Since 2017, physical therapists whose outpatient clinics are located in rural, medically underserved, and health professional shortage areas have been able to hire a qualified substitute provider (aka a locum tenens) on a short-term basis.1
Currently the locum tenens program in Medicare allows these physical therapists and a discreet list of physician types to hire a substitute provider on a per diem basis, for up to 60 days. The need for a licensed substitute physical therapist can range from being away for continuing medical education, jury duty, illness, or even a much-needed vacation. The program makes it so that when the enrolled provider is not in the clinic, Medicare beneficiaries can continue to receive care, and Medicare is then billed for the services using the NPI of the enrolled provider and the Q6 modifier.
Physical therapists are the only type of provider whose ability to use locum tenens is limited geographically. The Prevent Interruptions in Physical Therapy Act (S. 2612/H.R. 1611) seeks to expand the current program so that all physical therapists—nationwide—would be allowed to hire locum tenens to care for their patients who are Medicare beneficiaries.
A therapist’s need for locum tenens to ensure continued patient care is not tied to the physical location of the practice—instead the need hinges on whether or not that clinic has enough Medicare enrolled physical therapists to be able to rearrange schedules so that all of its Medicare patients receive care without delay. Without the ability to hire a licensed substitute physical therapist on short term basis, care is delayed and the revenue flow for the small business is interrupted.
If expansion of the locum tenens program would protect your patients’ access to care and make a difference to your bottom line, reach out to your Representative and Senators, and ask them to cosponsor the Prevent Interruptions in Physical Therapy Act (S. 2612/H.R. 1611).
1 21st Century Cures Act, Section 16006. Public Law 114-255 (12/13/2016). Bill language available at: https://www.govinfo.gov/content/pkg/PLAW-114publ255/pdf/PLAW-114publ255.pdf, pp296.