When it comes to healthcare in USA, accurate billing and reimbursement are crucial for both patients and healthcare providers. In order to achieve this, healthcare providers use a system of codes by CMS known as Place of Service Codes, also known as POS codes.
Place of Service codes are essential in ensuring that healthcare services are billed and reimbursed accurately based on where the service was provided. In this guide, we will take a closer look at Place of Service Codes, their significance, and how they are used in healthcare services billing and reimbursement.
Contents
- What are Place of Service Codes?
- Different Types of Place of Service Codes List
- Place of Service 01 – Pharmacy
- Place of Service 02 – Telehealth Provided Other than in Patient’s Home
- Place of Service 03 – School
- Place of Service 04 – Homeless Shelter
- Place of Service 05 – Indian Health Service Free- standing Facility
- Place of Service 06 – Indian Health Service Provider – based Facility
- Place of Service 07 – Tribal 638 Free-standing Facility
- Place of Service 08 – Tribal 638 Provider-based Facility
- Place of Service 09 – Prison/Correctional Facility
- Place of Service 10 – Telehealth Provided in Patient’s Home
- Place of Service 11 – Office
- Place of Service 12 – Home
- Place of Service 13 – Assisted Living Facility
- Place of Service 14 – Group Home
- Place of Service 15 – Mobile Unit
- Place of Service 16 – Temporary Lodging
- Place of Service 17 – Walk-in Retail Health Clinic
- Place of Service 18 – Place of Employment/Worksite
- Place of Service 19 – Off Campus Outpatient Hospital
- Place of Service 20 – Urgent Care Facility
- Place of Service 21 – Inpatient Hospital
- Place of Service 22 – On Campus Outpatient Hospital
- Place of Service 23 – Emergency Room – Hospital
- Place of Service 24 – Ambulatory Surgical Center
- Place of Service 25 – Birthing Center
- Place of Service 26 – Military Treatment Facility
- Place of Service 31 – Skilled Nursing Facility
- Place of Service 32 – Nursing Facility
- Place of Service 33 – Custodial Care Facility
- Place of Service 34 – Hospice
- Place of Service 41 – Ambulance on Land
- Place of Service 42 – Ambulance in Air or Water
- Place of Service 49 – Independent Clinic
- Place of Service 50 – Federally Qualified Health Center
- Place of Service 51 – Inpatient Psychiatric Facility
- Place of Service 52 – Psychiatric Facility, Partial Hospitalization
- Place of Service 53 – Community Mental Health Center
- Place of Service 54 – Intermediate Care Facility/Individuals with Intellectual Disabilities
- Place of Service 55 – Residential Substance Abuse Treatment Facility
- Place of Service 56 – Psychiatric Residential Treatment Center
- Place of Service 57 – Non-residential Substance Abuse Treatment Facility
- Place of Service 58 – Non-residential Opioid Treatment Facility
- Place of Service 60 – Mass Immunization Center
- Place of Service 61 – Comprehensive Inpatient Rehabilitation Facility
- Place of Service 62 – Comprehensive Outpatient Rehabilitation Facility
- Place of Service 65 – End-Stage Renal Disease Treatment Facility
- Place of Service 71 – Public Health Clinic
- Place of Service 72 – Rural Health Clinic
- Place of Service 81 – Independent Laboratory
- Place of Service 99 – Other Place of Service
- Most Common POS Codes
- Telehealth Place of Service Codes
- FAQs about POS Codes
- Concluding Place of Service Codes Guide
What are Place of Service Codes?
Place of Service Codes, also known as POS codes, are a set of two-digit codes used to indicate where a healthcare service was provided. These codes are used to describe the type of location where a healthcare service was provided, such as a hospital, clinic, or nursing home. In addition, POS codes are used to indicate whether a service was provided in person or through telehealth.
Importance of Place of Service Codes
The use of Place of Service Codes is essential in healthcare billing and reimbursement. By accurately indicating the location where a healthcare service was provided, healthcare providers can ensure that they are billing for the correct service and receiving the appropriate reimbursement. In addition, accurate use of POS codes helps to prevent fraud and abuse in the healthcare system.
How are Place of Service Codes Used?
Place of Service Codes are used in a variety of ways in healthcare. They are used by healthcare providers when submitting claims for reimbursement to insurance companies or government programs such as Medicare or Medicaid. In addition, POS codes are used by insurance companies and government programs to determine the appropriate level of reimbursement for a healthcare service.
Different Types of Place of Service Codes List
There are many different types of Place of Service Codes, each indicating a specific type of location where a healthcare service was provided. Below I have mentioned the complete list of place of service codes issued by CMS.
Place of Service 01 – Pharmacy
A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.
Effective Date: October 1, 2003
Place of Service 02 – Telehealth Provided Other than in Patient’s Home
The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.
Effective Date: January 1, 2017 – Description change effective January 1, 2022, and applicable for Medicare April 1, 2022.
Place of Service 03 – School
A facility whose primary purpose is education.
Effective Date: January 01, 2003
Place of Service 04 – Homeless Shelter
A facility or location whose primary purpose is to provide temporary housing to homeless individuals(e.g., emergency shelter, individual or family shelters).
Effective Date: January 1, 2003
Place of Service 05 – Indian Health Service Free- standing Facility
A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization.
Effective Date: January 1, 2003
Place of Service 06 – Indian Health Service Provider – based Facility
A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services rendered by, or under the supervision of, physicians to Americans, Indians and Alaska Natives admitted as inpatients or outpatients.
Effective Date: January 1, 2003
Place of Service 07 – Tribal 638 Free-standing Facility
A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe organization under a 638 agreement, which provide diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members who do not require hospitalization.
Effective Date: January 1, 2003
Place of Service 08 – Tribal 638 Provider-based Facility
A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe organization under a 638 agreement, which provide diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members admitted as inpatients or outpatients.
Effective Date: January 1, 2003
Place of Service 09 – Prison/Correctional Facility
A 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.
Effective Date: January 1, 2006
Place of Service 10 – Telehealth Provided in Patient’s Home
The location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home(which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
Place of Service 11 – Office
Location, 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.
Place of Service 12 – Home
Location, other than a hospital or other facility, where the patient receives care in a private residence.
Place of Service 13 – Assisted Living Facility
Congregate residential facility with self-contained living units providing assessment of each resident’s needs and on-site support 24 hours a day, 7 day a week, with the capacity to deliver or arrange for services including some health care and other services.
Effective Date: October 1, 2003
Place of Service 14 – Group Home
A residence, with shared living areas, where clients receive supervision and other services such as social and/or behavioral services, custodial services, and minimal services (e.g., medication administration).
Effective Date: October 1, 2003
Place of Service 15 – Mobile Unit
A facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services.
Effective Date: January 1, 2003
Place of Service 16 – Temporary Lodging
A 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.
Effective Date: January 1, 2008
Place of Service 17 – Walk-in Retail Health Clinic
A 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 provide, on a ambulatory basis, preventive and primary care services.
Place of Service 18 – Place of Employment/Worksite
A 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.
Effective Date:
Place of Service 19 – Off Campus Outpatient Hospital
A 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
Effective Date: January 1, 2016
Place of Service 20 – Urgent Care Facility
Location, 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.
Effective Date: January 1, 2003
Place of Service 21 – Inpatient Hospital
A 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 condition.
Place of Service 22 – On Campus Outpatient Hospital
A 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.
Effective Date: January 1, 2016
Place of Service 23 – Emergency Room – Hospital
A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.
Place of Service 24 – Ambulatory Surgical Center
A freestanding facility, other than a physician’s office, where surgical and diagnostic services are provided on an ambulatory basis.
Effective Date: January 1, 2016
Place of Service 25 – Birthing Center
A 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.
Place of Service 26 – Military Treatment Facility
A 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).
Place of Service 31 – Skilled Nursing Facility
A 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.
Place of Service 32 – Nursing Facility
A facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick person, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities.
Place of Service 33 – Custodial Care Facility
A 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 34 – Hospice
A facility, other than a patient’s home, in which palliative and supportive care for terminally ill patients and their families are provided.
Place of Service 41 – Ambulance on Land
A land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.
Place of Service 42 – Ambulance in Air or Water
An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.
Place of Service 49 – Independent Clinic
A 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.
Effective Date: October 1, 2003
Place of Service 50 – Federally Qualified Health Center
A facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a physician.
Place of Service 51 – Inpatient Psychiatric Facility
A 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.
Place of Service 52 – Psychiatric Facility, Partial Hospitalization
A 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.
Effective Date: October 1, 2003
Place of Service 53 – Community Mental Health Center
A facility that provides the following services: outpatient services, including specialized outpatient services for children, the elderly, individuals who 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 54 – Intermediate Care Facility/Individuals with Intellectual Disabilities
A 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.
Place of Service 55 – Residential Substance Abuse Treatment Facility
A 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 test, drugs and supplies, psychological testing, and room and board.
Place of Service 56 – Psychiatric Residential Treatment Center
A 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.
Place of Service 57 – Non-residential Substance Abuse Treatment Facility
A 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.
Effective Date: October 1, 2003
Place of Service 58 – Non-residential Opioid Treatment Facility
A location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment(MAT)
Effective Date: January 1, 2020
Place of Service 60 – Mass Immunization Center
A 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.
Place of Service 61 – Comprehensive Inpatient Rehabilitation Facility
A 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.
Place of Service 62 – Comprehensive Outpatient Rehabilitation Facility
A 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.
Place of Service 65 – End-Stage Renal Disease Treatment Facility
A facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis.
Place of Service 71 – Public Health Clinic
A facility maintained by either State or local health departments that provides ambulatory primary medical care under the general direction of a physician.
Place of Service 72 – Rural Health Clinic
A certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of physician.
Place of Service 81 – Independent Laboratory
A laboratory certified to perform diagnostic and/or clinical test independent of an institution or a physician’s office
Place of Service 99 – Other Place of Service
Other place of service not identified above.
Most Common POS Codes
Following are some of the most common place of service codes:
2 Digit Place of Service Code | POS Code Name |
---|---|
POS 11 | Office |
POS 21 | In-Patient Hospital |
POS 22 | On Campus Out-patient Hospital |
POS 31 | Skilled Nursing Facility |
POS 32 | Nursing Facility |
POS 49 | Independent Clinic |
POS 52 | Psychiatric Facility – Partial Hospitalization |
POS 23 | Emergency Room – Hospital |
Telehealth Place of Service Codes
In recent years, telehealth has become increasingly popular as a way to provide healthcare services remotely. When a healthcare service is provided through telehealth, a different set of place of service codes is used. These POS codes are used to indicate that the service was provided remotely and not in person.
Some of the most common telehealth POS codes include:
2 Digit Place of Service Code | POS Code Name |
---|---|
POS 02 | Telehealth Provided Other than in Patient’s Home |
POS 10 | Telehealth Provided in Patient’s Home |
FAQs about POS Codes
What happens if a healthcare provider uses the wrong Place of Service Code?
If a healthcare provider uses the wrong Place of Service Code when submitting a claim for reimbursement, it can result in incorrect billing and reimbursement. In some cases, using the wrong POS code can result in the claim being denied or rejected. It is important for healthcare providers to understand the correct use of POS codes to ensure accurate billing and reimbursement.
How can healthcare providers ensure accurate use of Place of Service Codes?
To ensure accurate use of Place of Service Codes, healthcare providers should familiarize themselves with the different types of POS codes and the appropriate use of each code. In addition, healthcare providers can consult with their billing and coding staff to ensure that they are using the correct POS code when submitting claims for reimbursement.
What box is for place of service in ub04?
On a UB-04 form, there is no specific box for entering the Place of Service code. Instead, the Place of Service is determined based on the bill type and other relevant information provided on the claim. This means that healthcare providers need to accurately enter all the necessary details in the correct fields to ensure that the correct Place of Service is determined for billing and reimbursement purposes.
What place is for place of service in HCFA1500?
The Place of Service information on the HCFA 1500 form is reported in Box 24B. This is where healthcare providers indicate the specific location where a service was provided. It is important to accurately report the Place of Service code in Box 24B to ensure proper billing and reimbursement for healthcare services.
Concluding Place of Service Codes Guide
In conclusion, Place of Service Codes play a critical role in healthcare billing and reimbursement. By accurately indicating where a healthcare service was provided, healthcare providers can ensure that they are billing for the correct service and receiving the appropriate reimbursement.
Understanding the different types of POS codes and their appropriate use is essential for healthcare providers to ensure accurate billing and reimbursement.
My name is Kathryn Belvin, a seasoned medical billing expert with over 20 years of experience in medical billing. I have a deep understanding of complex coding and billing reimbursement processes in the RCM field and a proven track record of success in optimizing revenue cycle for providers. My years of experience helped me build good PR with insurance representatives and I am here to assist fellow medical billers to reach out to insurance companies for claims processing.
Feel free to contact me at any time if you need any additional information which isn’t available on the website.