Place of Service Code

A two-digit code on a claim that indicates where the healthcare service was provided, affecting how the claim is processed and how much the payer reimburses.

Place of service codes tell the payer where you provided the service. This matters because reimbursement rates can differ based on the setting. An office visit billed with POS 11 (office) pays a different amount than the same service billed with POS 22 (outpatient hospital) because the facility component is handled differently. The most common place of service codes are: 11 for office, 12 for patient's home, 19 for off-campus outpatient hospital, 21 for inpatient hospital, 22 for on-campus outpatient hospital, 23 for emergency room, 31 for skilled nursing facility, 32 for nursing facility, 02 for telehealth provided in a patient's home, and 10 for telehealth provided in a healthcare facility. Using the wrong POS code is a common billing error that can result in either underpayment or overpayment. If you provide a service in your office but accidentally use POS 22 (outpatient hospital), the payer may pay the facility rate instead of the non-facility rate, which changes the reimbursement calculation. For telehealth specifically, POS codes have been evolving. The expansion of telehealth during the pandemic introduced POS 02 for telehealth services provided to patients in their homes. Previously, telehealth required the patient to be at an originating site (a healthcare facility), but that requirement has been relaxed for many services. Medicare and most commercial payers have different fee schedules for facility and non-facility settings. The non-facility rate (office) is generally higher because it includes the practice expense component that covers your overhead. The facility rate is lower because the hospital's facility fee covers the overhead. If you bill a non-facility code but are actually at a hospital outpatient department, you are overbilling. Audit your POS codes regularly. Make sure they accurately reflect where services are actually delivered. Systematic POS errors are a common audit finding.