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Healthcare Insights

Top 20 hospitals billing locum tenens claims

With staffing shortages and high contract labor costs continuing to strain hospitals, locum tenens are more important than ever to help fill the gaps to meet patient care needs.

To identify facilities in which these temporary work assignments took place, locum tenens services are billed using the Q6 procedure modifier.

What is the Q6 procedure modifier?

The Q6 modifier is used when a physician is away for an extended period of time and arranges for a locum tenens or substitute physician to provide services to their patients in their place. The Q6 modifier allows for a maximum billing period of sixty continuous days, with the exception being when a physician is on active duty. Typically, locum tenens physicians are paid directly through a temp agency and the provider they are filling in for will be listed as the rendering provider when coding for their claims.

Using data from the Definitive Healthcare HospitalView and PhysicianView products, we analyzed hospitals by their use of the Q6 modifier to identify locum tenens claims.

The following list shows the hospitals that billed the most locum tenens claims in 2022.

20 hospitals with the highest percentage of locum tenens claims

RankDefinitive IDHospital nameLocationNumber of beds% of U.S. locum tenens claimsExplore dataset
13589Warren General HospitalWarren, PA852.70%Explore
24034Mission Regional Medical CenterMission, TX2702.60%Explore
3873AdventHealth Orlando Orlando, FL22472.10%Explore
43207Miami Valley HospitalDayton, OH8782.00%Explore
53629Carolina Pines Regional Medical CenterHartsville, SC1161.70%Explore
63245Marietta Memorial Hospital CampusMarietta, OH1881.40%Explore
74036South Texas Health System Edinburg Edinburg, TX761.30%Explore
81076Pali Momi Medical CenterAiea, HI1181.30%Explore
9550006South Texas Health System McAllen McAllen, TX4411.20%Explore
104601Campbell County Memorial HospitalGillette, WY661.20%Explore
111198Rush Copley Medical CenterAurora, IL1921.10%Explore
124176DeTar Hospital NavarroVictoria, TX1811.10%Explore
13494Moreno Valley Medical CenterMoreno Valley, CA941.10%Explore
142654Cape Regional Health System (AKA Cape Regional Medical Center)Cape May Court House, NJ1491.10%Explore
151990MyMichigan Medical Center Alpena Alpena, MI1280.90%Explore
162193Lake Region Healthcare CorporationFergus Falls, MN800.80%Explore
17957Memorial Health University Medical Center (AKA Memorial Health)Savannah, GA5880.80%Explore
184177Citizens Medical CenterVictoria, TX2860.70%Explore
193441Forbes HospitalMonroeville, PA2340.70%Explore
202734Gerald Champion Regional Medical CenterAlamogordo, NM500.70%Explore

Fig. 1  Data is from Definitive Healthcare’s Atlas All-Payor Claims Dataset for calendar year 2022. Claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Accessed March 2023.

Which hospitals use the most locum tenens physicians?

The top hospital that billed the most locum tenens claims in 2022 is Warren General Hospital in Ohio. Mission Regional Medical Center in Texas is second on the list accounting for 2.6% of locum tenens claims billed in 2022. AdventHealth Orlando rounds out the top 3, accounting for 2.1% of locum tenens claims billed in 2022. This hospital also has one of the highest total contract labor expenses in the country.

On average, the top 20 hospitals on the list accounted for 27% of locum tenens claims in the country. Interestingly, two of the hospitals are part of the same IDN based in Texas, South Texas Health System. These hospitals include South Texas Health System Edinburg and South Texas Health System McAllen.

What is a procedure modifier?

A procedure modifier is made up of two characters (can be letters, numbers, or a combination of the two) appended to a CPT or HCPCS code to provide additional information about the procedure on a claim.

Modifiers are typically used to provide additional clarity about what occurred during a patient encounter. While the Q6 modifier is one such example, there are many use cases for modifiers. Some of these include providing details about the anatomic location of the procedure, whether there was more than one provider performing the procedure, or if the service has both professional and technical components.

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