Place of Service Codes
| Place of Service Code | Place of Service Name and Description |
|---|
Place of Service Code | Place of Service Name and Description |
|---|---|
| 1 | Place of Service 01 – Pharmacy |
| 2 | Place of Service 02 – Telehealth |
| 3 | Place of Service 03 – School refers to a facility dedicated primarily to providing educational services Effective: 01/01/2003 |
| 4 | Homeless shelters are essential facilities established to offer temporary housing to individuals experiencing homelessness. These shelters play a crucial role in providing safe and secure accommodation for those in need, including emergency shelters for immediate assistance and individual or family shelters for longer-term support. The primary objective of homeless shelters is to provide a temporary respite for individuals who lack stable housing, often due to economic hardship, personal crises, or other circumstances beyond their control. By offering a roof over their heads, access to basic amenities, and a supportive environment, these shelters serve as a critical lifeline for vulnerable populations facing homelessness. (Effective January 1, 2003) |
| 5 | Indian Health Service Free-standing facilities are integral components of the healthcare system for American Indians and Alaska Natives. These facilities, owned and operated by the Indian Health Service, offer a range of services including diagnostic, therapeutic (both surgical and non-surgical), and rehabilitation services. Designed to provide convenient access to essential healthcare services, these free-standing facilities play a crucial role in promoting the health and well-being of indigenous populations. (Effective January 1, 2003) |
| 6 | Indian Health Service provider-based facilities play a crucial role in providing healthcare services to American Indians and Alaska Natives. These facilities, owned and operated by the Indian Health Service (IHS), are dedicated to offering comprehensive diagnostic, therapeutic(surgical and non surgical), and rehabilitation services under the supervision of trained physicians. The primary aim of these facilities is to cater to the healthcare needs of Native Americans, both as inpatients and outpatients. (Effective January 1, 2003) |
| 7 | A Tribal 638 Free Standing Facility plays a pivotal role in the healthcare delivery system for federally recognized American Indian or Alaska Native tribes operating under a 638 agreement. This type of facility serves as a vital resource in providing comprehensive healthcare services to tribal members who do not require hospitalization. Its key components include diagnostic, therapeutic, surgical or non-surgical, and rehabilitation care, all tailored to meet the unique healthcare needs of the tribal community. Effective: 01/01/2003 |
| 8 | A Tribal 638 Provider-based Facility is a healthcare facility owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement. This type of facility offers a range of services including diagnostic, therapeutic, surgical, non-surgical, and rehabilitation services to tribal members, whether they are admitted as inpatients or outpatients. Effective: 01/01/2003 |
| 9 | Place of Service 09 refers to correctional facilities, including prisons, jails, reformatories, work farms, detention centers, and similar establishments operated by Federal, State, or local authorities to detain and rehabilitate adult or juvenile criminal offenders. This specific setting is designated by healthcare billing and coding systems to accurately reflect where healthcare services are rendered within the criminal justice system. Effective: 07/01/2006 |
| 11 | Place of Service 11 – Office |
| 12 | Home – Place of Service 12 |
| 13 | Place of Service 13 – Assisted Living Facility |
| 14 | Place of Service 14, signifies a group home setting. Group homes serve as residences where individuals live together and receive a range of services, including supervision, social and behavioral services, custodial care, and essential services such as medication administration. This setting plays a crucial role in supporting individuals in a communal environment while ensuring they receive the necessary care and support tailored to their needs. Effective from October 1, 2003, and revised from April 1, 2004 |
| 15 | Place of Service 15 – Mobile unit refers to a facility or unit equipped to provide preventive, screening, diagnostic, and/or treatment services that moves from place-to-place. Effective: 01/01/2003 |
| 16 | Place of Service 16, Temporary Lodging, is a unique setting where patients can receive care in a short-term accommodation like a hotel, campground, hostel, cruise ship, or resort. This POS code is distinct from others as it specifically denotes locations designed for temporary stays while still providing necessary medical services.. Effective: 01/01/2008 |
| 17 | Place of Service 17, the walk-in retail health clinic, plays a crucial role as a healthcare setting that effectively blends the convenience of retail operations with the provision of essential healthcare services. This unique setting serves as a bridge between traditional healthcare facilities, such as hospitals and primary care offices, and the fast-paced retail environment. This innovative model offers convenient access to preventive and primary care services on an ambulatory basis, catering to the needs of a modern, fast-paced society seeking efficient and quality healthcare options. The walk-in retail health clinic is distinct from traditional office settings, urgent care facilities, pharmacies, and independent clinics, as it is integrated within a retail operation. Effective: 05/01/2010 |
| 18 | Place of Service 18, known as Place of Employment Worksite, serves as a distinct location owned or operated by public or private entities where individuals are employed and receive continual or intermittent occupational medical, therapeutic, or rehabilitative services. Health professionals deliver specialized care within this setting to address the specific health needs of individuals in relation to their employment Effective 05/01/2003 |
| 19 | Place of Service 19 – Portion of Off Campus – Outpatient Hospital |
| 20 | Place of Service 20 – Urgent Care Facility |
| 21 | Place of Service 21 – Inpatient Hospital |
| 22 | Place of Service 22 – Portion of Hospital’s main campus |
| 23 | Place of Service 23 – Emergency Room – Hospital |
| 24 | Place of Service 24 – Ambulatory Surgical Center |
| 25 | Place of Service 25, Birthing Center, is a specialized facility that offers a unique setting for the entire childbirth process. Unlike hospitals or physician’s offices, birthing centers are dedicated spaces that provide comprehensive care for labor, delivery, and immediate postpartum care for both the mother and newborn. |
| 26 | Place of Service 26, commonly known as Military Treatment Facility (MTF), refers to a medical facility operated by one or more of the Uniformed Services. These facilities play a crucial role in providing healthcare services to active duty servicemembers, retirees, and their dependents. The primary goal of MTFs is to ensure the health and well-being of military personnel by delivering a wide range of medical services, from routine check-ups to specialized treatments. Furthermore, the term MTF also encompasses certain former U.S. Public Health Service (USPHS) facilities that have been reclassified as Uniformed Service Treatment Facilities (USTF). This change in designation reflects the integration of various healthcare resources to streamline the delivery of care for members of the Uniformed Services. |
| 27 | Place of Service 27 (POS 27) – Outreach site/street – is a newly designated healthcare setting effective from October 1, 2023. This setting specifically caters to unsheltered homeless individuals and is defined as a non-permanent location on the street or found environment, not covered by any existing POS code. Health professionals at POS 27 deliver a range of comprehensive services including preventive, screening, diagnostic, and treatment services to address the unique healthcare needs of this vulnerable population. |
| 31 | Place of Service 31 – Skilled Nursing Facility |
| 32 | Place of Service 32 refers to Nursing Facilities, which are specialized facilities primarily focused on providing skilled nursing care and related services for the rehabilitation and care of individuals who are injured, disabled, or sick. These facilities offer healthcare services that go beyond custodial care and cater to individuals in need of specialized health-related care. Nursing Facilities are designed to support the physical and emotional well-being of residents, offering assistance with activities of daily living, medical supervision, rehabilitation programs, and other healthcare services tailored to individual needs |
| 33 | Place of Service 33, also known as a Custodial Care Facility, is a dedicated establishment that offers long-term, non-medical care within a regulated setting. Patients in these facilities mainly receive aid with activities of daily living and supervision, with less emphasis on medical treatment. These facilities cater to individuals who require assistance with tasks such as bathing, dressing, and eating, rather than extensive medical interventions The services offered at a custodial care facility are aimed at promoting comfort, safety, and well-being for individuals who may have difficulty living independently due to physical or cognitive impairments. |
| 34 | Place of Service 34 – Hospice |
| 41 | Place of Service 41 represents the setting in which ambulance land vehicles operate. These vehicles are specialized to provide lifesaving care and transport for individuals who are sick or injured. Equipped with essential medical devices and staffed with trained personnel, ambulances play a critical role in the healthcare system by ensuring timely and efficient transportation of patients to medical facilities. |
| 42 | Place of Service 42 refers to the use of air or water vehicles equipped with special equipment and a trained staff for the purpose of providing life-saving assistance and transporting individuals who are sick or injured. These vehicles play a critical role in emergency medical services, particularly in remote or hard-to-reach areas where traditional ambulances may not be able to access. The specialized equipment on these vehicles enables medical professionals to provide immediate care to patients in critical condition while en route to a medical facility. |
| 49 | Place of Service 49, Independent Clinic, is a distinct location dedicated to providing a wide range of healthcare services to outpatients exclusively. It is an organized and operated facility that focuses on delivering preventive, diagnostic, therapeutic, rehabilitative, and palliative care. This specific Place of Service code delineates facilities that are separate entities from hospitals, offering comprehensive healthcare tailored towards outpatient needs. Eff: October 1, 2023 |
| 50 | Place of Service 50, Federally Qualified Health Center (FQHC), is a designated facility that operates in medically underserved areas to deliver preventive primary medical care to Medicare beneficiaries under the oversight of a physician. FQHCs play a vital role in ensuring access to healthcare for underserved populations, including low-income individuals, migrant workers, and those facing barriers to receiving traditional medical services. |
| 51 | Place of Service 51, the Inpatient Psychiatric Facility, is a specialized facility that offers comprehensive psychiatric services for individuals requiring a high level of care for the diagnosis and treatment of mental health conditions. These facilities operate 24 hours a day, with services provided by a multidisciplinary team under the supervision of a physician |
| 52 | Place of Service 52, a Psychiatric Facility-Partial Hospitalization, serves as a crucial resource for individuals with mental illness who do not require full-time hospitalization but need more comprehensive care than traditional outpatient services can provide. This facility focuses on delivering a planned therapeutic program tailored to each patient’s needs, offering a structured environment for diagnosis and treatment |
| 53 | Community Mental Health Centers (CMHCs), designated as Place of Service 53, serve as essential hubs for delivering a comprehensive array of mental health services to individuals within their specific service regions. These facilities offer outpatient services to various populations such as children, the elderly, chronic illness sufferers, and individuals discharged from inpatient mental health facilities. In addition to outpatient services, CMHCs also provide 24-hour emergency care, day treatment, partial hospitalization, and psychosocial rehabilitation services. They conduct screening assessments for potential admissions to state mental health facilities, ensuring appropriate placement. Consultation and education services further enhance the CMHC’s impact on mental health care delivery within the community. By offering comprehensive and specialized services tailored to the unique needs of their target populations, Place of Service 53 facilities exemplify a patient-centered approach to mental health treatment and support |
| 54 | Place of Service 54, the Intermediate Care Facility/Individuals with Intellectual Disabilities, serves as a crucial healthcare setting that offers specialized and comprehensive care to individuals with intellectual disabilities. This facility primarily focuses on providing health-related services that go beyond custodial care, tailored to meet the unique needs of this population. While not offering the same level of care and treatment as hospitals or Skilled Nursing Facilities (SNFs) |
| 55 | Place of Service 55, the Residential Substance Abuse Treatment Facility, is a specialized center designed to provide comprehensive treatment for individuals dealing with substance abuse issues. This facility offers live-in residents a supportive environment where they can focus on their recovery without the need for acute medical care. The range of services provided at this facility includes individual and group therapy, counseling sessions, family therapy, laboratory tests, prescription drugs and medical supplies, psychological evaluations, and room and board. |
| 56 | Place of Service 56, the Psychiatric Residential Treatment Center (PRTC), is a specialized facility designed to provide comprehensive psychiatric care within a therapeutic environment. This setting offers round-the-clock services in a structured group living and learning space that is both professionally staffed and tailored to meet the unique needs of individuals requiring intensive psychiatric treatment. The PRTC setting is meticulously planned to offer a holistic approach to mental health care, integrating various therapeutic modalities, medical interventions, and educational components to support residents in achieving optimal mental well-being |
| 57 | Place of Service 57 refers to a Non-residential Substance Abuse Treatment Facility where individuals can receive treatment for substance abuse, specifically alcohol and drug abuse, on an ambulatory basis. The type of facility described is a comprehensive healthcare center that provides a wide array of services to support the mental health and well-being of individuals. These services typically include individual therapy, group therapy, counseling, family therapy, laboratory tests, provision of medications and medical supplies, as well as psychological testing. Effective: 10/01/2023 |
| 58 | Place of Service 58, also known as a Non-residential Opioid Treatment Facility, is a crucial location that offers treatment for opioid use disorder on an ambulatory basis. This setting provides a range of services, including the administration of methadone and other forms of Medication Assisted Treatment (MAT). Patients who visit a Place of Service 57 can receive comprehensive care and support to address their opioid use disorder in a structured and monitored environment. Effective January 1, 2020 |
| 60 | Place of Service 60, known as Mass Immunization Center, is a designated location where healthcare providers administer pneumococcal pneumonia and influenza virus vaccinations. These services are submitted through electronic media claims, paper claims, or utilizing the roster billing method. While Mass Immunization Centers are typically associated with mass vaccination events held at venues like public health centers, pharmacies, or malls, they can also encompass physician office settings. |
| 61 | Place of Service 61, Comprehensive Inpatient Rehabilitation Facility, is a specialized facility offering a wide range of comprehensive rehabilitation services to inpatients with physical disabilities. These services are provided under the direct supervision of a physician and encompass various disciplines including physical therapy, occupational therapy, speech pathology, social or psychological services, and orthotics and prosthetics services. |
| 62 | Place of Service 62, the Comprehensive Outpatient Rehabilitation Facility (CORF), is a specialized facility that offers a wide range of outpatient rehabilitation services for individuals with physical disabilities. These services are provided under the supervision of a physician and aim to enhance the quality of life and functional ability of patients. Comprehensive Outpatient Rehabilitation Facility services typically include physical therapy, speech pathology services, and occupational therapy. Physical therapy focuses on improving mobility, strength, and coordination, while speech pathology services address speech and communication difficulties. Occupational therapy aims to help individuals perform daily activities and tasks more independently. |
| 65 | Place of Service 65, also known as an End-Stage Renal Disease Treatment Facility, is a specialized healthcare setting dedicated to providing dialysis treatment, maintenance, and training to patients with end-stage renal disease. These facilities offer a crucial service for individuals whose kidneys are no longer able to function effectively, requiring regular dialysis to remove waste products and excess fluids from their blood. |
| 66 | Place of Service 66 refers to Programs of All-Inclusive Care for the Elderly (PACE) Centers, which are specialized facilities offering a comprehensive range of medical and social services for elderly individuals enrolled in PACE. These services cover primary care, social work services, restorative therapies like physical and occupational therapy, personal care and supportive services, nutritional counseling, recreational therapy, and provision of meals. PACE Centers are designed to ensure that elderly individuals receive holistic care and support to maintain their health and well-being. |
| 71 | Place of Service 71, Public Health Clinic, refers to a facility operated by State or local health departments that offer ambulatory primary medical care under the supervision of a physician |
| 72 | Place of Service 72, Rural Health Clinic, is a vital certified facility that plays a crucial role in delivering ambulatory primary medical care in rural medically underserved areas. These clinics operate under the general guidance of a physician, focusing on providing comprehensive and accessible healthcare services to populations in rural regions. |
| 81 | Place of Service 81 – Independent Laboratory |
| 99 | Place of Service 99, designated as “Other place of service not identified above,” |
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What is Place of Service Codes?
Place of Service (POS) codes are two-digit codes used in medical billing to indicate where a healthcare service was provided. These codes play a crucial role in determining reimbursement levels from insurance companies, Medicare, and Medicaid. There are various POS codes that correspond to different locations where healthcare services can be rendered, such as hospitals, clinics, nursing homes, or even a patient’s home.
The accurate reporting of POS codes is essential for proper billing and coding in the healthcare industry. It helps insurance providers and government payers understand the setting in which a service took place, ensuring that the appropriate reimbursement rates are applied based on the services provided. Additionally, POS codes can also impact how certain healthcare services are covered under insurance plans, as some services may be covered differently depending on where they are administered.
Healthcare providers and billing staff must be knowledgeable about Place of Service codes to ensure compliance with billing regulations and optimize reimbursement for services provided. Failure to accurately use POS codes can result in claim denials, delays in payment, or potential audits from regulatory agencies.
In conclusion, Place of Service codes are a critical component of medical billing and coding, playing a key role in accurately documenting where healthcare services are provided and ensuring proper reimbursement levels. Healthcare providers and billing professionals must understand the significance of POS codes and use them correctly to maintain financial health in the healthcare industry