Locum Tenens Credentialing

The credentialing process for temporary or substitute healthcare providers who fill in at practices or facilities on a short-term basis.

Credentialing for locum tenens providers has unique challenges because you are constantly moving between different facilities and payers. Every assignment potentially requires credentialing with new payers and privileging at new facilities in new states. Most locum tenens providers work through staffing agencies. The agency typically handles a large portion of the credentialing paperwork, but the responsibility for having current credentials still falls on you. Keep your CAQH profile immaculate, maintain licenses in every state you might work in, and make sure your malpractice insurance covers locum work. Medicare has a specific locum tenens billing provision. When you work as a locum filling in for an absent provider, you can bill under the absent provider's NPI and billing number for up to 60 continuous days. The claim must include modifier Q6 to indicate locum tenens status. After 60 days, you need your own Medicare enrollment at that location. This 60-day rule is one of the most commonly violated Medicare billing rules. Practices bring in a locum, bill under the absent provider's NPI for six months, and then get flagged in an audit. The consequence is repayment of every claim submitted after day 60 plus potential penalties. For commercial payers, locum tenens credentialing varies. Some payers have expedited processes for temporary providers. Others require the full credentialing process regardless of how long the assignment lasts. Some accept the absent provider billing arrangement similar to Medicare's Q6 provision, but not all. If you do locum work regularly, maintain a portfolio of active state licenses that covers the states where you are most likely to accept assignments. Having licenses ready eliminates the biggest bottleneck in locum credentialing. A multi-state licensing strategy through the Interstate Medical Licensure Compact can streamline this significantly. Keep a detailed log of every assignment: facility name, dates, payers billed, and whether you billed under your own NPI or under a Q6 arrangement. This documentation is essential for future credentialing applications and for audit defense.