Identify of Service Codes (CMS1500 box 24b)

Place of Service Codes are two-digit codes placed on health intendance professional person claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the wellness intendance manufacture.

This lawmaking set is required for use in the implementation guide adopted as the national standard for electronic manual of professional health care claims under the provisions of the Wellness Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA directed the Secretary of HHS to prefer national standards for electronic transactions. These standard transactions crave all wellness plans and providers to use standard code sets to populate data elements in each transaction. The Transaction and Code Set Rule adopted the ASC X12N-837 Health Care Claim: Professional person, volumes 1 and ii, version 4010, as the standard for electronic submission of professional claims. This standard names the POS code set currently maintained past CMS equally the code set to be used for describing sites of service in such claims. POS information is ofttimes needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider.

Listing of Identify of Service Codes

(updated Jan one, 2022)

Listed below are place of service codes and descriptions. These codes should be used on professional claims to specify the entity where service(s) were rendered. Check with individual payers (e.m., Medicare, Medicaid, other individual insurance) for reimbursement policies regarding these codes. If you lot would similar to annotate on a code(due south) or description(south), please send your asking to posinfo@cms.hhs.gov.

Code(s) Place of Service Name Identify of Service Description Effective Date
01 Pharmacy A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients. 2005-ten-01
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 abode when receiving health services or health related services through telecommunication engineering science.
(Description change effective January 1, 2022, and applicative for Medicare April 1, 2022.)

Special Considerations
Note that while the modification of POS Code 02 and the creation of POS Lawmaking x are effective in the National POS code set effective Jan 1, 2022, Medicare contractors received instructions regarding how to process claims with these codes starting April 4, 2022, and so that Medicare would align with existing Telehealth claims processing policy, also every bit exist considered HIPAA compliant.

2017-01-01
2022-01-01
03 School A facility whose primary purpose is education. 2003-01-01
04 Homeless Shelter A facility or location whose primary purpose is to provide temporary housing to homeless individuals (e.g., emergency shelters, individual or family unit shelters).

Special Considerations
Note that for the purposes of receiving durable medical equipment (DME), a homeless shelter is considered the beneficiary's abode. Because DME is payable in the casher'southward home, the crosswalk for Homeless Shelter (code 04) to Office (code 11) that was mandated constructive January 1, 2003, may need to be adjusted or local policy adult then that HCPCS codes for DME are covered when other conditions are met and the beneficiary is in a homeless shelter. If desired, local contractors are permitted to work with their medical directors to determine a new crosswalk such as from Homeless Shelter (code 04) to Home (code 12) or Custodial Care Facility (code 33) for DME provided in a homeless shelter setting. If a local contractor is currently paying claims correctly, even so, it is not necessary to change the current crosswalk.

2003-01-01
05 Indian Health Service Free-continuing Facility A facility or location, endemic 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.  (See 05-08 Special Considerations beneath.) 2003-01-01
06 Indian Health Service Provider-based Facility A facility or location, endemic and operated past the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services rendered by, or nether the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients.  (Run across 05-08 Special Considerations below.) 2003-01-01
07 Tribal 638 Gratuitous-continuing Facility A 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 nonsurgical), and rehabilitation services to tribal members who exercise not require hospitalization.  (Come across 05-08 Special Considerations beneath.) 2003-01-01
08 Tribal 638 Provider-based Facility A facility or location owned and operated past a federally recognized American Indian or Alaska Native tribe or tribal system nether a 638 agreement, which provides diagnostic, therapeutic (surgical and nonsurgical), and rehabilitation services to tribal members admitted as inpatients or outpatients.  (Run across 05-08 Special Considerations below.) 2003-01-01
05-08 Special Considerations
Medicare does non currently utilise the POS codes designated for these settings. Follow the instructions yous have received regarding how to procedure claims for services rendered in IHS and Tribal 638 settings. If y'all receive claims with these codes, you must initially accept them in terms of HIPAA compliance. However, follow your "render equally unprocessable" procedures subsequently this initial compliance cheque. Follow your "return as unprocessable" procedures when you lot receive paper claims with these codes. (Note that while these codes became part of the National POS code set up effective January 1, 2003, Medicare contractors received instructions regarding how to process claims with these codes effective Oct 1, 2003, so that Medicare could be HIPAA compliant by October sixteen, 2003).
09 Prison/ Correctional Facility A prison, jail, reformatory, work farm, detention heart, or any other like facility maintained by either Federal, Country or local authorities for the purpose of confinement or rehabilitation of adult or juvenile criminal offenders.

Special Considerations
The add-on of code 09 to the POS code set and Medicare claims processing reflects Medicare'south compliance with HIPAA laws and regulations. Local contractors must continue to comply with CMS current policy that does not permit payment for Medicare services in a penal institution in well-nigh cases. The add-on of a POS code for a prison/correctional facility setting does non supersede this policy. (See Pub. 100-04, Medicare Claims Processing, section x.4, chapter one.)

2006-07-01
10 Telehealth Provided in Patient's Home The location where health services and health related services are provided or received, through telecommunication engineering. Patient is located in their dwelling house (which is a location other than a infirmary or other facility where the patient receives care in a individual residence) when receiving wellness services or wellness related services through telecommunication engineering.
(This code is effective Jan 1, 2022, and available to Medicare April one, 2022.)

Special Considerations
Note that while the modification of POS Code 02 and the creation of POS Code ten are effective in the National POS code fix constructive Jan 1, 2022, Medicare contractors received instructions regarding how to process claims with these codes starting April 4, 2022, so that Medicare would align with existing Telehealth claims processing policy, as well every bit exist considered HIPAA compliant.

2022-01-01
11 Office Location, other than a hospital, skilled nursing facility (SNF), military handling facility, community wellness center, Country or local public wellness clinic, or intermediate intendance facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an convalescent ground. prior to 2003
12 Dwelling Location, other than a hospital or other facility, where the patient receives care in a private residence. prior to 2003
13 Assisted Living Facility Besiege residential facility with self-independent living units providing assessment of each resident'southward needs and on-site support 24 hours a 24-hour interval, seven days a week, with the capacity to deliver or arrange for services including some wellness care and other services. 2003-x-01
14 Grouping Habitation A residence, with shared living areas, where clients receive supervision and other services such every bit social and/or behavioral services, custodial service, and minimal services (e.g., medication administration). 2004-04-01
15 Mobile Unit of measurement A facility/unit that moves from identify-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services.

Special Considerations
When services are furnished in a mobile unit of measurement, they are frequently provided to serve an entity for which another POS lawmaking exists. For instance, a mobile unit of measurement may exist sent to a physician'southward office or a skilled nursing facility. If the mobile unit is serving an entity for which another POS code already exists, providers should utilise the POS lawmaking for that entity. However, if the mobile unit is not serving an entity which could be described past an existing POS lawmaking, the providers are to apply the Mobile Unit of measurement POS lawmaking 15. Use the non-facility charge per unit to payments for services designated as being furnished in POS code 15; apply the appropriate facility or not-facility rate for the POS code designated when a code other than the mobile unit of measurement code is indicated.

A physician or practitioner's role, even if mobile, qualifies to serve equally a telehealth originating site. Bold such an office also fulfills the requirement that it be located in either a rural health professional person shortage area equally defined under section 332(a)(1)(A) of the Public Health Service Act (42 The statesC. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Expanse every bit divers in department 1886(d)(2)(D) of the Deed, the originating physician's office should use POS code xi (Role) in guild to ensure advisable payment for services on the listing of Medicare Telehealth Services.

2003-01-01
16 Temporary Lodging A short term adaptation such as a hotel, campsite footing, hostel, prowl ship or resort where the patient receives intendance, and which is not identified by any other POS lawmaking. 2008-04-01
17 Walk-in Retail Health Clinic A walk-in health dispensary, other than an office, urgent care facility, pharmacy or contained dispensary and not described past any other Place of Service lawmaking, that is located inside a retail operation and provides, on an ambulatory basis, preventive and chief care services.

Special Considerations:
It should exist noted that, while some entities in the industry may elect to use POS code 17 to track the setting of immunizations, Medicare continues to require its billing rules for immunizations claims, which are found in chapter xviii, section 10 of this manual. Contractors are to instruct providers and suppliers of immunizations to continue to follow these Medicare billing rules. However, Medicare contractors are to accept and adjudicate claims containing POS code 17, even if its presence on a merits is opposite to these billing instructions.

Payment Rate: Not applicable for adjudication of Medicare claims; systems must recognize for HIPAA

2010-05-01
18 Place of Employment/Worksite A location, not described by any other POS code, endemic 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.

Payment Rate: Not applicable for adjudication of Medicare claims; systems must recognize for HIPAA

 2013-05-01
nineteen 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 exercise not require hospitalization or institutionalization. 2016-01-01
xx 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. 2003-01-01
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 conditions. prior to 2003
22 On Campus-Outpatient Hospital A portion of a hospital which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to ill or injured persons who practice not crave hospitalization or institutionalization. prior to 2003, Description change effective Jan 1, 2016
23 Emergency Room - Hospital A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided. prior to 2003
24 Convalescent Surgical Middle A freestanding facility, other than a md's office, where surgical and diagnostic services are provided on an ambulatory basis.

Special Considerations:
When a dr./practitioner furnishes services to a patient in a Medicare-participating convalescent surgical center (ASC), the POS code 24 (ASC) shall be used.

Note: Physicians/practitioners who perform services in an ASC shall utilize POS code 24 (ASC). Physicians/practitioners are not to use POS code 11 (part) for ASC based services unless the physician has an office at the same physical location of the ASC, which meets all other requirements for operating as a physician office at the same concrete location as the ASC – including coming together the "distinct entity" criteria divers in the ASC Country Operations Manual that precludes the ASC and an adjacent physician office from existence open up at the aforementioned time -- and the doc service was actually performed in the role suite portion of the facility. See Pub 100-07, Medicare State Operations Manual, Appendix 50 - Guidance for Surveyors: Ambulatory Surgical Centers for a complete set of applicable ASC definitions, basic requirements, and conditions of coverage. It is bachelor at the following link: http://world wide web.cms.gov/manuals/Downloads/som107ap_l_ambulatory.pdf

 prior to 2003
25 Birthing Middle A facility, other than a hospital's maternity facilities or a physician'due south office, which provides a setting for labor, delivery, and immediate postpartum care as well as immediate care of new built-in infants. prior to 2003
26 Armed forces Handling Facility A medical facility operated by one or more than of the Uniformed Services. War machine Handling Facility (MTF) also refers to certain former U.Due south. Public Wellness Service (USPHS) facilities at present designated every bit Uniformed Service Treatment Facilities (USTF).
27-xxx Unassigned N/A
31 Skilled Nursing Facility A facility which primarily provides inpatient skilled nursing care and related services to patients who crave medical, nursing, or rehabilitative services but does not provide the level of care or treatment bachelor in a hospital. prior to 2003
32 Nursing Facility A 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 to a higher place the level of custodial care to other than individuals with intellectual disabilities.
33 Custodial Intendance Facility A facility which provides room, board and other personal assistance services, mostly on a long-term basis, and which does not include a medical component. prior to 2003
34 Hospice A facility, other than a patient'due south home, in which palliative and supportive care for terminally ill patients and their families are provided.

Special Considerations:
When a physician/practitioner furnishes services to a patient under the hospice benefit, use the following guidelines to place the appropriate POS. When a beneficiary is in an "inpatient" respite or general "inpatient" care stay, the POS code 34 (hospice) shall exist used. When a beneficiary who has elected coverage nether the Hospice benefit is receiving inpatient hospice intendance in a infirmary, SNF, or hospice inpatient facility, POS lawmaking 34 (Hospice) shall exist used to designate the POS on the merits. For services provided to a hospice beneficiary in an outpatient setting, such equally the dr./nonphysician practitioner's function (POS 11); the beneficiary's habitation (POS 12), i.e., non operated by the hospice; or other outpatient setting (eastward.thousand., outpatient hospital (POS 22)), the patient's physician or nonphysician practitioner or hospice contained attending physician or nurse practitioner, shall assign the POS code that represents that setting, as appropriate. At that place may be apply of nursing homes as the hospice patient'due south "home," where the patient resides in the facility but is receiving a home level of care. In addition, hospices are besides operating "houses" or hospice residential entities where hospice patients receive a abode level of care. In these cases, physicians and nonphysician practitioners, including the patient's independent attending doctor or nurse practitioner, shall use the appropriate POS code representing the detail setting, e.one thousand., POS code 32 for nursing home, POS code 13 for an assisted living facility, or POS code 14 for grouping dwelling house.

prior to 2003
35-40 Unassigned N/A
41 Ambulance - Land A country vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured. prior to 2003
42 Ambulance - Air or Water An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured. prior to 2003
43-48 Unassigned N/A
49 Contained Dispensary A location, non function of a hospital and not described by whatever other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only. 2003-ten-01
50 Federally Qualified Wellness Centre A facility located in a medically underserved expanse that provides Medicare beneficiaries preventive main medical care under the general direction of a doc. prior to 2003
51 Inpatient Psychiatric Facility A facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour footing, by or under the supervision of a medico. prior to 2003
52 Psychiatric Facility-Fractional Hospitalization A facility for the diagnosis and treatment of mental disease 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 infirmary-affiliated facility. prior to 2003
53 Community Mental Health Center A facility that provides the post-obit 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 access to State mental health facilities to determine the appropriateness of such admission; and consultation and didactics services. prior to 2003
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 mentally retarded individuals but does non provide the level of intendance or treatment available in a hospital or SNF. prior to 2003
55 Residential Substance Abuse Treatment Facility A facility which provides handling for substance (alcohol and drug) abuse to live-in residents who do not crave astute medical intendance. Services include private and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board. prior to 2003
56 Psychiatric Residential Treatment Centre 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. prior to 2003
57 Non-residential Substance Abuse Treatment Facility A location which provides treatment for substance (booze and drug) abuse on an ambulatory footing. Services include private and grouping therapy and counseling, family unit counseling, laboratory tests, drugs and supplies, and psychological testing. 2003-01-01
58 Non-residential Opioid Treatment Facility A location that provides treatment for opioid use disorder on an convalescent basis. Services include methadone and other forms of Medication Assisted Treatment (MAT).

Special Considerations
Notation: OUD treatment services furnished at Opioid Treatment Programs are not considered physician services and are separately paid under the bundled payment established nether sections 1833(a)(1)(CC) and 1834(w) of the Social Security Human activity.

2020-01-01
59 Unassigned N/A
60 Mass Immunization Center A location where providers administer pneumococcal pneumonia and influenza virus vaccinations and submit these services equally electronic media claims, paper claims, or using the roster billing method. This generally takes place in a mass immunization setting, such equally, a public health center, chemist's, or mall only may include a medico office setting. prior to 2003
61 Comprehensive Inpatient Rehabilitation Facility A facility that provides comprehensive rehabilitation services under the supervision of a medico to inpatients with physical disabilities. Services include concrete therapy, occupational therapy, spoken communication pathology, social or psychological services, and orthotics and prosthetics services. prior to 2003
62 Comprehensive Outpatient Rehabilitation Facility A facility that provides comprehensive rehabilitation services under the supervision of a md to outpatients with physical disabilities. Services include physical therapy, occupational therapy, and oral communication pathology services. prior to 2003
63-64 Unassigned N/A
65 Stop-Phase Renal Illness Handling Facility A facility other than a infirmary, which provides dialysis treatment, maintenance, and/or grooming to patients or caregivers on an ambulatory or dwelling-care footing. prior to 2003
66-seventy Unassigned N/A
71 Public Wellness Clinic A facility maintained by either State or local health departments that provides ambulatory primary medical intendance nether the general management of a dr.. prior to 2003
72 Rural Health Clinic A certified facility which is located in a rural medically underserved area that provides ambulatory master medical care under the full general direction of a physician. prior to 2003
73-80 Unassigned Due north/A
81 Independent Laboratory A laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a dr.'s office. prior to 2003
82-98 Unassigned N/A
99 Other Place of Service Other place of service not identified above. prior to 2003

Other Special Considerations

Special Considerations for Services Furnished to Registered Inpatients

When a physician/practitioner furnishes services to a registered inpatient, payment is made nether the PFS at the facility rate. To that end, a medico/practitioner/supplier furnishing services to a patient who is a registered inpatient, shall, at a minimum, report the inpatient hospital POS code 21 irrespective of the setting where the patient actually receives the confront-to-face up encounter. In other words, reporting the inpatient infirmary POS lawmaking 21 is a minimum requirement for purposes of triggering the facility payment under the PFS when services are provided to a registered inpatient. If the physician/practitioner is aware of the exact setting the beneficiary is a registered inpatient, the appropriate inpatient POS lawmaking may be reported consistent with the lawmaking list annotated in this department (instead of POS 21). For example, a dr./practitioner may apply POS 31, for a patient in a SNF receiving inpatient skilled nursing intendance, POS 51, for a patient registered in a Psychiatric Inpatient Facility, and POS 61 for patients registered in a Comprehensive Inpatient Rehabilitation Facility.


Special Considerations for Outpatient Infirmary Departments

When a doctor/practitioner furnishes services to an outpatient of a hospital, payment is made under the PFS at the facility charge per unit. Physicians/practitioners who furnish services to a infirmary outpatient, including in a hospital outpatient department (including in a provider-based department of that hospital) or under arrangement to a hospital shall, at a minimum, written report the outpatient hospital POS lawmaking 22 irrespective of the setting where the patient actually receives the confront-to-confront encounter. In other words, reporting the outpatient infirmary POS lawmaking 22 is a minimum requirement for purposes of triggering the facility payment amount under the PFS when services are provided to a registered outpatient. If the physician/practitioner is enlightened of the exact setting the casher is a registered infirmary outpatient, the appropriate outpatient facility POS code may be reported consistent with the code list annotated in this department (instead of POS 22). For example, physicians/practitioners may use POS code 23 for services furnished to a patient registered in the emergency room, POS 24 for patients registered in an ambulatory surgical eye, and POS 56 for patients registered in a psychiatric residential treatment center.

NOTE: Physicians/practitioners who perform services in a hospital outpatient section shall utilise, at a minimum, POS code 22 (Outpatient Hospital). Lawmaking 22 (or other appropriate outpatient department POS code as described to a higher place) shall exist used unless the doctor maintains separate part space in the hospital or on the hospital campus and that md function space is non considered a provider-based department of the hospital as defined in 42. C.F.R. 413.65. Physicians shall use POS code eleven (office) when services are performed in a separately maintained physician part space in the hospital or on the hospital campus and that physician office infinite is not considered a provider-based department of the hospital. Employ of POS code 11(part) in the hospital outpatient department or on hospital campus is subject to the physician cocky-referral provisions set along in 42 C.F.R 411.353 through 411.357.

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