> ## Documentation Index
> Fetch the complete documentation index at: https://dso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Place of service codes

> The POS table with the crossover-relevant codes starred, and the facility versus non-facility reimbursement implications for medical claims.

**Place of service (POS)** codes identify where a service was delivered. They appear in the medical claim's `CLM05` composite and they **affect payment**, because the Medicare Physician Fee Schedule's practice expense component differs between facility and non-facility settings.

CMS maintains the code set.<sup>1</sup>

**For a dental group, POS matters mainly in crossover billing.** An 837D carries a place-of-treatment indication, but the facility and non-facility payment mechanics on this page belong to medical fee schedules. They apply when billing a medical plan on an 837P for oral surgery, sleep appliances, trauma, or hospital-OR dentistry. Groups that do not bill medical plans generally need only a basic understanding. See [Bill medical plans for dental work](/guides/billing/bill-medical-for-dental-work).

## Why POS affects payment

The practice expense RVU differs by setting. When a service is delivered in a **facility**, where the facility bears the overhead and bills separately, the professional payment is lower. When it is delivered in a **non-facility** setting like your office, the professional payment includes the practice expense.

| Setting                                | Practice expense      | Professional payment |
| -------------------------------------- | --------------------- | -------------------- |
| **Non-facility** (e.g. POS 11, office) | Borne by the practice | **Higher**           |
| **Facility** (e.g. POS 21, 22)         | Borne by the facility | **Lower**            |

Using the wrong POS can cause either an underpayment or an overpayment. An overpayment may create a refund obligation.

## Common crossover codes

| POS      | Description                                              | Facility?    |
| -------- | -------------------------------------------------------- | ------------ |
| **★ 02** | **Telehealth provided other than in the patient's home** | Facility     |
| **★ 10** | **Telehealth provided in the patient's home**            | Non-facility |
| **★ 11** | **Office**                                               | Non-facility |
| 12       | Home                                                     | Non-facility |
| **★ 19** | Off-campus outpatient hospital                           | Facility     |
| 20       | Urgent care facility                                     | Non-facility |
| **★ 21** | Inpatient hospital                                       | Facility     |
| **★ 22** | On-campus outpatient hospital                            | Facility     |
| 23       | Emergency room, hospital                                 | Facility     |
| **★ 24** | Ambulatory surgical center                               | Facility     |
| 31       | Skilled nursing facility                                 | Facility     |
| 32       | Nursing facility                                         | Non-facility |
| 49       | Independent clinic                                       | Non-facility |
| 50       | Federally qualified health center                        | Non-facility |
| 62       | Comprehensive outpatient rehabilitation facility         | Non-facility |
| 65       | End-stage renal disease treatment facility               | Non-facility |
| 71       | Public health clinic                                     | Non-facility |
| 81       | Independent laboratory                                   | Non-facility |
| 99       | Other place of service                                   | Varies       |

★ = the ones a dental group's crossover claims most often carry: the office (11), the hospital settings where OR dentistry and major oral surgery happen (19, 21, 22), the ambulatory surgical center (24), and telehealth (02, 10).

**Facility/non-facility designations and their payment consequences can change.** Verify current designations against the CMS POS code set and the current fee schedule rather than relying on a static table; telehealth designations in particular have shifted repeatedly.

## Distinguishing telehealth POS 02 and 10

**Confusing POS 02 and POS 10 is a common outpatient billing error and can affect payment.**

* **POS 02**, telehealth provided **other than** in the patient's home
* **POS 10**, telehealth provided **in** the patient's home

The distinction is about **where the patient is**, not where the dentist is. A patient at home is POS 10; a patient at an originating site clinic is POS 02.

Note the split with dental claims: teledentistry on an 837D is reported with the CDT teledentistry codes (D9995 synchronous, D9996 asynchronous) alongside the clinical procedure; POS 02/10 mechanics apply when the encounter is billed to a **medical** plan.

They carry different facility designations and therefore different payment. And payer policies on telehealth POS have changed repeatedly since 2020; **confirm current requirements per payer**, because commercial payers do not all follow Medicare here.

Modifier usage also matters: modifier **95** identifies synchronous telemedicine. Some payers require POS 11 plus modifier 95 rather than POS 02 or 10. Follow the current instructions for the payer and product.

## The full list

The complete POS code set is published and maintained by CMS. Beyond the codes above, it includes settings for pharmacies, schools, homeless shelters, prisons, military treatment facilities, tribal facilities, hospices, psychiatric facilities, substance abuse treatment facilities, mass immunization centers, birthing centers, and others.

Consult the CMS list for anything not in the table above.

## Common failures

| Failure                                                                       | Consequence                                                    |
| ----------------------------------------------------------------------------- | -------------------------------------------------------------- |
| **POS 02 vs 10 confusion**                                                    | Wrong payment; potential overpayment                           |
| POS 11 for a service delivered at a facility                                  | Overpayment, the practice expense wasn't yours                 |
| POS 22 for an office service                                                  | Underpayment                                                   |
| POS not matching the service location on file with the payer                  | Denial                                                         |
| Static POS defaults in the PMS or medical-billing system                      | Claims may carry the wrong setting when the template is reused |
| Following Medicare's telehealth POS rules for a commercial payer that differs | Denials or wrong payment                                       |

<Tip>
  **Audit your POS distribution quarterly.** A practice that delivers only office and telehealth services should show POS 11 and 10 (or 02) almost exclusively. Anything else in the distribution is worth explaining.
</Tip>

## Sources

1. CMS, [Place of Service Code Set](https://www.cms.gov/medicare/coding-billing/place-of-service-codes/code-sets). Facility/non-facility designations affect payment under the Medicare Physician Fee Schedule; see CMS, [Physician Fee Schedule](https://www.cms.gov/medicare/payment/fee-schedules/physician).