A locum tenens contract sets the terms for a temporary clinical assignment. It can cover your pay, schedule, malpractice coverage, travel, cancellation rights, and other responsibilities. Before you sign, review each section carefully so you understand your obligations, compensation, coverage, and what happens if the assignment changes.
What Does Locum Tenens Mean?
Locum tenens means providing temporary medical services at a healthcare facility. Physicians and advanced practice providers (APPs) take locum assignments to cover staffing needs, employee leave, increased patient demand, or open positions. A locum arrangement can last from a short-term assignment to several months or longer.
How Locum Tenens Contracts Work
A locum arrangement can involve three parties: the provider, the staffing agency, and the healthcare facility.
Physician or APP → Locum Agency → Healthcare Facility
Two agreements commonly shape the arrangement:
Provider-Agency Agreement
This agreement establishes the relationship between you and the staffing agency. It may address compensation, assignment terms, malpractice coverage, travel, cancellation, and your responsibilities.
Agency-Facility Agreement
This agreement establishes the business relationship between the staffing agency and the healthcare facility. It can cover the facility’s staffing needs, assignment requirements, rates, scheduling, cancellation terms, and other business conditions.
You may not see every term in the agency-facility agreement. However, you should understand any terms that affect your assignment, responsibilities, or compensation before you sign.
Key Terms to Review in a Locum Tenens Contract
Each part of the contract can affect your pay, responsibilities, schedule, or coverage. Review these key terms carefully before signing.
Compensation, Rates, and Call Pay
Start with the compensation section. Do not rely only on a rate discussed during recruitment.
What it means:
This section explains how you will be paid and what work the rate covers. Depending on the assignment, locum providers may receive an hourly or daily rate. For more details on locum tenens pay, including different rate structures, see our guide to locum tenens pay and salary.
What to look for:
- Hourly or daily rate
- Regular clinical hours covered by the rate
- Overtime rate
- Night, weekend, or holiday pay
- Call compensation
- Extra shift compensation
- Payment schedule
- Timesheet requirements
- Any deductions or fees
Make sure the written contract matches the compensation terms you agreed to with the agency.
Assignment Length, Schedule, and Extensions
The contract should clearly define when and where you will work.
Schedule flexibility is also a major consideration for locum providers. The 2024 Survey of Locum Tenens Physicians and Advanced Practitioners found that 86% of respondents viewed achieving a better schedule as an important factor in choosing locum work.
For a broader look at the benefits of locum tenens, see our guide to why choose locum tenens.
What it means:
This section establishes the assignment start date, end date, expected schedule, and conditions for extending the assignment.
What to look for:
- Start and end dates
- Expected shifts
- Hours per shift
- Call responsibilities
- Weekend or holiday requirements
- Extension terms
- How schedule changes are handled
Do not assume an extension will use the same terms as the original assignment. Ask how extensions work and get any changes in writing.
Malpractice Insurance and Tail Coverage
Malpractice coverage deserves careful attention because the contract should identify who provides coverage and what happens after the assignment ends.
What it means:
A locum arrangement may provide professional liability coverage through the agency or facility. The contract should explain the type and limits of coverage and address any responsibilities after the policy period ends.
What to look for:
- Who provides malpractice coverage
- Coverage limits
- Type of policy
- Policy period
- Who pays for the coverage
- Who handles claims
- Whether tail coverage is included
- Who pays for tail coverage, if required
Do not assume malpractice coverage automatically continues after your assignment. Ask the agency to explain your coverage and responsibilities.
Travel, Housing, and Licensing Costs
Travel terms can affect the overall value and convenience of an assignment.
What it means:
The contract may address airfare, housing, rental cars, mileage, meals, licensing, and other assignment-related expenses. It should make clear which costs the agency or facility covers and which costs remain your responsibility.
What to look for:
- Airfare
- Housing
- Rental car or transportation
- Mileage reimbursement
- Meals or per diem
- Travel days
- Licensing fees
- Credentialing-related costs
- Reimbursement rules and receipt requirements
Check each expense individually instead of assuming all assignment costs are covered.
Cancellation Terms and Notice Periods
Cancellation language matters when either side needs to end or change an assignment.
What it means:
This section explains how the provider, agency, or facility can cancel or terminate the assignment and how much notice may be required.
What to look for:
- Provider cancellation notice
- Facility cancellation notice
- Termination procedures
- Penalties or fees
- Documentation requirements
- Auto-renewal language
- Pay or reimbursement if the facility cancels
Review the cancellation terms for both sides. Make sure you understand your obligations if you need to leave the assignment and what happens if the facility cancels it.
Non-Compete and Permanent-Hire Terms
Pay close attention to provisions that affect your ability to work with a facility after an assignment.
What it means:
A contract may include restrictions on working directly with a facility after an agency introduces you to it. It may also explain what happens if the facility wants to hire you permanently.
What to look for:
- Length of any restriction
- Geographic scope
- Facilities covered
- Restrictions involving other agencies
- Direct-hire or conversion terms
- Buyout or conversion fees
- What happens after the assignment ends
These provisions can vary by contract and jurisdiction. Review the exact language and ask questions about any restriction or conversion term you do not understand.
Credentialing and Privileging Responsibilities
Credentialing can affect when you can start an assignment, so clarify responsibilities early.
The American Medical Association reports that 81% of respondents in the AMN survey rated the credentialing process as either most or moderately challenging. This makes it important to confirm responsibilities and deadlines early.
What it means:
Locum providers may need to complete licensing, credentialing, privileging, background checks, references, certifications, and other requirements before starting clinical work.
What to look for:
- Who submits credentialing documents
- Required licenses
- Hospital privileges
- Controlled substance registration, when applicable
- Background checks
- References
- Required certifications
- Document submission deadlines
- Responsibility for licensing and credentialing fees
Confirm which tasks the agency handles and which remain your responsibility.
Red Flags to Watch For
Review the contract more closely if you find:
- Compensation that does not match the negotiated offer
- Unclear overtime or call-pay language
- Broad cancellation penalties
- One-sided termination provisions
- Unclear malpractice or tail coverage
- Expenses discussed verbally but missing from the contract
- Broad or unclear post-assignment restrictions
- Unclear conversion or buyout terms
- Responsibilities that are not clearly assigned
- Automatic renewal terms you did not expect
Do not rely on a verbal conversation to resolve an important contract issue. Ask for significant changes or clarifications in writing.
Can You Negotiate a Locum Tenens Contract?
Some locum contract terms can be negotiated, but the flexibility depends on the assignment, facility, agency, specialty, schedule, and other circumstances.
Compensation may be one area to discuss. Other terms can include assignment dates, schedule, overtime, call expectations, travel arrangements, cancellation terms, and other conditions.
Before negotiating, identify the terms that matter most to you. Ask the recruiter or agency which provisions are flexible, then make sure any agreed changes appear in the final contract.
Locum Tenens Contract Checklist
Use this checklist before signing:
☐ Pay rate and payment schedule are clearly stated.
☐ Overtime, call, weekend, and holiday pay are explained.
☐ Assignment start and end dates are correct.
☐ Work schedule and call expectations are clear.
☐ Extension terms are explained.
☐ Malpractice coverage and limits are identified.
☐ Tail coverage responsibilities are clear.
☐ Travel and housing arrangements are documented.
☐ Licensing and credentialing costs are assigned.
☐ Cancellation and termination notice periods are clear.
☐ Cancellation penalties or fees are identified.
☐ Non-compete or other post-assignment restrictions are understood.
☐ Permanent-hire or conversion terms are clear.
☐ Credentialing and privileging responsibilities are assigned.
☐ Negotiated changes appear in writing.
☐ You understand the major obligations before signing.
Keep a copy of the final signed contract and any written amendments for your records.
Review Your Contract Before You Sign
A locum tenens contract should clearly explain your pay, schedule, responsibilities, coverage, expenses, and what happens if the assignment changes. Review the full agreement before signing, and make sure important terms discussed during recruitment are reflected in writing.
This article provides general information and is not legal advice. Contract terms vary, and a healthcare attorney can help you understand how a specific agreement applies to your situation.
If you are considering a locum assignment and want help finding an opportunity, talk to a recruiter at Imperial Locum about your next assignment.
FAQs
What Is a Locum Tenens Master Agreement?
A master agreement sets the general terms between a healthcare organization and a locums agency. It can cover payment, insurance, dispute resolution, and other basic working terms.
What Does a Name Clear Mean in Locum Tenens?
A name clear confirms that a hospital has not previously engaged a physician through its own recruiting efforts or another agency. This helps determine when an agency fee may apply.
When Can a Locum Tenens Contract Be Terminated?
A contract may end without cause with the required notice, or for cause when a serious issue occurs. The agreement should explain the notice period and reasons for immediate termination.
Can a Locum Tenens Contract Include a Non-Compete?
A locum tenens contract may include restrictions on working with a facility after an assignment. The enforceability of non-compete terms varies by state, so review the specific language carefully.
Where Can Locum Tenens Providers Work?
Locum tenens providers can work in hospitals, primary care centers, hospices, dental offices, and other healthcare settings. Assignments are available across many locations and specialties.
How Long Do Locum Tenens Assignments Last?
Assignment length depends on the facility’s staffing needs. Some assignments last a few days, while others can continue for a year or longer.
How Much Can Locum Tenens Providers Earn?
Locum tenens pay varies by specialty, location, schedule, and assignment terms. Providers may be paid hourly or daily, with additional compensation possible for call or extra shifts.
How Can Locum Tenens Providers Get Health Insurance?
Locum providers can explore health insurance through state marketplaces, private plans, or independent insurance agents. The right option depends on their individual circumstances.
What Does the Locum Tenens Credentialing Process Include?
Credentialing may require verification of your education, training, experience, medical license, and other professional credentials. Requirements can vary by facility and assignment.
Are Locum Physicians 1099 Contractors?
Many locum arrangements use independent-contractor structures, but locum work is not automatically classified as 1099 work. Worker classification depends on the actual relationship between the parties and other relevant factors.
Should a Healthcare Attorney Review a Locum Contract?
Consider having a healthcare attorney review the agreement if you have concerns about compensation, liability, termination, restrictive terms, or other legal obligations.
