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Basics about Q6 modifier

Locum physicians are the Credential Medicare substitute physician who is also called as locum tenens. These physicians are independent contractor. The physician takes care of regular physician services in their absence. These physicians are paid a fixed price by the regular physician for taking care of services in their absence. The locum physician is independent to move from one area to another and is not restricted to the physician’s office. Already we have learnt about coding numerical modifier 58, 78, 79, 22 , 23 ,24, 25 and 76, but today will learn the HCPCS modifier Q6. Use of HCPCS modifier Q6 is used for billing the services of Locum physicians. . These physicians are the temporary replacement of regular physician only a period of 60 days. Hence, the regular physician can submit the locum physician services with HCPCS Q6 modifier for the first 60 days. Do not use these services inappropriate once finishing the 60 days period. It is the responsibility of the regular physician not to use the locum physician services for long time and use them only when it is required.

Q6 modifier is used for locum physicians. These physicians give services only when the concerned physician is absent or on a long vacation leave. For Medicare, you bill for locum physician using Q6 modifier if the regular physician is not available or absent. Also, should be noted that the regular physician should not be billing the locum physician services for long time, not long the 60 days.

If in future, again the physician is absent for any reason, the same locum physician can take his or her place for the next 60 days period.

While filling the Claim form, the CPT code or the procedure codes should be assigned with Q6 modifier, which will denote the services provided by the locum tenens physician.

For Medicare, it is important to note that, the locum physician services in the postoperative period in not to billed separately. Hence, do not billed or use Q6 for locum physician when the postop services are under global period.
For commercial payer or insurance, the medical claim can be billed with Q6 modifier under the regular physician’s NPI (National Provider Identifier). For Medicare or non-contract payers, the credentials are not required for physicians.

Do’s and Don’t with Q6 modifier

Do not use Q6 modifier after 60 days.
Use Q6 modifier only for locum physician in absence of regular physician. Use of modifier Q6 in presence of regular physician can be considered as FRAUD.
Do check with the commercial payers or contract payers before assigning Q6 modifier, some commercial payers do not accept this modifier.

References: https://www.locumtenens.com/documents/billingforlt.pdf

http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Railroad-Medicare~8EELHJ3576

https://www.aapc.com/blog/24682-get-the-most-out-of-locum-tenens-physicians/