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STACY Posted Thu 01st of February, 2018 15:49:37 PM
I have a doctor that is going on vacation for month. An outside doctor (not under the same tax id) has agreed to manage his patients while he is absent. I am trying to figure out the difference in the Q5 and the Q6 modifier. Can someone please clarify!!
SuperCoder Answered Fri 02nd of February, 2018 02:38:43 AM


>Modifier Q6 is used for Locum tenens providers

>Locum tenens providers are a growing segment of physicians temporarily taking another physician's place because of illness, pregnancy, vacation time or continuing medical education. HCPCS allows you to easily distinguish these services by appending modifier Q6 (>Service furnished by a locum tenens physician>) to the CPT procedure code for whatever service the locum provides. To bill for locum tenens, create the bill under the doctor they are filling in for but include a Q6 modifier on all procedures and place the locum UPIN in box 23 on the claim. You should place the locum tenens physician's National Provider Identifier (NPI) or Unique Physician Identification Number (UPIN) in block 23 on the CMS-1500 form, and the NPI/PIN for your doctor who is absent goes in 33 and 24K (as it normally does).>  

Modifier Q5: This is used for reciprocal billing under the same EIN. It is used when a physician covers for another physician within the same group. Modifier Q5 is entered after the procedure code in 24d. Both providers must be enrolled in Medicare. For billing Q5 doctor must bill under same tax Id. 

Hope that helps!

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