Locum Tenen for PT

[Cpatel]

Does anyone know the Medicare guidelines for locum tenens for a physical therapist? This would be in a doctor's office setting. How do we bill for Locum Tenen for PT? Are Locum tenens are allowed for PTs?

[kristin]

I don't think a PT qualifies for it, they have to be an actual physician, see here:

https://med.noridianmedicare.com/web/jeb/specialties/locum-tenens-and-reciprocal-billing

[Cpatel]

Kristin you are right that Locum tenen are not allowed, but can other Medicare Credentialed PT can see the patients? and we are able to bill under our practice NPI?

[kristin]

I would think that for any PT to bill under the group NPI of a practice they are not a part of, that they would have to be added on to the group...they just can't "fill in" for someone else. Hopefully others jump in with their advice.

[Michele]

I believe Kristin is correct.  If they want to bill under the group NPI they must notify the insurance carriers first to be added/linked to that group.  I know that is definite for Medicare.  We actually have run into this before.  The regular PT was going out for surgery so she wanted to hire someone to come in for 6-8 weeks while she was out.  We were advised we had to completely credential the other PT with the group in order to have it billed under the group NPI & EIN.  Otherwise they would have billed under their own NPI/Tax ID and add the new location to their file.  Either way, it's not a simple process.