: billing for temporary provider

Locum tenens is physician only

Sep 27th, 2012 - diannew 1 

re: billing for temporary provider

Do you know how I should bill in this situation?

Sep 28th, 2012 - nmaguire   2,606 

re: billing for temporary provider

A qualified professional means a physical therapist, occupational therapist, speech-language pathologist, physician, nurse practitioner, clinical nurse specialist or physician’s assistant who is licensed or certified by the state to perform therapy services and who also may appropriately perform therapy services under Medicare policies.
Must qualify to bill Medicare directly as a therapist, each individual must be enrolled as a private practitioner and employed in one of the following practice types: an unincorporated solo practice, unincorporated partnership, unincorporated group practice, physician/Non-Physician Practitioner (NPP) group or groups that are not professional corporations, if allowed by state and local law. Physician/NPP group practices may employ TPP(therapist in private practice) if state and local laws permit this employee relationship.
For purposes of this provision, a physician/NPP group practice is defined as one or more physicians/NPPs enrolled with Medicare who may bill as one entity. For further details on issues concerning enrollment, see the Provider Enrollment Web site at:
http://www.cms.gov/MedicareProviderSupEnroll/
The supporting personnel, including other therapists, must be salaried (W-2) or contract (1099) employees of the TPP or other qualified employer.



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