MLN: Place of Service (POS) Codes for Professional Claims
Reference to the CMS Place of Service code set used on professional claims to identify where a service was furnished, affecting payment under the facility/non-facility differential.
Primary source
CMS Place of Service Code Set →https://www.cms.gov/medicare/coding-billing/place-of-service-codes
Verified May 23, 2026 · This is the authoritative regulator URL. The summary below is a research aid; the linked source controls.
CMS Place of Service codes are a two-digit code reported on the CMS-1500 (Box 24B) or 837P claim that identifies where a service was furnished. POS affects payment because many CPT codes have two values on the Medicare Physician Fee Schedule:
- Non-facility (free-standing office) rate: higher, reflects practice expense including overhead.
- Facility rate: lower, reflects the facility separately billing its own facility fee.
POS codes:
- 02: Telehealth Provided Other than in Patient's Home
- 10: Telehealth Provided in Patient's Home (added 2022)
- 11: Office
- 12: Home (not the same as 10 — POS 12 applies to in-person home visits)
- 20: Urgent Care Facility
- 21-23: Inpatient Hospital / On-Campus Outpatient / Emergency Room
- 22: On-Campus Outpatient Hospital
- 49: Independent Clinic
- 50: Federally Qualified Health Center
- 72: Rural Health Clinic
- 81: Independent Laboratory
POS misreporting is a recurring audit and overpayment issue. Common errors: billing facility-furnished services at POS 11 (office), failing to update POS after a practice transitions to or from hospital-based licensure, and POS 02 vs. 10 confusion for telehealth.
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Related regulations
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Related across the archive
- RegulationMLN: 2021 E/M Office Visit Coding RevisionsReference to the 2021 CPT E/M office visit (99202-99215) code revisions: history and exam no longer used for code selection; medical decision making or time controls.
- RegulationMLN: 'Incident To' Services in Medicare Part BReference to Medicare's incident-to billing rules permitting auxiliary personnel to furnish services billed under the physician's NPI, with strict supervision and treatment-plan requirements.
- RegulationMLN: Medicare Telehealth ServicesReference to Medicare's telehealth policy: covered services list, originating and distant site rules, technology requirements, and the COVID-era flexibilities and their post-PHE status.
- GlossaryPlace of Service (POS) CodeTwo-digit code on a CMS-1500 claim identifying where a service was provided.
- RegulationMLN: Advance Beneficiary Notice of Noncoverage (ABN, CMS-R-131)Reference to Medicare's ABN form required before furnishing items or services Medicare may not cover, shifting financial responsibility to the beneficiary.
- RegulationMLN: Medical Necessity — Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)Reference to Medicare's coverage determinations: NCDs are issued by CMS; LCDs are issued by MACs; both define when an item or service is reasonable and necessary.
- RegulationMLN: High-Frequency Medicare Modifier ReferenceReference to the modifiers most commonly used in Medicare professional billing: 25, 26, 50, 51, 57, 58, 59, 76, 77, 78, 79, 80, 82, and the X{EPSU} series.
- RegulationMLN: 60-Day Overpayment Refund Rule (42 USC 1320a-7k(d))Reference to the ACA-added requirement that a Medicare or Medicaid overpayment be reported and returned within 60 days of identification, with FCA exposure for retention beyond that window.
Last reviewed May 23, 2026 · Citation verified May 23, 2026
Research aid, not legal advice. This summary is an administrative research aid prepared by D3rx. It does not certify compliance, provide legal advice, replace counsel, or guarantee an audit outcome. For authoritative regulatory text follow the primary source link at the top of this page. The practice remains responsible for reviewing, adopting, and maintaining its compliance program.