Nov. 17, 225
When filing professional claims, it’s important to use the correct place of service codes. These codes designate where the patient is located when they received services from you.
If you use the wrong POS code, your claim may be denied or payment may be delayed.
Familiarize yourself with POS codes using guidance from the American Medical Association. When filing claims, follow these POS code examples, which may include but aren’t limited to:
- POS 3 is for services provided in a school
- POS 11 is for services provided in the office
- POS 12 is for services provided in the patient’s home
- POS 49 is for services provided in an independent clinic
- POS 53 is for services provided in a community mental health center
- POS 99 is for services provided in settings not listed in Current Procedural Terminology (CPT®); for instance, community and daycare locations
Note: Claims are subject to the terms of a member’s coverage and medical necessity review.
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
The material presented here is for informational/educational purposes only, is not intended to be medical advice or a definitive source for coding claims and is not a substitute for the independent medical judgment of a physician or other health care provider. Health care providers are encouraged to exercise their own independent medical judgment based upon their evaluation of their patients’ conditions and all available information, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials. References to other third-party sources or organizations are not a representation, warranty or endorsement of such resources or organizations. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their member contract or member guide for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.