Wednesday, 13th, 2022 by Utilities4Portfolio

What Are the Place of Service Codes

These are two-digit codes placed on the claims submitted by healthcare providers in order to indicate the setting(office, ambulance, mass immunization center, etc) in which a service was rendered. Place of service (POS) codes are used throughout the healthcare industry and maintained by the Centers for Medicare & Medicaid Services (CMS).

POS code set is a requirement for use in the implementation guide adopted as the national standard for electronic transmission of professional health care claims under the provisions of HIPAA. Health Insurance Portability and Accountability Act (HIPPA) made a direction to the secretary of HHS to adopt national standards for electronic transactions. These are standard transactions that require all health plans and providers to use standard code sets to populate data elements in each of the transactions. Many times it is crucial to get POS information to determine the acceptability of direct billing of health insurance companies by a given care provider. 

Place of Service Codes for Professional Claims

Here we have listed the place of service codes and their description. 

01 Pharmacy

It is a facility where drugs and related items are sold, or directly provided to patients. 

02 Telehealth Provided Other than Home

The location(other than in the patient’s home) where health services and health-related services are provided or received, through a telecommunication system. 

03 School

A facility whose primary purpose is education. 

04 Homeless Shelter

A facility or location whose primary purpose is to provide temporary residence to homeless individuals and families. 

05 Indian Health Service Free-standing Facility

It is a facility under the Federal Health Program, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic, and rehabilitation services to Native American Tribes and Alaska Native people who do not require hospitalization. 

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06 Indian Health Service Provider-based Facility

It is a facility under the Federal Health Program, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic, and rehabilitation services rendered by, or under the supervision of, physicians to Native American Tribes and Alaska Native people admitted as inpatients or outpatients. 

07 Tribal 638 Free-standing Facility

A facility owned by federally recognized Native American or Alaska Native tribes or tribal organizations under a 638 agreement to provide diagnostic, therapeutic, and rehabilitation services to tribal members who do not require hospitalization. 

08 Tribal 638 Provider-based Facility

A facility owned by federally recognized Native American or Alaska Native tribes or tribal organizations under a 638 agreement to provide diagnostic, therapeutic, and rehabilitation services to tribal members admitted as inpatients or outpatients. 

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 where people are legally detained. 

10 Telehealth Provided in Patient’s Home

Health services are provided through telecommunication technology when the patient is located at their home. 

11 Office

A location (other than a hospital, SNF, community health center, public health clinic, or ICF) where the health care professional regularly provides services. 

12 Home

A location, other than a hospital or a similar facility, where the beneficiary receives care in a private residence. 

13 Assisted Living Facility

It is a congregate residential facility with self-contained living units providing an 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, because this type of housing is designed for people who need various levels of medical and personal care. 

14 Group Home

A group home is a residence with shared living areas where beneficiaries receive supervision and other services. 

15 Mobile Unit 

A mobile Unit is a facility/unit that moves from one place to another, and is equipped to provide preventive, screening, diagnostic, and/or treatment services to the persons who require any or all of these.

16 Temporary Lodging

A short term accommodation where the beneficiary receives care, and which is not identified by any other place of service code. 

17 Walk-in Retail Health Clinic

It is a facility, other than an office, urgent care facility, pharmacy, or independent clinic and not described by any other POS code, that is located within a retail operation and provides preventive and primary care services. 

18 Place of Employment-Worksite

A location that is owned or operated by a public or private entity where the beneficiary is employed and it is not described by any other place of service code. 

19 Off Campus-Outpatient Hospital

A portion of an off-campus hospital provider-based department that provides care to sick or injured persons who do not require hospitalization or institutionalization. 

20 Urgent Care Facility

It is a location that is distinct from a hospital emergency room or a clinic whose main purpose is to diagnose and treat illness or injury for unscheduled patients in need of medical attention. 

21 Inpatient Hospital

It is a facility whose primary purpose is to provide diagnostic, therapeutic, and rehabilitation services by (or under the supervision of) doctors to the patients who are admitted in the hospital. 

22 On Campus Outpatient Hospital

On Campus Outpatient Hospital is a portion of a hospital’s main campus that provides diagnostic, therapeutic, and rehabilitation services who are not in need of hospitalization. 

23 Emergency Room – Hospital 

It is a particular portion of a hospital where emergency diagnosis and treatment is provided to the patients.

24 Ambulatory Surgical Center

Ambulatory Surgical Center is a freestanding facility other than a physician’s office, where health care services are rendered to beneficiaries on an ambulatory basis. 

25 Birthing Center

Birthing Center is essentially a facility other than a hospital’s maternity facility or a physician’s office that provides a setting for expecting mothers’ labor, delivery, and immediate postpartum care as well as immediate care of newborns. 

26 Military Treatment Facility

A military Treatment Facility (MTF) also refers to certain former U.S. Public Health Service (USPHS) facilities now designated as Uniformed Service Treatment Facilities (USTF), and is a medical facility operated by Uniformed Services. 

27-30 Unassigned N/A 

31 Skilled Nursing Facility

A Skilled Nursing Facility (SNF) is a facility that essentially provides inpatient skilled nursing care and other services to beneficiaries who are in need of medical, nursing, or rehabilitative services but the care or treatment they get is not of the same level as one gets in a hospital. 

32 Nursing Facility

The nursing facility mainly provides to residents skilled nursing care and other related services that are required 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. 

33 Custodial Care Facility

Custodial Care Facility primarily provides room, board, and other personal assistance services, but this facility does not include a medical component. 

34 Hospice

Hospice is a facility, other than a patient’s home, in which palliative and supportive care is offered for terminally ill patients and their family members. 

35-40 Unassigned N/A 

41 Ambulance – Land

It is a land vehicle that is specifically designed, equipped, and staffed for lifesaving and transporting the sick or injured from one place to another. 

42 Ambulance – Air or Water

It is primarily an air or water vehicle that is particularly designed, equipped, and staffed for lifesaving and transporting the sick or injured from one place to another. 

43-48 Unassigned N/A 

49 Independent Clinic

An independent clinic is a location, not part of a hospital and not described by any other Place of Service code, that is essentially organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only who are in need of care. 

50 Federally Qualified Health Center

A Federally Qualified Health Center is a facility located in an underserved area that primarily provides Medicare beneficiaries preventive primary medical care under the general direction of a physician. 

51 Inpatient Psychiatric Facility

An inpatient psychiatric facility essentially provides inpatient psychiatric services for the diagnosis and treatment of mental illnesses on a 24-hour basis, by or under the supervision of a qualified physician. 

52 Psychiatric Facility-Partial Hospitalization

It is a facility that primarily offers the diagnosis and treatment of mental illness and also provides a planned therapeutic program for patients who do not require full-time hospitalization, but are in need of broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility. 

53 Community Mental Health Center

A community mental health center is a facility that provides outpatient services, including specialized outpatient services for children, the elderly, chronically ill individuals, 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; day treatment, other partial hospitalization services, or psychosocial rehabilitation services; screening for patients being considered for admission to State mental health facilities to examine the appropriateness of such admission; and consultation and education services.

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54 Intermediate Care Facility For Individuals with Intellectual Disabilities

It is essentially a facility that mainly provides health-related care and services above the level of custodial care to individuals but the care and treatment are not of the same level as one can get in a hospital or skilled nursing facility.

55 Residential Substance Abuse Treatment Facility

Residential Substance Abuse Treatment Facility provides treatment for substance abuse to live-in residents who are not in need of acute medical care. 

56 Psychiatric Residential Treatment Center

Psychiatric Residential Treatment Center is a facility or specific part of a facility for psychiatric care which provides a total 24-hour therapeutically planned and professionally staffed group living and learning environment.

57 Non-residential Substance Abuse Treatment Facility

The Non-residential Substance Abuse Treatment Facility is a location that offers treatment for substance abuse on an ambulatory basis.

58 Non-residential Opioid Treatment Facility

The Non-residential Opioid Treatment Facility offers treatment for opioid use disorder on an ambulatory basis with services such as methadone and other forms of Medication Assisted Treatment (MAT). 

59 Unassigned N/A 

60 Mass Immunization Center

The Mass Immunization Center offers pneumococcal pneumonia and influenza virus vaccinations and these services are submitted by providers as electronic media claims, paper claims, or using the roster billing method. 

61 Comprehensive Inpatient Rehabilitation Facility

The Comprehensive Inpatient Rehabilitation Facility offers comprehensive rehabilitation services under the supervision of a doctor to inpatients who have physical disabilities. 

62 Comprehensive Outpatient Rehabilitation Facility

Comprehensive Outpatient Rehabilitation Facility basically offers comprehensive rehabilitation services to outpatients with physical disabilities that are rendered under the supervision of a physician. 

63-64 Unassigned N/A 

65 End-Stage Renal Disease Treatment Facility

The  End-Stage Renal Disease Treatment Facility is a facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or their caregivers. 

66-70 Unassigned N/A

71 Public Health Clinic

A Public Health Clinic is a care facility maintained by either State or local health departments that offers ambulatory primary medical care under the general direction of a doctor.

72 Rural Health Clinic

A Rural Health Clinic is a certified facility that is located in a rural or underserved area that offers ambulatory primary medical care under the general direction of a doctor.

73-80 Unassigned N/A

81 Independent Laboratory

Independent Laboratory is a laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician’s office.

82-98 Unassigned N/A

99 Other Place of Service

Another place of service that is not identified above.