Navigating the complexities of medical billing requires precision, especially when it comes to Place of Service (POS) codes. These two-digit codes are essential for professional claims, as they specify the location where healthcare services are rendered. For healthcare providers and billing professionals aiming for efficient and accurate claim submissions, understanding POS codes is paramount. Leveraging tools such as Immediate Care Medical Coding Software can streamline this process, ensuring claims are not only accurate but also optimized for timely reimbursement. This article provides a comprehensive guide to POS codes, crucial for anyone involved in medical billing and coding.
| POS Code | Place of Service Name | Description |
|---|---|---|
| 01 | Pharmacy | Used when services are provided at a pharmacy, a facility dispensing drugs and medically related items directly to patients. This is applicable for services provided within a pharmacy setting, not just the dispensing of medication itself. |
| 02 | Telehealth Provided Other than in Patient’s Home | Designates telehealth services delivered when the patient is not at their home. This could be in an office, clinic, or any location other than the patient’s private residence. This code is vital for claims involving remote consultations where the patient is at another healthcare facility or location. |
| 03 | School | Applicable when services are rendered at an educational institution whose primary function is education. This includes elementary schools, high schools, colleges, and universities, when healthcare services are provided on-site. |
| 04 | Homeless Shelter | For services provided at a facility primarily purposed to offer temporary housing to individuals experiencing homelessness. This covers emergency shelters and family shelters, highlighting services directed towards vulnerable populations. |
| 05 | Indian Health Service Free-standing Facility | Specifies services at a facility owned and operated by the Indian Health Service. These facilities offer a range of services, excluding hospitalization, to American Indians and Alaska Natives. |
| 06 | Indian Health Service Provider-based Facility | Similar to POS 05, but for facilities within the Indian Health Service where services are provided by or supervised by physicians, for both inpatients and outpatients. |
| 07 | Tribal 638 Free-standing Facility | For facilities owned and operated by recognized tribes under a 638 agreement, offering services to tribal members without requiring hospitalization. |
| 08 | Tribal 638 Provider-based Facility | Tribally operated facilities under 638 agreements, where physician-led services are provided to tribal members, including inpatient and outpatient care. |
| 09 | Prison/Correctional Facility | Used when services are provided within a correctional setting, including prisons, jails, and detention centers, for both adult and juvenile offenders. |
| 10 | Telehealth Provided in Patient’s Home | Specifically for telehealth services when the patient is at their home. This code distinguishes home-based telehealth from other telehealth locations, reflecting the growing trend of remote patient care in domestic settings. |
| 11 | Office | The standard code for services in a physician’s office or clinic, excluding hospitals, SNFs, military facilities, community health centers, public health clinics, or ICFs. This is the most common POS code for ambulatory care in private practice. |
| 12 | Home | For when healthcare services are delivered in a patient’s private residence, other than a hospital or facility. This encompasses house calls and home healthcare services. |
| 13 | Assisted Living Facility | Used for services provided in a congregate residential facility that offers support services and some healthcare for residents. This setting is for individuals needing assistance with daily living but not acute hospital care. |
| 14 | Group Home | Applicable to residential settings with shared living areas where clients receive supervision and various support services, like social, behavioral, or minimal medical services. |
| 15 | Mobile Unit | For services delivered via a mobile healthcare unit, such as a van or bus, that travels to different locations to provide care. This is common for outreach programs and community health initiatives. |
| 16 | Temporary Lodging | Used when healthcare is provided in short-term accommodations like hotels, campgrounds, or resorts, not covered by other POS codes. This might apply to tourists or individuals temporarily residing away from home. |
| 17 | Walk-in Retail Health Clinic | For healthcare services in a retail-based clinic, often found in pharmacies or stores, offering ambulatory preventive and primary care. These clinics provide convenient access to basic healthcare services. |
| 18 | Place of Employment-Worksite | When occupational medical, therapeutic, or rehabilitative services are provided at the patient’s workplace. This code is specific to employer-sponsored healthcare services on-site. |
| 19 | Off Campus-Outpatient Hospital | For outpatient services provided by a hospital department located off the main hospital campus. This clarifies that the services are hospital-related but not on the primary campus. |
| 20 | Urgent Care Facility | Designates services provided at an urgent care center, distinct from a hospital emergency room or doctor’s office, for immediate, unscheduled medical needs. Urgent care centers bridge the gap between primary care and emergency services. |
| 21 | Inpatient Hospital | The code for services provided to patients admitted to a hospital for overnight stays. This is for acute care settings requiring hospitalization. |
| 22 | On Campus-Outpatient Hospital | For outpatient services provided within the main hospital campus. This is for hospital-based outpatient care on the primary premises. |
| 23 | Emergency Room – Hospital | Specifically for services provided in a hospital emergency room, for emergency diagnosis and treatment. |
| 24 | Ambulatory Surgical Center | For surgical and diagnostic services performed at a freestanding ambulatory surgical center, not a physician’s office or hospital. |
| 25 | Birthing Center | Used for services in a facility, not a hospital or physician’s office, dedicated to labor, delivery, and immediate postpartum and newborn care. |
| 26 | Military Treatment Facility | For healthcare services within a medical facility operated by the Uniformed Services, including certain former U.S. Public Health Service facilities. |
| 27 | Outreach Site/Street | Applies to non-permanent locations like streets or outdoor environments where healthcare professionals offer services to unsheltered homeless individuals. |
| 31 | Skilled Nursing Facility | For services in a facility providing inpatient skilled nursing care and rehabilitation services, but not the level of care of an acute hospital. |
| 32 | Nursing Facility | A facility providing skilled nursing care and rehabilitation services, or regular health-related care above custodial level, not for individuals with intellectual disabilities. |
| 33 | Custodial Care Facility | For facilities providing room, board, and personal assistance services, generally long-term, without a significant medical component. |
| 34 | Hospice | Used for palliative and supportive care for terminally ill patients and their families in a hospice facility, other than the patient’s home. |
| 41 | Ambulance – Land | For transportation services via a land ambulance, equipped for life support. |
| 42 | Ambulance – Air or Water | Transportation via air or water ambulance, similarly equipped for emergency care. |
| 49 | Independent Clinic | For services at a clinic not part of a hospital and not described by other POS codes, offering outpatient preventive, diagnostic, therapeutic, or palliative services. |
| 50 | Federally Qualified Health Center | For facilities in underserved areas providing primary medical care to Medicare beneficiaries, under physician direction. |
| 51 | Inpatient Psychiatric Facility | For 24-hour inpatient psychiatric services for mental illness diagnosis and treatment, under physician supervision. |
| 52 | Psychiatric Facility-Partial Hospitalization | For facilities offering therapeutic programs for mental illness, for patients needing more than outpatient care but not full hospitalization. |
| 53 | Community Mental Health Center | For facilities providing comprehensive mental health services, including outpatient, emergency, day treatment, and consultation services. |
| 54 | Intermediate Care Facility/ Individuals with Intellectual Disabilities | For facilities providing health-related care above custodial level for individuals with intellectual disabilities, but less than hospital or SNF level. |
| 55 | Residential Substance Abuse Treatment Facility | For live-in facilities treating substance abuse, offering therapy, counseling, and support services, excluding acute medical care. |
| 56 | Psychiatric Residential Treatment Center | For facilities providing 24-hour planned and staffed group living and learning environments for psychiatric care. |
| 57 | Non-residential Substance Abuse Treatment Facility | For ambulatory substance abuse treatment, including therapy, counseling, and testing. |
| 58 | Non-residential Opioid Treatment Facility | For ambulatory treatment of opioid use disorder, including Medication Assisted Treatment (MAT). |
| 60 | Mass Immunization Center | Locations for mass immunization programs, like flu or pneumonia vaccines, often in public health centers or pharmacies. |
| 61 | Comprehensive Inpatient Rehabilitation Facility | For inpatient facilities providing comprehensive rehabilitation services for physical disabilities, including therapy and prosthetic services. |
| 62 | Comprehensive Outpatient Rehabilitation Facility | For outpatient facilities offering comprehensive rehabilitation, including physical, occupational, and speech therapy. |
| 65 | End-Stage Renal Disease Treatment Facility | For non-hospital facilities providing dialysis treatment, maintenance, and training. |
| 66 | Programs of All-Inclusive Care for the Elderly (PACE) Center | Facilities providing comprehensive medical and social services for the elderly under the PACE program, including primary care, therapy, and social services. |
| 71 | Public Health Clinic | Facilities run by state or local health departments offering ambulatory primary medical care. |
| 72 | Rural Health Clinic | Certified facilities in rural underserved areas providing ambulatory primary medical care. |
| 81 | Independent Laboratory | Laboratories certified for diagnostic and clinical tests, independent of hospitals or physician offices. |
| 99 | Other Place of Service | A catch-all code for places of service not specifically listed, requiring detailed specification in the claim. |
Accurate assignment of POS codes is not just about compliance; it directly impacts reimbursement and the efficiency of revenue cycle management. In fast-paced healthcare environments, especially immediate care settings like urgent care facilities or walk-in clinics, the speed and accuracy of coding are critical. Immediate care medical coding software solutions are designed to address these challenges, offering features that automate code lookup, verify coding accuracy, and integrate with billing systems. By utilizing such software, healthcare providers can minimize errors, accelerate claim processing, and ultimately focus more on patient care.
In conclusion, understanding and correctly applying Place of Service codes is a cornerstone of effective medical billing. From traditional office visits to telehealth and specialized facilities, each POS code carries specific implications for claim processing and reimbursement. For practices looking to optimize their billing operations, particularly in immediate care scenarios, investing in immediate care medical coding software represents a strategic move towards enhanced accuracy, efficiency, and financial health. Staying updated with the latest POS code guidelines and leveraging technological solutions are key to navigating the ever-evolving landscape of medical billing.
