In medical billing, accurate coding is non-negotiable. Among the most crucial elements are the two-digit Place of Service (POS) codes, which tell payers, including Medicare, precisely where a healthcare service was rendered. Understanding the pos meaning in medical billing is vital for maximizing reimbursement and avoiding claim denials.
This comprehensive guide covers the all pos codes in medical billing, detailing their definitions, typical uses, and the key differences between them. Whether you’re searching for the complete list of place of service codes or need to know what is a pos code for a specific setting, this is your definitive resource for professional claims.
The POS code directly impacts reimbursement because it determines whether a service is billed with a Facility or Non-Facility payment rate.
Non-Facility POS Codes (e.g., POS 11) generally cover the physician’s professional fee and the overhead costs of operating a private office, leading to a higher professional fee component.
Facility POS Codes (e.g., POS 21 or POS 22) cover services rendered in institutional settings (like a hospital pos). In these cases, the facility bills for its overhead costs separately (known as the Technical Component), and the physician receives a lower professional fee component.
POS Code | Name | Description | Typical Use Case | Billing Notes | Common Mistakes |
1 | Pharmacy | A place where healthcare providers give medications and medical items directly to patients. Pharmacists here can provide medication advice and fill prescriptions. | Prescription fills or medication counseling | Use only for drug dispensing services | Using for clinical services in pharmacies |
2 | Telehealth services delivered outside the patient’s residence | This code is used when a patient obtains virtual medical treatment while away from home. The patient could be at work, school, a hotel, or any other location. | Video visit with a patient at work or other location | Include telehealth modifiers | Confusing with POS 10 (home telehealth) |
3 | School | A place mainly used for education where health services might be provided to students. This includes elementary, high, and college, where school nurses or visiting healthcare providers offer care. | School nurse visit or therapy session | Services must be on school grounds | Using for after-school programs in separate locations |
4 | Homeless Shelter | A temporary housing facility for homeless people may offer healthcare services. Visiting doctors or staff on-site can provide these services. | Health checks or vaccines at the shelter | Document shelter as a service site | Using when the patient isn’t at the shelter |
5 | Indian Health Service Free-standing Facility | A facility run by the Indian Health Service that is not associated with a hospital. These clinics provide outpatient care specifically for American Indians and Alaska Natives. | Wellness check at IHS clinic | Only for non-hospital IHS facilities | Using hospital-based IHS services |
6 | Indian Health Service Provider-based Facility | An Indian Health Service facility that is part of a hospital or operates as a hospital’s department. These provide both inpatient and outpatient services. | Surgery at IHS hospital | Must be a provider-based facility | Confusing with code 05 |
7 | Tribal 638 Free-standing Facility | A tribe or tribal group operates a healthcare facility under Public Law 93-638 that does not link to a hospital. | Physical exam at tribal clinic | For tribal-run, non-hospital facilities | Using for hospital-based tribal care |
8 | Tribal 638 Provider-based Facility | A hospital-based healthcare facility run by a tribe or tribal organization under Public Law 93-638. | Overnight stay at tribal hospital | Must be hospital-affiliated | Using for free-standing tribal clinics |
9 | Prison/Correctional Facility | A place where persons are being held owing to judicial action. This includes prisons, jails, detention centers, and related facilities. | Medical care for an inmate | The patient must be in custody | Using for care of parolees |
10 | Telehealth Provided in Patient’s Home | It is used when a patient receives healthcare services virtually at home. This was particularly crucial during the COVID-19 epidemic. | Video visit with patient at home | Use telehealth modifiers | Using for in-person home visits |
11 | Office | A location where a doctor or other healthcare provider routinely sees patients. The most common POS code includes medical offices, clinics, and group practices. | Check-up at doctor’s office | The address must match the provider’s office | Using for hospital-based clinics |
12 | Home | The patient’s residence where they live. This does not include facilities or temporary lodging. | Nurse home visit for wound care | Document as patient’s residence | Using for facilities or temporary housing |
13 | Assisted Living Facility | A housing institution that offers individual assistance, supervision, and some healthcare services, but less than nursing homes. | Doctor visit to assisted living | Only for licensed facilities | Using for nursing homes or group homes |
14 | Group Home | A residence where multiple people live together with some supervision and minimal healthcare services. Frequently used for those with developmental difficulties or behavioral health issues. | Psychiatrist visit to group home | Only for licensed group homes | Using for assisted living or nursing homes |
15 | Mobile Unit | A facility that is not fixed to one location and provides diagnostic, preventive, or treatment services. | Mammogram in a mobile van | Specify the mobile unit in the documentation | Using for temporary fixed locations |
16 | Temporary Lodging | Short-term accommodations like hotels, campgrounds, or cruise ships where a patient might temporarily stay. | Medical care at a hotel | Document temporary lodging setting | Using for patient’s home |
17 | Walk-in Retail Health Clinic | A clinic located within a retail store, supermarket, or pharmacy that provides basic healthcare services without appointments. | Strep test at grocery store clinic | Only for retail-based clinics | Using for urgent care centers |
18 | Place of Employment-Worksite | An employer owns or maintains a facility that provides healthcare to employees. | Flu shots at the factory | Services at the patient’s workplace | Using for off-site employee clinics |
19 | Off Campus-Outpatient Hospital | A hospital facility is separate from the main hospital building. However, the hospital still owns and operates it. | MRI at a separate hospital building | Must be hospital-owned, off-campus | Using independent clinics |
20 | Urgent Care Facility | A facility that gives quick medical care for non-life-threatening issues. You do not need an appointment, but it is not an emergency room. | Sprained ankle treatment | Only for dedicated urgent care | Using for ER or regular office visits |
21 | Inpatient Hospital | A facility that provides care requiring an overnight stay where patients are formally admitted. | Surgery requiring admission | Only for admitted patients | Using for ER or outpatient services |
22 | On Campus-Outpatient Hospital | A portion of a hospital’s main campus is used for outpatient services where patients don’t stay overnight. | Outpatient surgery at the hospital | It must be on the main campus | Using off-campus facilities |
23 | Emergency Room – Hospital | The section of a hospital is equipped to handle medical emergencies. | Chest pain evaluation | Only for hospital ER services | Using for urgent care visits |
24 | Ambulatory Surgical Center | A separate facility focused on same-day surgical procedures where patients don’t stay overnight. | Cataract surgery at day center | Only for certified ASCs | Using for hospital outpatient surgery |
25 | Birthing Center | A non-hospital facility designed specifically for labor and delivery. | Natural childbirth with a midwife | Only licensed birthing centers | Using for hospital maternity wards |
26 | Military Treatment Facility | A medical center run by a Uniformed Services member for military members and their families. | Care at military base hospital | Only for DoD/USPHS facilities | Using for VA hospitals |
27 | Outreach Site/Street | Services are provided to homeless people or other hard-to-reach populations in temporary, non-facility settings. | Medical care under bridge | Only for non-permanent locations | Using for shelters or clinics |
28-30 | Unassigned | N/A | |||
31 | Skilled Nursing Facility | A facility provides skilled nursing care and rehabilitation services to inpatients daily. | Rehab after hip surgery | Need skilled care requirement | Using for custodial care |
32 | Nursing Facility | A place that provides nursing care for patients. These patients need medical help but do not require a hospital. | Ongoing care for a chronic condition | Only licensed nursing facilities | Using for assisted living |
33 | Custodial Care Facility | A facility that offers lodging, board, and other personal help services but does not provide extensive medical treatment. | Help with daily activities | For personal rather than medical care | Using for nursing facilities |
34 | Hospice | An institution that provides terminally ill patients with care that prioritizes comfort over cure. | End-of-life care for cancer patient | Only for hospice facility care | Using for home hospice services |
35-40 | Unassigned | N/A | |||
41 | Ambulance – Land | A ground vehicle specially designed for transporting sick or injured people. | Transport after car accident | Only for services during transport | Using for services before/after transport |
42 | Ambulance – Air or Water | An aircraft or boat specially equipped for transporting sick or injured people. | Helicopter transport to a trauma center | Only for air/water transport | Using for ground ambulance |
43-48 | Unassigned | N/A | |||
49 | Independent Clinic | A non-hospital outpatient center. | A check-up at a community clinic | Not for hospital-owned clinics | Using for hospital outpatient departments |
50 | Federally Qualified Health Center | A federally financed community health center that provides care to underprivileged regions regardless of capacity to pay. | Primary care for low-income patient | Only for certified FQHCs | Using for similar non-certified clinics |
51 | Inpatient Psychiatric Facility | A facility dedicated to providing 24-hour inpatient psychiatric care. | Treatment for severe depression | Only for psychiatric hospitals | Using for outpatient mental health |
52 | Psychiatric Facility-Partial Hospitalization | A facility providing intensive psychiatric services during the day but where patients return home at night. | Day program for mental health | Only for certified programs | Using for regular outpatient therapy |
53 | Community Mental Health Center | A facility providing outpatient mental health services to a community. | Therapy at a local mental health center | Only for certified CMHCs | Using for private practice offices |
54 | Intermediate Care Facility/Individuals with Intellectual Disabilities | A facility that provides health treatment to persons with intellectual impairments. | Care for a person with Down syndrome | Only for certified ICF/IID | Using for group homes |
55 | Residential Substance Abuse Treatment Facility | A live-in facility providing treatment for drug or alcohol addiction. | Residential alcohol rehab | Only for live-in treatment | Using for outpatient addiction treatment |
56 | Psychiatric Residential Treatment Center | A non-hospital setting provides 24-hour psychiatric services to individuals who require ongoing treatment. | Teen behavioral treatment | Only for residential psychiatric centers | Using for inpatient psychiatric hospitals |
57 | Non-residential Substance Abuse Treatment Facility | A facility providing outpatient treatment for drug or alcohol addiction. | Day treatment for addiction | Only for outpatient programs | Using for residential programs |
58 | Non-residential Opioid Treatment Facility | A facility specifically focused on outpatient treatment of opioid addiction, often using medication-assisted treatment. | Methadone clinic visit | Only opioid treatment facilities | Using for general substance abuse programs |
59 | Unassigned | N/A | |||
60 | Mass Immunization Center | A place where healthcare staff may swiftly deliver immunizations to many individuals. | Community flu shot clinic | Only for mass vaccination events | Using for routine office vaccinations |
61 | Comprehensive Inpatient Rehabilitation Facility | A facility providing intensive rehabilitation services requiring hospital-level care. | Stroke rehabilitation | Only for certified inpatient rehab | Using skilled nursing facilities |
62 | Comprehensive Outpatient Rehabilitation Facility | A facility providing coordinated outpatient rehabilitation services. | Multiple therapy types after accident | Only for certified CORFs | Using private therapy practices |
63-64 | Unassigned | N/A | |||
65 | End-Stage Renal Disease Treatment Facility | A facility that gives dialysis treatment to patients with kidney failure. | Regular hemodialysis treatment | Only certified dialysis centers | Using for hospital inpatient dialysis |
66 | PACE Center | An all-inclusive aged care plan offers complete services to older people. | Elderly Care Services Center | Only for certified PACE programs | Using for adult day health centers |
67-70 | Unassigned | N/A | |||
71 | Public Health Clinic | A clinic is run by the state or local health authority. | STI testing at the health department | Only government health clinics | Using private clinics |
72 | Rural Health Clinic | A federally certified clinic in a rural, underserved area. | Care at the small-town clinic | Only for certified RHCs | Using for non-certified rural clinics |
73-80 | Unassigned | N/A | |||
81 | Independent Laboratory | A laboratory that is not part of a hospital or physician’s office. | Blood test at a commercial lab | Only for independent labs | Using for office or hospital labs |
82-98 | Unassigned | N/A | |||
99 | Other Place of Service | A place of service not described by any other code. | Unusual service location | Use only as a last resort | Using as default for unknown setting |
Correct POS codes are critical to speedy payment and fewer claim rejections. Our team of certified medical coders knows all CMS’s latest rules and updates. We handle complex billing situations across all healthcare settings and ensure your claims have the correct codes every time. Contact us today to boost your payments and reduce errors.
Relevant Guide: POS 11 in Medical Billing
No. CPT place of service codes is a common misconception. CPT (Current Procedural Terminology) codes describe the procedure performed (e.g., 99213 for an office visit), while POS codes (like 11) describe the location where the procedure took place. Both are required on professional claims.
The primary purpose of place of service codes for professional claims is to allow the payer to determine the correct facility payment indicator and calculate the appropriate reimbursement rate for the physician component of the service.
Yes, certain scenarios require pos modifiers. For example, the use of POS 10 (Telehealth in patient's home) often requires specific telehealth modifiers (like 95) to be appended to the CPT code. Always check payer guidelines for specific rules.
The main hospital pos codes are:
POS 21 (Inpatient Hospital)
POS 22 (On Campus-Outpatient Hospital)
POS 19 (Off Campus-Outpatient Hospital)
POS 23 (Emergency Room—Hospital)
POS 13 stands for Assisted Living Facility. This code is used when a provider delivers services to a patient residing in a licensed facility that provides personal care services, but not the level of skilled nursing care found in a POS 31 or POS 32 facility.
A general Nursing Facility is POS 32, while a facility providing a higher level of care (Skilled Nursing) is POS 31.
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