Understanding Place of Service (POS) codes is fundamental to accurate medical billing. Yet many healthcare providers—whether they run private practices or large clinics—struggle with these simple two-digit codes. A mistake in the POS field can delay reimbursement, trigger audits, or lead to claim denials.
At Global Tech Billing LLC, we’ve seen firsthand how even experienced practices overlook this vital billing element. This article breaks down what POS codes are, how they impact reimbursement, and provides a handy cheat sheet to help you bill with confidence and precision.
What Are Place of Service (POS) Codes?
Place of Service codes are two-digit numeric codes used on insurance claims to indicate the location where the service was rendered. They tell payers where a patient received care—be it in-office, at home, in a hospital, or via telehealth.
These codes are required for claims submitted to:
- Medicare
- Medicaid
- Commercial insurers
And they directly influence:
- Reimbursement rates
- Claim adjudication
- Payer coverage determinations
Why POS Codes Matter
Mistakes in POS coding are more than minor errors—they can cost you real money. Here’s why:
1. Incorrect Reimbursement
Many payers reimburse differently based on POS. For example, office visits (POS 11) typically reimburse less than hospital outpatients (POS 22).
2. Telehealth Compliance
Using the wrong POS for virtual visits can lead to denials, especially with updated CMS rules. POS 02 vs. 10 matters now more than ever.
3. Modifier Requirements
Certain POS codes require specific CPT modifiers (e.g., GT, 95) for telehealth or home visits.
At Global Tech Billing LLC, we ensure POS codes are accurately mapped to services, reducing claim rejections and avoiding underpayment issues.
Top 15 Place of Service Codes Every Provider Should Know
Here’s a cheat sheet with the most commonly used POS codes and their definitions:
POS CodeDescriptionCommon Use Case
11 Office Most outpatient private practice visits
02 Telehealth (non-home) Video visits conducted outside the patient’s home
10 Telehealth (home) Virtual visits while the patient is at home
21 Inpatient Hospital Hospital-based inpatient services
22 Outpatient Hospital Hospital outpatient department visits
23 Emergency Room – Hospital ER services in a hospital setting
12 Home Home visits (typically by PCPs or therapists)
19 Off-Campus Outpatient Hospital Satellite clinic or off-site hospital campus
31 Skilled Nursing Facility (SNF) Long-term rehab/skilled nursing care
32 Nursing Facility Non-skilled, custodial care
41 Ambulance – Land Ground transportation to care
50 Federally Qualified Health Center Rural clinics with enhanced reimbursement
72 Rural Health Clinic Designated rural health sites
03 School School-based services (pediatrics, therapy)
20 Urgent Care Facility Non-emergency urgent care centers
Tip: Always verify with each payer, as reimbursement policies can vary significantly based on POS.
Real-World Example: When the Wrong POS Code Costs You
A primary care clinic in Maryland submitted over 200 Medicare claims with POS 11 (office) for visits that were conducted via telehealth. Because of this, CMS denied or reduced payment for over $18,000 in services.
After partnering with Global Tech Billing LLC, we audited their claims, corrected the POS errors, and helped them resubmit with proper POS 10 and Modifier 95. Within 45 days, they recovered 87% of the lost revenue and implemented new POS checks within their EHR.
Key POS Mistakes to Avoid
Using POS 11 for Telehealth
This was allowed during early COVID-19 policies but is now restricted by some payers. Check whether you should use 02 or 10 depending on patient location.
Forgetting Modifiers for POS Codes
Certain POS codes require CPT modifiers:
- Modifier 95 – Synchronous telemedicine
- Modifier GT – For older systems still using legacy codes
- Modifier Q3014 – Facility fee for telehealth originating site
Mismatching POS With CPT Code
Not all CPT codes are reimbursed in all POS locations. For example, certain procedures aren’t covered at home (POS 12) or via telehealth (POS 10).
At Global Tech Billing LLC, we validate each CPT/POS combination before submission—reducing denials and ensuring clean claims.
POS Codes and Reimbursement Rates: What You Should Know
Here’s how reimbursement can vary based on POS for the same service:
- 99214 at POS 11 (Office): $95
- 99214 at POS 22 (Outpatient Hospital): $110
- 99214 at POS 02 (Telehealth): $85
If you bill incorrectly using POS 11 for telehealth, you may get underpaid or denied, even if the visit was legitimate.
How to Ensure POS Accuracy in Your Workflow
Train Your Front Desk and Billing Team
Ensure staff know how to capture service locations accurately during intake and scheduling.
Use EHR Templates with POS Prompts
Modern EHRs should allow POS tagging at the time of documentation or charge entry.
Run Weekly POS Audits
Review claims before submission to spot errors, especially for high-volume providers like therapists or internists.
Partner With a Knowledgeable RCM Company
Outsourcing to a team like Global Tech Billing LLC ensures each claim has accurate POS codes, modifiers, and payer-specific edits in place.
Conclusion: Don’t Let POS Code Errors Drain Your Revenue
Inaccurate Place of Service coding is one of the most overlooked causes of claim denials and revenue loss—yet one of the easiest to fix. With the right cheat sheet, payer policies, and claim checks in place, you can protect your revenue and ensure full compliance.
At Global Tech Billing LLC, we help healthcare providers eliminate simple coding mistakes with robust workflows, accurate claim validation, and staff education. Whether you’re a solo provider or a multi-location clinic, we’ll help you code smarter, reduce denials, and get paid faster.
FAQs
1. What’s the difference between POS 02 and POS 10 for telehealth?
POS 02 is used when the patient receives telehealth outside their home. POS 10 is for telehealth conducted in the patient’s home.
2. Can I use the same CPT code in different POS codes?
Yes, but reimbursement may differ. For example, 99214 reimburses differently at POS 11 (office) vs. POS 22 (hospital outpatient).
3. What happens if I use the wrong POS code?
You may face denials, underpayment, or even payer audits. POS accuracy is crucial for clean claims.
4. Do POS codes impact Medicaid claims?
Yes. Medicaid and its MCOs require accurate POS codes and sometimes reject claims without them—especially for home visits and telehealth.
5. How can Global Tech Billing LLC help with POS compliance?
We audit claims for POS accuracy, train your staff, customize billing templates, and ensure compliance with each payer’s requirements.
