Codapedia is now a division of Find-A-Code

Physicians Reciprocal Billing Arrangements

October 18th, 2017 - Chris Woolstenhulme, CPC, CMRS
Categories:   Billing   Practice Management  
0 Votes - Sign in to vote or comment.

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

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

CMS Compliance Guidelines Focused Trainings
April 9th, 2018 - Christine Woolstenhulme, QCC, CMCS, CPC, CMRS
Since the publication of the Compliance Program Guidelines in 2012, the Medicare Part C & D Oversight and Enforcement Group, Division of Compliance Enforcement, has presented a series of focused trainings for the industry on the application of the seven elements of an effective compliance program. These trainings are designed ...
Home Oxygen Therapy – Medical Record Requirements
March 27th, 2018 - Raquel Shumway
Medical Records must contain sufficient documentation to substantiate the need for Home Oxygen Therapy. Information to be included in the documentation.
Home Oxygen Therapy – Written Order Prior to Delivery (WOPD)
March 27th, 2018 - Raquel Shumway
A Written Order (Prescription) Prior to Delivery (WOPD) must be provided to the supplier BEFORE the supplier delivers the oxygen and/or equipment to the patient. The WOPD may be completed by an employee of the physician, but the physician must review, sign, and date the WOPD. An NP, CNS, or PA may...
Q/A: Which Modifiers to Use When Billing 44005 and 36556 Together
March 26th, 2018 - Chris Woolstenhulme QCC, CMCS, CPC, CMRS
I have a denial for 44005 and 36556 being billed together. I added modifiers 51, 59, and Q6 to 36556 but I am afraid it will deny again?
Q/A: Billing for GI Anesthesia
March 21st, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Medicare’s policy requires the use of a different code when a screening colonoscopy becomes a diagnostic procedure requiring you to bill with CPT code 00811 when treating a Medicare Beneficiary.
Documentation for Enteral Nutrition
March 9th, 2018 - Medicare Learning Network
The Medicare Learning Network provides guidance on required documentation for enteral nutrition. ...
Documentation for Negative Pressure Wound Therapy
March 9th, 2018 - Medicare Learning Network
The Medicare Learning Network provides guidance on required documentation for negative pressure wound therapy.



About Codapedia & Find-A-Code Contact Us Terms of Use Privacy Policy Advertise with Us

Codapedia™/Find-A-Code™ - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2009-2018 Find A Code, LLC - CPT® copyright American Medical Association