• This arrangement can only exist between physicians, not non-physician practitioners (e.g., PAs, SPs and CRNAs)
  • When a physician needs to take a leave of absence for any reason, another physician can fill his/her duties for up to 60 days
  • HCPCS modifier Q6 should be used, and all claims should be billed under the NPI of the physician on leave
  • After 60 days, the substituting physician must begin submitting claims under his/her own NPI

Note: Because Medicare requires all providers of covered services to have a Medicare Provider Number, please refer to the Palmetto GBA Provider Enrollment web page to access the appropriate CMS-855 applications.


  • Download the appropriate CMS 855 form (JJ) (JM) from the Enrollment Application Finder tool. Please complete, print, sign and mail to Palmetto GBA.
  • Complete and submit your application through PECOS website. Your application may be processed up to 50 percent faster than applications submitted on paper.

Resource: The CMS Medicare Claims Processing Manual (Pub. 100-04), Chapter 1, Section 30.2.1 I and 30.2.11 (PDF, 1.59 MB).

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

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