skip to Main Content

How to Bill for Locum Tenens as a PT

Written by: Mediware Bloggers on Monday, June 19, 2017 Posted in:

As of June 13, 2017, patients you serve in your outpatient therapy practice may be able to continue receiving therapy, even when you take a temporary leave from work. This arrangement, which was previously known as “locum tenens” and applicable only to physicians, now applies to some physical therapists as well.

According to the Medicare Learning Network’s MLN Matters Number: MM10090, “outpatient physical therapy services furnished by therapists in a Health Professional Shortage Area (HPSA), a Medically Underserved Area (MUA), or in a rural area can be billed under reciprocal billing and fee-for-time compensation arrangements in the same manner as physicians bill.” To determine if you are in a HPSA or an MUA, visit the Health Resources & Services Administration (HRSA) website at www.hrsa.gov.

The official instruction from the Centers for Medicare & Medicaid Services (CMS) further explains that physical therapists can only bill Medicare for services performed under reciprocal billing arrangements in the following circumstances:

  • The regular PT is unavailable
  • The Medicare beneficiary sought services from the regular PT
  • The arrangement will last for less than 60 days (unless the regular PT is absent due to active duty in the Armed Forces)
  • The PT uses the appropriate modifiers to signify a reciprocal billing arrangement

MediLinks systems track all billing to Medicare, allowing private practice PTs to take full advantage of their newfound ability to hire temporary help during periods of absence. Let Medilinks help you with billing Medicare.