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Physicians Reciprocal Billing Arrangements

October 18th, 2017 - Chris Woolstenhulme, CPC, CMRS
Categories:   Billing   Practice Management  
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A reciprocal billing arrangement is when there is an agreement between physicians to cover each others practice. 

A physician or his practice may set up reciprocal billing arrangements with one or more physicians to cover another practice or their own practice.  There is certain criteria that must be met to receive Physician Payment under Reciprocal Billing Arrangements.

Billing for services: 

The regular physician bills the visit under his/her NPI using the appropriate HCPCS modifier, in this case Q5.  The reimbursement will be paid to the regular physician, not the substitute physician. 

Reciprocal Billing Arrangements – Use Q5 Modifier

Locum Tenens now called "Payment Under Fee-For-Time Compensation" Arrangements – Use Q6 Modifier

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