How Does Locum Tenens Work?

TLDR; Locum tenens offers flexible, temporary healthcare roles that give providers new career opportunities and assist facilities in managing staffing shortages. The process typically involves the creation and filling of the assignment through an agency partner, followed by a period of credentialing before the work begins.

Whether you’re a physician considering your career options, or a facility that urgently needs to fill a staffing gap, you've probably heard about locum tenens. But is it the right path for you or your hospital?

Let's take a look at the roadmap you can expect to follow throughout the locums process, so you can make an informed decision about whether to start the journey.

The Locum Tenens Process

• What Is Locum Tenens?
• Who Uses Locum Tenens Services?
• How Does Locum Tenens Work for Healthcare Providers?
• How Does Locum Tenens Work for Facilities?
• Is Locum Tenens Worth It?
• How Do Locum Tenens Contracts Work?
• Compensation and Billing in Locum Tenens
• Discover Concierge Locums Services

What Is Locum Tenens?

Locum tenens, a Latin phrase meaning “to hold a place,” refers to temporary medical staffing arrangements where healthcare providers fill in on a short-term basis. Locum tenens assignments can last from a few days to several months, and are vital to hospitals, clinics, and private practices' ability to maintain consistent patient care.

For facilities, locums staffing ensures uninterrupted care delivery even during staffing transitions, vacations, or periods of high patient demand. Physicians, nurse practitioners, physician assistants, and other healthcare professionals often take on locums roles to meet those fluctuating staffing needs of medical facilities.

The patients benefit, but so can the healthcare providers taking on the assignments. Locum tenens can give you a flexible career path when compared to permanent residency. Physicians in locums roles often emphasize the opportunities they get to work in diverse settings, gain valuable experience, set different schedules and pay rates, and explore different locations across the country.

Locum tenens, a Latin phrase meaning “to hold a place,” refers to temporary medical staffing arrangements where healthcare providers fill in on a short-term basis.

What Is the Difference Between Locums Tenens and Per Diem?

Per diem work refers to temporary healthcare roles that are filled on an as-needed, day-to-day basis, often within a provider's local area. Per diem providers usually fill in for absentee staff or cover high-demand days without the commitment of a long-term assignment. Locum tenens, by contrast, typically involves longer assignments with more extensive travel, housing, and credentialing support. 

Who Uses Locum Tenens Services?

A wide range of medical facilities rely on locum tenens services to address staffing challenges. Hospitals often use locums providers to cover for physicians or specialists on extended leave, during transitions between permanent hires, or when patient demand exceeds their current capacity. Similarly, private practices benefit from locum tenens by maintaining operations while searching for permanent staff or covering during peak seasons.

Locum tenens services are especially critical in rural and underserved areas — anywhere you'll encounter challenges for recruiting and retaining full-time healthcare providers. For these communities, locum tenens practitioners help fill the gaps in care, ensuring that residents have access to timely medical services. 

How Does Locum Tenens Work for Healthcare Providers?

For healthcare providers, the locum tenens process typically begins with identifying opportunities through a locum tenens agency. While providers can apply for locums roles independently, they're unlikely to get as high a rate, or assistance with contracts, credentialing, and moving, than they are when working with an expert recruiter. Agencies play that crucial role in matching providers with their ideal assignments, making sure that their specialty, preferences, and availability align with clinical staffing needs.

As we mentioned, once a provider selects an opportunity, they must complete credentialing, licensing, and other onboarding steps, which can vary depending on the state and facility. This stage often includes verifying qualifications, obtaining malpractice insurance, and ensuring compliance with regulatory requirements. This is where a locums recruiter really steps up to help both the physician and the employer experience a smooth hiring process.

Once the logistics are in place, the provider is ready to begin their assignment. Most locum tenens positions include travel and housing arrangements, often coordinated by the agency. Providers also negotiate their compensation and terms upfront, ensuring clarity around pay, hours, and responsibilities. This structured process allows providers to focus on delivering high-quality patient care while benefiting from flexibility and diverse work experiences.

1. Find an apply for an open locums position
2. Connect with the locums agency and prepare for interviews
3. Job offer and acceptance
4. Credentialing and onboarding
5. Working the assignment — Locums agency continues to assist with documentation and billing
6. Assignment wrap up — Physician either moves to a new assignment or transitions to full employee

How Does Locum Tenens Work for Facilities?

For healthcare facilities, the locum tenens process starts with identifying the staffing gaps they need to fill, like temporary leaves, seasonal demand spikes, or unfilled permanent positions. Facilities often partner with locums agencies to streamline the search for qualified candidates. Agencies handle much of the heavy lifting, including sourcing providers, verifying credentials, and coordinating logistics, allowing facilities to focus on ensuring seamless integration into their team.

Once a provider is selected, facilities establish clear expectations regarding duties, schedules, and team dynamics. Effective onboarding is crucial to help locum tenens professionals adapt quickly to the facility’s systems and workflows. By leveraging locum tenens providers, facilities can maintain patient care continuity and support their permanent staff, even during periods of uncertainty or high demand.

1. Identify a position that needs to be filled
2. Post a job opening or work with a locums agency to solicit applications
3. Job interviews
4. Select a candidate
5. Credentialing & onboarding
6. Working the assignment - Locums agency continues to assist with documentation & billing
7. Assignment wrap up - Physician either moves to a new assignment or transitions to full employee

Is Locum Tenens Worth It?

Locum tenens can be highly rewarding, offering significant advantages for both healthcare providers and facilities. For providers, the flexibility to choose assignments based on location, duration, and specialty is a major benefit. Additionally, locums often offers competitive pay and covers travel and housing expenses, making it financially appealing. Facilities benefit by using locum tenens to ensure continuity of care, reduce burnout for full-time staff, and manage temporary staffing gaps with ease.

But locum tenens is not without its challenges. Credentialing delays can postpone start dates and disrupt schedules, and it requires careful planning and patience from providers and facilities alike. Healthcare professionals must also adapt quickly to new environments, including unfamiliar teams and workflows, which can be demanding. Balancing the frequent travel and temporary nature of assignments with personal life can add another layer of complexity. 

Despite these potential drawbacks, many providers and facilities agree that the flexibility, efficiency, and ability to maintain high-quality care make locum tenens a worthwhile solution in today’s healthcare landscape.

How Do Locum Tenens Contracts Work?

Locum tenens contracts are agreements between a healthcare provider and a facility, often facilitated by a staffing agency, outlining the terms of a temporary assignment. These contracts detail the provider's responsibilities, including work hours, patient care expectations, and any on-call duties. They also specify compensation, reimbursement for travel and housing, and whether malpractice insurance is provided. Contracts are typically negotiated upfront to ensure clarity and alignment between the provider and the facility. While agencies often standardize parts of the agreement, providers should review the terms carefully, especially clauses related to termination, renewal, and compliance with state licensing requirements.

How Long Are Locum Tenens Contracts Typically?

The length of a locum tenens contract can vary widely depending on the needs of the facility and the provider's availability. Contracts can range from just a few days to several months, with some extending to a year or more. Short-term assignments are common for covering sudden absences or peak demand, while longer contracts are often used for facilities in rural areas or those experiencing prolonged staffing shortages. Providers and facilities often like the flexibility of locum tenens contracts because they can tailor them to the duration to their unique circumstances.

Is There a Time Limit for Locum Tenens?

While locum tenens assignments vary in length depending on the contract, certain regulations and policies can impose limits. For example, under Medicare’s 60-day rule, locum tenens providers can only bill for services under a substitute physician arrangement for up to 60 consecutive days per assignment. After this period, a new locum tenens provider must take over, or the facility must transition to a different billing method. 

Outside of Medicare-specific rules, facilities may limit assignment lengths to avoid long-term dependency or to comply with internal policies. However, many locum tenens assignments can be extended or renewed by mutual agreement, offering flexibility for both providers and facilities while ensuring compliance with applicable regulations.

Compensation and Billing in Locum Tenens

Compensation and billing in locum tenens differ from traditional employment structures, offering unique financial benefits for providers. Locum tenens providers are typically compensated at a higher hourly or daily rate compared to permanent staff, reflecting the temporary nature of their work and the flexibility they provide to facilities. In addition to base pay, many locum tenens arrangements include reimbursement for travel, housing, and licensure expenses. Billing, on the other hand, involves the facility or agency submitting claims for the services rendered by the locum provider, often under the facility’s tax ID and Medicare/Medicaid credentials.

Why Does Locum Tenens Pay More?

Locum tenens staff are often 1099 contractors, so higher pay offsets the lack of traditional employment benefits, such as paid time off or employer-provided health insurance, and accounts for the provider's need to manage their own taxes and other expenses. The flexibility, travel, and adaptability required in locum tenens work also justify the elevated compensation. Finally, facilities are often willing to pay a premium to address urgent staffing shortages or maintain continuity of care during gaps in permanent coverage. 

What Is the Highest Paid Locum Tenens Specialty?

According to On Call Solutions, the highest paid locum tenens specialty for 2024 was anesthesiologists, who can make up to $660,400 a year. They were followed by cardiologists, who can make up to $611,000 working locums full time. These specialties command such high pay due to the critical and specialized nature of their work, as well as the high demand and limited supply of practitioners in these fields. Additionally, the level of training and skill required for these specialties further contributes to their elevated earning potential.

Keep in mind, however, that pay can fluctuate greatly by region as well as speciality. Facilities are often willing to offer premium compensation to attract locum tenens providers in areas that are underserved or high-need regions, where staffing shortages are most acute.

How Does Locums Billing Work?

Locums billing involves the facility or agency handling claims for services provided by the locum tenens professional. In most cases, the facility bills insurance providers, Medicare, or Medicaid under their tax ID and credentials, as the locum provider is considered a temporary extension of their staff. For Medicare, billing often follows the "substitute physician" rules, allowing claims to be made under the regular provider's ID for up to 60 days. Clear communication between the facility, agency, and provider ensures accurate and timely billing while maintaining compliance with regulations.

Experience Concierge Locums Services

Interested in exploring a locum tenens career or filling the gaps in your staffing needs? Era Locums specializes in providing tailored, concierge-level services to healthcare providers and facilities alike. Our expert recruiters focus on personalized support, seamless credentialing, and providing exceptional opportunities. Put another way, we make locums work for you. Contact us today to connect with a recruiter!