Section 16.03.09.504 - PHYSICIAN SERVICES: PROVIDER QUALIFICATIONS AND DUTIES01.Misrepresentation of Services. Any representation that a service provided by a nurse practitioner, nurse midwife, physical therapist, physician assistant, psychologist, social worker, or other nonphysician professional as a physician service is prohibited.02.Locum Tenens Claims and Reciprocal Billing. a. In reimbursement for Locum Tenens/reciprocal billing, the patient's regular physician may submit the claim and receive payment for covered physician services (including emergency visits and related services) provided by a Locum Tenens physician who is not an employee of the regular physician if:i. The regular physician is unavailable to provide the visit services.ii. The Medicaid patient has arranged for or seeks to receive services from the regular physician.iii. The regular physician pays the Locum Tenens for their services on a per diem or similar fee-for-time basis.iv. The substitute physician does not provide the visit services to Medicaid patients over a continuous period of longer than ninety (90) days for Locum Tenens and over a continuous period of fourteen (14) days for reciprocal billing.v. The regular physician identifies the services as substitute physician services meeting the requirements of this rule by appending modifier-Q6 (service furnished by a Locum Tenens physician) to the procedure code or Q5 (services furnished by a substitute physician under reciprocal billing arrangements).vi. The regular physician must keep on file a record of each service provided by the substitute physician associated with the substitute physician's UPIN, and make this record available to the department upon request.vii. The claim identifies, in a manner specified by the Department, the physician who furnished the services.b. If the only Locum Tenens/reciprocal billing services a physician performs in connection with an operation are post-operative services furnished during the period covered by the global fee, those services may not be reported separately on the claim as substitution services, but must be deemed as included in the global fee payment.c. A physician may have Locum Tenens/reciprocal billing arrangements with more than one (1) physician. The arrangements need not be in writing. Locum Tenens/reciprocal billing services need not be provided in the office of the regular physician.Idaho Admin. Code r. 16.03.09.504