Place of Service (POS) codes are integral to the accuracy of medical billing and claims processing. These two-digit codes, utilized on professional claims, specify the location where medical services are rendered. For healthcare providers, especially those in dynamic environments like urgent care facilities, understanding and correctly applying POS codes is paramount for ensuring proper reimbursement and compliance.
Navigating the complexities of medical coding can be challenging. For professionals seeking to enhance their expertise in this critical area, an Urgent Care Coding Class can provide invaluable skills and knowledge. Accurate coding directly impacts revenue cycles and compliance, making specialized training a worthwhile investment for individuals and healthcare facilities alike.
Below is a detailed guide to Place of Service codes, essential for healthcare professionals involved in medical billing and coding. This information is based on the latest updates and is intended to serve as a comprehensive reference. Always verify specific payer requirements with individual insurance providers, including Medicare and Medicaid, as reimbursement policies can vary.
Place of Service Code Database
| POS Code | Place of Service Name | Description |
|---|---|---|
| 01 | Pharmacy | A facility where medications and other health-related items are dispensed or sold directly to patients. |
| 02 | Telehealth Provided Other than in Patient’s Home | Services delivered via telecommunication technology when the patient is not at their home. |
| 03 | School | An educational institution with the primary function of providing education. |
| 04 | Homeless Shelter | A temporary housing facility for individuals experiencing homelessness. |
| 05 | Indian Health Service Free-standing Facility | A facility operated by the Indian Health Service providing outpatient diagnostic, therapeutic, and rehabilitation services. |
| 06 | Indian Health Service Provider-based Facility | An Indian Health Service facility offering diagnostic, therapeutic, and rehabilitation services to both inpatients and outpatients under physician supervision. |
| 07 | Tribal 638 Free-standing Facility | A facility owned and operated by a federally recognized tribe under a 638 agreement, providing outpatient services to tribal members. |
| 08 | Tribal 638 Provider-based Facility | A tribal facility under a 638 agreement offering diagnostic, therapeutic, and rehabilitation services to tribal members, both inpatients and outpatients. |
| 09 | Prison/ Correctional Facility | Facilities for the confinement and rehabilitation of adult or juvenile offenders under federal, state, or local authority. |
| 10 | Telehealth Provided in Patient’s Home | Telehealth services delivered when the patient is at their private residence (excluding hospitals or facilities). |
| 11 | Office | A location, excluding hospitals and certain other facilities, where healthcare professionals routinely provide ambulatory health services. |
| 12 | Home | A patient’s private residence, excluding hospitals or facilities, where care is received. |
| 13 | Assisted Living Facility | A residential facility providing 24/7 on-site support and assistance with health and other services for residents. |
| 14 | Group Home | A shared living residence offering supervision and support services like social, behavioral, and minimal health services. |
| 15 | Mobile Unit | A transportable facility equipped to deliver preventive, screening, diagnostic, and treatment services in various locations. |
| 16 | Temporary Lodging | Short-term accommodations like hotels or resorts where patient care is provided, not covered by other POS codes. |
| 17 | Walk-in Retail Health Clinic | Clinics within retail operations (excluding offices, urgent care, or pharmacies) offering ambulatory preventive and primary care. |
| 18 | Place of Employment-Worksite | A worksite location where occupational medical, therapeutic, or rehabilitative services are provided to employees. |
| 19 | Off Campus-Outpatient Hospital | An off-campus hospital department providing outpatient diagnostic, therapeutic, and rehabilitation services. |
| 20 | Urgent Care Facility | A location distinct from a hospital emergency room, office, or clinic, focused on diagnosing and treating unscheduled, walk-in patients needing immediate medical attention. This is a critical POS code for facilities specializing in urgent care. For those working in or managing such facilities, an urgent care coding class can offer focused training on accurate coding practices specific to this setting. |
| 21 | Inpatient Hospital | A hospital providing comprehensive inpatient medical, surgical, and rehabilitative services. |
| 22 | On Campus-Outpatient Hospital | An on-campus hospital department providing outpatient diagnostic, therapeutic, and rehabilitation services. |
| 23 | Emergency Room – Hospital | The section of a hospital dedicated to providing emergency diagnosis and treatment. |
| 24 | Ambulatory Surgical Center | A freestanding facility, not a physician’s office, offering ambulatory surgical and diagnostic services. |
| 25 | Birthing Center | A non-hospital facility providing a setting for labor, delivery, postpartum, and newborn care. |
| 26 | Military Treatment Facility | A medical facility operated by the Uniformed Services, including certain former U.S. Public Health Service facilities. |
| 27 | Outreach Site/ Street | Non-permanent locations like streets where health professionals offer services to unsheltered homeless individuals. |
| 31 | Skilled Nursing Facility | A facility providing inpatient skilled nursing care and related services, not equivalent to hospital-level care. |
| 32 | Nursing Facility | A facility providing skilled nursing care and rehabilitation services, or health-related care above custodial level. |
| 33 | Custodial Care Facility | A facility primarily providing room, board, and personal assistance services without a significant medical component. |
| 34 | Hospice | A facility (non-home) providing palliative and supportive care for terminally ill patients and their families. |
| 41 | Ambulance – Land | Land vehicles designed and equipped for emergency medical transport. |
| 42 | Ambulance – Air or Water | Air or water vehicles designed and equipped for emergency medical transport. |
| 49 | Independent Clinic | A non-hospital location providing outpatient preventive, diagnostic, therapeutic, rehabilitative, or palliative services. |
| 50 | Federally Qualified Health Center | Facilities in underserved areas providing primary medical care to Medicare beneficiaries under physician direction. |
| 51 | Inpatient Psychiatric Facility | A facility offering 24-hour inpatient psychiatric services for mental illness diagnosis and treatment. |
| 52 | Psychiatric Facility-Partial Hospitalization | Facilities for mental illness treatment, offering structured therapeutic programs for patients not requiring full hospitalization. |
| 53 | Community Mental Health Center | Facilities providing outpatient, emergency, day treatment, and consultation services for mental health. |
| 54 | Intermediate Care Facility/ Individuals with Intellectual Disabilities | 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 | Facilities offering treatment for substance abuse to live-in residents not requiring acute medical care. |
| 56 | Psychiatric Residential Treatment Center | Facilities providing 24-hour therapeutically planned group living and learning environments for psychiatric care. |
| 57 | Non-residential Substance Abuse Treatment Facility | Locations providing ambulatory substance abuse treatment services. |
| 58 | Non-residential Opioid Treatment Facility | Locations offering ambulatory treatment for opioid use disorder, including Medication Assisted Treatment (MAT). |
| 60 | Mass Immunization Center | Locations for administering mass vaccinations like influenza and pneumonia, often in public health settings or pharmacies. |
| 61 | Comprehensive Inpatient Rehabilitation Facility | Facilities providing comprehensive inpatient rehabilitation services for physical disabilities under physician supervision. |
| 62 | Comprehensive Outpatient Rehabilitation Facility | Facilities providing comprehensive outpatient rehabilitation services for physical disabilities under physician supervision. |
| 65 | End-Stage Renal Disease Treatment Facility | Non-hospital facilities providing dialysis treatment, maintenance, and training for patients or caregivers. |
| 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. |
| 71 | Public Health Clinic | State or local health department facilities providing ambulatory primary medical care under physician direction. |
| 72 | Rural Health Clinic | Certified rural facilities in underserved areas providing ambulatory primary medical care under physician direction. |
| 81 | Independent Laboratory | Laboratories certified to perform diagnostic and clinical tests independently of institutions or physician offices. |
| 99 | Other Place of Service | A catch-all code for service locations not specified by other POS codes. |
The Importance of Accurate POS Coding and Specialized Training
Correctly utilizing Place of Service codes is crucial for several reasons:
- Accurate Claim Adjudication: Payers use POS codes to determine appropriate reimbursement rates. Incorrect codes can lead to claim denials or underpayments, significantly impacting revenue.
- Compliance and Audits: Accurate coding ensures compliance with payer regulations and reduces the risk of audits and penalties.
- Data Analytics: POS data helps healthcare organizations analyze service utilization patterns across different locations, aiding in resource allocation and service planning.
For facilities like urgent care centers, which bridge the gap between primary care offices and hospital emergency rooms, the correct application of POS code 20 is particularly important. Given the unique nature of urgent care settings, specific training, such as an urgent care coding class, becomes highly beneficial. These specialized classes can delve into the nuances of coding for urgent care services, addressing scenarios and challenges unique to this environment.
Conclusion
Mastering Place of Service codes is an essential skill for anyone involved in medical billing and coding. This guide provides a comprehensive overview of the current POS code set. However, the healthcare landscape is constantly evolving, with coding guidelines and payer policies subject to change. Continuous learning and specialized training, such as enrolling in an urgent care coding class, are vital for staying current and ensuring accurate, compliant, and optimized medical billing practices. By investing in professional development and focusing on precision in coding, healthcare providers can secure proper reimbursement, maintain compliance, and ultimately deliver better patient care.
