Place of Service Code (POS)

Key facts

Maintained by

Centers for Medicare and Medicaid Services (CMS)

Format

Two-digit numeric code

Reported on

Professional claims (CMS-1500 paper form or 837P electronic claim)

Example codes

11 office, 12 home, 21 inpatient hospital, 23 emergency room

What is a Place of Service code?

Physicians and other practitioners report a Place of Service (POS) code on each line of a professional claim. The code tells the payer where the patient received the service, which affects both how the service is paid and how claims data can be read.

CMS maintains the national POS code set, and Medicare, Medicaid and commercial payers use it on professional claims. Hospitals and other institutions billing on the institutional claim (UB-04 or 837I) do not use POS codes; the setting on those claims is described by the type of bill and revenue codes.

Common POS codes

The code set has dozens of values. Some of the most frequently used are:

• 02: telehealth provided other than in the patient's home.
• 10: telehealth provided in the patient's home.
• 11: office.
• 12: home.
• 19: off-campus outpatient hospital.
• 21: inpatient hospital.
• 22: on-campus outpatient hospital.
• 23: emergency room, hospital.
• 24: ambulatory surgical center.
• 31: skilled nursing facility.
• 81: independent laboratory.

Why POS codes matter

The setting on a claim changes both payment and interpretation:

• Under the Medicare Physician Fee Schedule, many services pay a higher non-facility rate in settings such as an office and a lower facility rate in hospitals and other facilities that bill their own costs separately.
• Site-of-care analysis, such as the shift of infusions or procedures from hospital outpatient departments to offices and ambulatory surgical centers, relies on POS codes.
• Telehealth POS codes separate virtual visits from in-person care in utilization data.
• Public Medicare utilization files for physicians and other practitioners report services separately for facility and non-facility settings.

Limitations of POS data

A POS code describes the type of setting, not the specific facility. A line coded 22 does not say which hospital was involved, so linking professional services to facilities requires other fields or claims. Payers can also apply their own POS rules, so commercial claims do not always follow Medicare instructions.