Posted on June 14, 2017

Using the right ePlace of Service Code (POS) for each claim is crucial so the physician gets paid the right amount. Knowing the right code to use is easy – once we know the codes. Until then, use this handy reference for all your POS code needs and questions.

Place of Service Codes

Place of Service Codes are codes for CMS-1500 forms that tell the payer where the patient’s medical care was given. That could be an office (POS 11), state or local public health clinic (POS 71), outpatient hospital (Place of Service 22), or other location.

You don’t need to memorize the codes to work in a clinic or private practice. But after doing it long enough, you will!

Printable Place of Service Codes List [2017]

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The printable list above is a handy reference for the most common 25 Place of Service Codes, updated for 2017. To print it, click here (PDF)For the complete list with descriptions for each item, scroll down or click here.

For a Complete List, Click Here or Scroll Down

Looking for a more thorough list of Place of Service Codes? Click here or scroll down to see the full list below. It’s got all 99 codes, with names and full descriptions.

For a little extra info on Place of Service, see the sections below. There’s an intro for complete beginners, FAQ for new rules, and some recent changes new for 2017.

Place of Service Codes for Beginners

The video below gives a short introduction to place of service codes. It’s clear, straightforward, and it won’t take up your entire lunch break. It was put together as a bit of CPC Exam prep. It’s got a screenshot of POS entry and a quick walkthrough of how to enter the codes in a 1500 form.

Why Should We Care About Place of Service?

Of course we care about submitting the right POS, but did you know without the right code, the claim can get derailed?

Based on where services are rendered to a patient, there are different authorization and referral requirements. The Place of Service Code will also change the way the claim gets routed, and the amount of the physician’s fee.

With the wrong POS, the claim can even get denied outright with a “no authorization” reply. For instance, let’s say your patient went to the Emergency Room, but you accidentally submitted a CMS-1500 with the POS code 22 for Outpatient Hospital. In that case, the outpatient authorization wouldn’t exist, so the claim would get denied.

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FAQ for Rules for Place of Service Codes

Questions and puzzle pieces
There’s a short list of common questions about POS below. For more detailed reference, see the Revised and Clarified Place of Service (POS) Coding Instructions on the CMS.gov website.

Q: How do we pick the POS code for physician services?

A: We match the place where the service was provided in person to the code from the short table above or the long table below.

Q: How does Place of Service apply to reading diagnostic tests?

A: Sometimes a physician or other medical professional will interpret a diagnostic test that was done in a different location. When this happens, we use the code for the location where the patient participated in the test in person.

Example: A patient gets an ultrasound at a hospital near her house. The hospital submits the claim for the Technical Component (TC) of the test. A physician in another state reads and interprets the results in his own office. Since the patient’s face-to-face participation in the ultrasound happened at the hospital, the physician will bill for the reading under Place of Service 22, or Outpatient Hospital.

Q: Are there exceptions to the Place of Service rule?

A: The rule has two exceptions. First, when a patient receives service as a hospital outpatient or inpatient (POS 22 and 21), the claim is paid under the Medicare Physician Fee Schedule (MFPS). Second, if a physician has a separate office space on hospital grounds, then the physician will use POS 11 (office).

Q: What if my Place of Service doesn’t match any of the existing codes?

A: CMS.gov provides a process for modifying existing codes or requesting new codes. Submit requests to CMS.gov in writing to the POS Coordinator. Requests should be sent along with all relevant information per the instructions on the CMS.gov site here.

Recent Changes to Place of Service Codes

Via: BlueDiamondGallery.com
In 2016, CMS made a few changes to the POS codes.

First, as more physician practices become more hospital-based, separating out the proper POS becomes more difficult.

Second, CMS wanted to more accurately reflect the value of postoperative visits.

To reflect these needs, CMS created the new POS 19 code. POS 19 is Off Campus – Outpatient Hospital. This reflects part of an off-campus department that provides services to patients who don’t need hospitalization.

CMS also modified POS 22, Outpatient Hospital. The code now describes part of a hospital’s main campus that provides services to patients who don’t need hospitalization.

In a nutshell, POS 22 is on-campus outpatient hospital, and POS 19 is off-campus outpatient.

Full Place of Service Codes for 2017 [List]

The table below provides the comprehensive Place of Service Codes list, complete with all POS numbers, descriptors, and explanations.

Place of Service Code(s)Place of Service NamePlace of Service Description
1Pharmacy**

A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.

2TelehealthThe location where health services and health related services are provided or received, through a telecommunication system.
3SchoolA facility whose primary purpose is education.
4Homeless ShelterA facility or location whose primary purpose is to provide temporary hosing to homeless individuals (e.g., emergency shelters, individual or family shelters).
5Indian Health Service SeparateA facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non- surgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization.
6Indian Health Service Provider- based FacilityA facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non- surgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients.
7Tribal 638 Free- standing FacilityA facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members who do not require hospitalization.
8Tribal 638 Provider-based FacilityA facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members admitted as inpatients or outpatients.
9Prison/Correctional FacilityA prison, jail, reformatory, work farm, detention center, or any other similar facility maintained by either Federal, State or local authorities for the purpose of confinement or rehabilitation of adult or juvenile criminal offenders.
10UnassignedN/A
Place of Service Code(s)Place of Service NamePlace of Service Description
11OfficeLocation, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.
12HomeLocation, other than a hospital or other facility, where the patient receives care in a private residence.
13Assisted Living FacilityCongregate residential facility with self- contained living units providing assessment of each resident’s needs and on-site support 24 hours a day, 7 days a week, with the capacity to deliver or arrange for services including some health care and other services.
14Group Home*A residence, with shared living areas, where clients receive supervision and other services such as social and/or behavioral services, custodial service, and minimal services (e.g., medication administration).
15Mobile UnitA facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services.
16Temporary LodgingA short term accommodation such as a hotel, camp ground, hostel, cruise ship or resort where the patient receives care, and which is not identified by any other POS code.
17Walk-in Retail Health ClinicA walk-in health clinic, other than an office, urgent care facility, pharmacy or independent clinic and not described by any other Place of Service code, that is located within a retail operation and provides, on an ambulatory basis, preventive and primary care services.
18Place of Employment- WorksiteA location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic or rehabilitative services to the individual.
19Off Campus- Outpatient HospitalA portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.
20Urgent Care FacilityLocation, distinct from a hospital emergency room, an office, or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention.
Place of Service Code(s)Place of Service NamePlace of Service Description
21Inpatient HospitalA facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions.
22On Campus- Outpatient HospitalA portion of a hospital’s main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016)
23Emergency Room – HospitalA portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.
24Ambulatory Surgical CenterA freestanding facility, other than a physician’s office, where surgical and diagnostic services are provided on an ambulatory basis.
25Birthing CenterA facility, other than a hospital’s maternity facilities or a physician’s office, which provides a setting for labor, delivery, and immediate post-partum care as well as immediate care of new born infants.
26Military Treatment FacilityA medical facility operated by one or more of the Uniformed Services. Military Treatment Facility (MTF) also refers to certain former U.S. Public Health Service (USPHS) facilities now designated as Uniformed Service Treatment Facilities (USTF).
27-30UnassignedN/A
31Skilled Nursing FacilityA facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital.
32Nursing FacilityA facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities.
33Custodial Care FacilityA facility which provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component.
Place of Service Code(s)Place of Service NamePlace of Service Description
34HospiceA facility, other than a patient’s home, in which palliative and supportive care for terminally ill patients and their families are provided.
35-40UnassignedN/A
41Ambulance – LandA land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.
42Ambulance – Air or WaterAn air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.
43-48UnassignedN/A
49Independent ClinicA location, not part of a hospital and not described by any other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only.
50Federally Qualified Health CenterA facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a physician.
51Inpatient Psychiatric FacilityA facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a physician.
52Psychiatric Facility – Partial HospitalizationA facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital- affiliated facility.
53Community Mental Health CenterA facility that provides the following services: outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically ill, and residents of the CMHC’s mental health services area who have been discharged from inpatient treatment at a mental health facility; 24 hour a day emergency care services; day treatment, other partial hospitalization services, or psychosocial rehabilitation services; screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission; and consultation and education services.
Place of Service Code(s)Place of Service NamePlace of Service Description
54Intermediate Care Facility/Individuals with Intellectual DisabilitiesA facility which primarily provides health- related care and services above the level of custodial care to individuals but does not provide the level of care or treatment available in a hospital or SNF.
55Residential Substance Abuse Treatment FacilityA facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board.
56Psychiatric Residential Treatment CenterA facility or distinct part of a facility for psychiatric care which provides a total 24-hour therapeutically planned and professionally staffed group living and learning environment.
57Non-residential Substance Abuse Treatment FacilityA location which provides treatment for substance (alcohol and drug) abuse on an ambulatory basis. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, and psychological testing.
58-59UnassignedN/A
Place of Service Code(s)Place of Service NamePlace of Service Description
60Mass Immunization CenterA location where providers administer pneumococcal pneumonia and influenza virus vaccinations and submit these services as electronic media claims, paper claims, or using the roster billing method. This generally takes place in a mass immunization setting, such as, a public health center, pharmacy, or mall but may include a physician office setting.
61Comprehensive Inpatient Rehabilitation FacilityA facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. Services include physical therapy, occupational therapy, speech pathology, social or psychological services, and orthotics and prosthetics services.
62Comprehensive Outpatient Rehabilitation FacilityA facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. Services include physical therapy, occupational therapy, and speech pathology services.
63-64UnassignedN/A
65End-Stage Renal Disease Treatment FacilityA facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis.
66-70UnassignedN/A
71Public Health ClinicA facility maintained by either State or local health departments that provides ambulatory primary medical care under the general direction of a physician.
72Rural Health ClinicA certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of a physician.
73-80UnassignedN/A
Place of Service Code(s)Place of Service NamePlace of Service Description
81Independent LaboratoryA laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician’s office.
82-98UnassignedN/A
99Other Place of ServiceOther place of service not identified above.

Conclusion

Place of Service codes are a vital part of how a physician, practice, clinic, or other medical entity makes its money. The wrong POS code can result in the wrong fee amount or an outright denial of a claim.

Use the handy, printable Place of Service Codes list (updated for 2017) at the top of this article to ensure the right code every time. For tough questions about which code to use, see our FAQs section near the top half of this article.

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