Billing

Common Reciprocal Billing Questions and Answers

  1. If a practice, the same specialty as ours, wants us to take calls for them for two weeks, can we bill under their number as a reciprocal billing arrangement?

    Answer: No. In a reciprocal billing situation, the physician practice that performed the services does not bill. The practice for the doctor who is out would bill and would use the Q5 modifier.
     
  2. One of our physicians is terminally ill and some of his colleagues have offered to come in and cover for him. Is this reciprocal billing?

    Answer: If the terminally ill physician is unable to return to his practice, this would not be a reciprocal billing situation.
     
  3. A member of our physician group is designated as the attending physician for a hospice patient. Members of our group employ reciprocal billing arrangements. If a group member physician provides a service under the reciprocal arrangement, how do we submit the claim?

    Answer: The group will submit the claim showing the NPI of the attending physician, the Q5 modifier to indicate reciprocal billing, and the GV modifier to show attending physician.
     
  4. How does claim preparation and submission work for reciprocal billing?

    Answer: If the conditions are met, the regular physician submits the "covered visit service" under his/her NPI, using the appropriate procedure codes and HCPCS modifier Q5. The regular physician, not the substitute physician, receives any Medicare payment for the service.
     
  5. Where can I find the guidelines for reciprocal billing arrangements?

    Answer: CMS guidelines are found in the CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 1, Section 30.2.10. (1 MB)

Revised 8/28/2024