A substitute physician, sometimes called a locum tenens physician, is a physician who is hired to temporarily replace another physician (“usual” physician). The usual physician may be absent for reasons such as illness, pregnancy, vacation or continuing medical education. This absence should not exceed 60-days unless the usual physician has been called to active duty in the Armed Forces.
The usual physician bills and receives payment for the substitute (locum tenens) physician’s services as though the usual physician performed the services. The usual physician is responsible for reimbursing the substitute (locum tenens) physician for services rendered and ensure that the substitute (locum tenens) physician shall not bill or seek payment from the member. The usual physician identifies the reported services as locum tenens physician services by entering code modifier Q6 (service furnished by a locum tenens physician) after the procedure code on the CMS-1500 claim form.