Reciprocal billing arrangements are often informal, and Medicare does not require them to be in writing. No money changes hands, and the regular physician compensates the covering physician by reciprocating in the future under similar circumstances. Physicians can have reciprocal billing arrangements with more than one physician. Coverage periods are usually brief, although Medicare allows them to last up to 60 days if certain criteria are met. Examples of how physicians can use a reciprocal billing arrangement include physicians who occasionally cover for their colleagues during extended office hours and who cover for colleagues who are on-call on the weekend.
Locum tenens arrangements are different.
The substitute physician generally does not maintain a practice and travels from area to area as needed. The regular physician typically pays the substitute physician a fixed per-diem amount, with the substitute physician working as an independent contractor, not an employee. The coverage period goes from the first day that the substitute physician provides Medicare Part B services to the regular physician's patients to the last day on which the substitute physician provides services before the regular physician returns to work. As an example, suppose you plan to go on vacation from July 28 until Aug. 6 and you have arranged for a substitute physician to see your patients in your absence. You can bill for the services that the substitute physician provides to your patients while you are on vacation since the continuous coverage period of 10 days is well under the 60-day limit.