Professional Claims/Intermediate/20 minutes/Reviewed 2026-07-10

Place of Service Codes for Professional Claims

Choose the two-digit setting code that matches where the professional service was actually furnished.

Quick answer

POS codes identify the service setting on professional claims. The correct code depends on the actual location and payer rules, and can change payment and coverage edits.

Rules to know

POS 11 is office, 21 inpatient hospital, 22 on-campus outpatient hospital, and 23 hospital emergency room.
POS 02 and 10 distinguish telehealth settings under applicable payer rules.
POS should reflect the physical setting, not merely the billing provider's address.
Always verify the current CMS code set and service-specific rule.

Operational workflow

01Identify where the patient and practitioner were located.
02Determine whether the claim is professional or institutional.
03Select the current POS definition that matches the setting.
04Check service-specific coverage, facility/nonfacility payment, and telehealth rules.
05Make the record and claim location facts consistent.

High-use place-of-service reference

These short descriptions orient professional-claim research. Always confirm the current CMS code-set wording and the service-specific payment or coverage rule for the date of service.

POS	Setting	Key distinction
02	Telehealth provided other than in the patient's home	Distinguish from POS 10 and apply current telehealth instructions.
10	Telehealth provided in the patient's home	The patient's location, not the billing office, drives this distinction.
11	Office	Do not use merely because the billing practitioner owns an office.
12	Home	The beneficiary's private residence; confirm any DME or home-service rule separately.
13	Assisted living facility	Not interchangeable with home, SNF, or nursing facility.
21	Inpatient hospital	Requires inpatient setting facts; campus location alone is insufficient.
22	On-campus outpatient hospital	Different from inpatient hospital and off-campus outpatient hospital.
24	Ambulatory surgical center	Use for the professional service in an ASC when applicable.
31	Skilled nursing facility	Different from POS 32 nursing facility and may trigger consolidated-billing review.
32	Nursing facility	Do not infer skilled status from the facility name alone.
81	Independent laboratory	Use only when the service and entity meet the setting definition.
99	Other place of service	Use only when no more specific current POS accurately describes the setting.

Common failure modes

Using office POS for services actually furnished in a facility.
Confusing inpatient status with a hospital campus location.
Selecting telehealth POS without checking date-specific rules.

Knowledge check

What does a POS code describe?

Why a claim deniedWhere a professional service was furnishedWho owns the practiceThe patient's diagnosis

Official sources

Place of Service Code SetCenters for Medicare & Medicaid ServicesReviewed 2026-07-10 Medicare Billing: 837P and Form CMS-1500Medicare Learning NetworkReviewed 2026-07-10

Apply this lesson

Build a denial action packet Plan an appeal deadline Search related policies and codes

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Continue this track

IntermediateCMS-1500 and 837P Professional Claims

Education only. Verify the current code set, payer contract, coverage policy, implementation guide, and claim-specific facts. Do not enter protected health information into this site.