A locum tenens physician covering for an absent provider can bill Medicare under the absent provider's NPI with the Q6 modifier for up to 60 continuous days, without being enrolled at the practice. Beyond that, or when the locum is filling a vacancy rather than covering an absence, the locum must be credentialed and enrolled in their own right. Commercial payers each have their own version of these rules.
ClainetRCM sorts out which arrangement applies, obtains temporary or expedited privileges where the assignment is at a hospital, and, when a locum is staying, converts the arrangement into full credentialing without a gap.
Where this usually goes wrong
What ClainetRCM handles
One coordinator owns the file from intake to effective date, so you always know who to call and what is outstanding.
- Assessment of whether locum billing rules or full enrollment applies to the assignment
- Temporary or expedited hospital privileges applications with primary source verification
- Medicare locum billing setup with the correct modifier and record keeping
- Commercial payer locum notifications where required
- Full credentialing and enrollment when a locum converts to permanent
- Clean-up of billing and privileges when the assignment ends
Locum billing rules that matter
| Medicare Q6 | Bill under the absent provider's NPI with modifier Q6 for a locum covering an absence, up to 60 continuous days. The absent provider must be enrolled and the practice must keep a record of the locum's NPI. |
|---|---|
| Beyond 60 days | The locum must enroll and reassign to the group. See Medicare provider enrollment. |
| Filling a vacancy | No absent provider means no locum billing exception. Full enrollment is required from day one. |
| Commercial payers | Rules vary from following Medicare to requiring credentialing for any locum. We confirm each payer's policy. |
| Hospital privileges | Temporary privileges typically granted for a limited period with expedited verification. See hospital privileging. |
How the work runs
The sequence is the same for every payer and provider type; what changes is which documents and portals each step touches.
- Intake and gap review
Licenses, DEA, board certificates, malpractice, work history and NPI details are collected and compared against what each target payer asks for.
- Profile setup
CAQH ProView, PECOS and payer portals are created or cleaned up, attested and linked to the correct Tax ID and locations.
- Application submission
Every enrollment is filed in dependency order, with a tracking record for each payer, date and reference number.
- Follow-up on a fixed cadence
Payers are contacted on a schedule. Requests for more information are answered the same business day.
- Approval, contract and handoff
Effective dates, provider IDs and fee schedules are logged and loaded into your billing system.
Frequently asked questions
Do locum tenens providers need to be credentialed?
For hospital work, yes, at least temporary privileges. For Medicare billing, a locum covering an absent provider for up to 60 days can bill under that provider with Q6 and does not need enrollment. Commercial payers vary, and locums filling vacancies must be fully enrolled.
How fast can a locum be credentialed?
Temporary hospital privileges can often be granted in one to two weeks with a complete file. Full payer enrollment follows normal timelines, which is why we start it immediately if the assignment may extend.
Can a locum bill under my group?
Under Medicare's locum rules, yes, for covered absences within the 60-day window. Otherwise the locum needs their own enrollment and a reassignment to the group. See group practice credentialing.
What happens when a locum becomes a permanent hire?
Full credentialing with every payer, Medicare reassignment, CAQH updates and hospital appointment. We start this as soon as the decision is made so the transition is seamless.
Read next
Or return to the provider credentialing overview.