Coding Guide

Place of Service Codes

The place of service code tells the payer where the patient was when the service happened. It drives pricing - facility vs non-facility rates - and wrong POS is an instant, silent revenue leak.

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POS Reference

Place of Service Codes and Billing Impact

The codes you will use most, and what each one changes.

POS	Description	Billing impact
11	Office	Non-facility rate - the higher physician payment. The default for clinic work.
21	Inpatient hospital	Facility rate applies. POS must match the inpatient stay or the claim mismatches.
22	Outpatient hospital	Facility rate. Common mismatch: office POS billed for hospital outpatient work.
23	Emergency room	Facility rate. ED E/M levels 99281-99285 live here.
20	Urgent care	Urgent care centers. Some payers want 20, others accept 11 - know your contracts.
24	Ambulatory surgical center	ASC facility claims pair with the surgeon's professional claim.
31	Skilled nursing facility	SNF consolidated billing rules can swallow physician services - check before billing separately.
32	Nursing facility	Long-term care setting. Distinct from SNF for coverage purposes.
49	Independent clinic	Non-hospital clinic not part of a larger facility.
81	Independent laboratory	Lab-only claims. The lab's POS, not the ordering physician's.
02	Telehealth	Patient at home or originating site via telecom. Pairs with modifier 95.
19	Off-campus outpatient hospital	Provider-based department off the main campus. Site-neutral payment rules apply.

Why POS Matters

How Wrong POS Costs Money

POS errors are quiet - the claim pays, just at the wrong rate. Or it denies outright.

Facility vs non-facility pricing: the same CPT pays differently by POS, and the gap is real money at volume
POS 22 vs 11 is the classic leak - hospital outpatient work billed at office rates, or the reverse causing denials
Telehealth without POS 02 (or the payer's required equivalent) denies even when the visit was perfect
SNF consolidated billing: services inside a covered SNF stay often belong on the facility claim, not the physician claim
Our scrubbers cross-check POS against the service facility in Box 32 on every claim

FAQ

Questions, Answered

Straight answers, no jargon.

What is a place of service code?

A two-digit code on the claim (Box 24B on the CMS-1500) identifying where the service was performed - office, hospital, ER, telehealth and so on. It drives the facility vs non-facility payment rate.

What is the difference between POS 11 and POS 22?

POS 11 is a physician office (non-facility, higher professional rate). POS 22 is outpatient hospital (facility rate, lower professional payment because the facility bills separately). Using the wrong one misprices the claim.

What POS do I use for telehealth?

POS 02 for telehealth when the patient is at home or an originating site, typically paired with modifier 95. Some payers still use POS 11 with modifier 95 - check each payer's rule.

Does POS affect how much I get paid?

Yes. Medicare pays a facility rate and a non-facility rate for most codes. The same procedure can pay noticeably different amounts depending on POS.

What happens if POS does not match Box 32?

The claim looks internally inconsistent - the location code says one thing, the facility address says another. Payers deny these or flag them for review.

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