POS Code Decision Tree: Which Place of Service Code Do I Use?

The Thing That Actually Costs You Money

Place of service is not administrative trivia — it selects which of two payment rates you get. Medicare's fee schedule carries a non-facility rate and a lower facility rate for most services. The non-facility rate applies where your practice carries the overhead, such as POS 11. The facility rate applies where somebody else bills separately for that overhead — 19, 21, 22, 23.

So a wrong POS code does one of two things, and both are bad: it underpays you on every affected claim, or it overpays you and creates a recoupment later. Neither shows up as a denial, which is exactly why place-of-service errors run for months before anyone notices.

Every POS Code, With the Pay Impact

POS	Setting	Use it when	Pays
11	Office	A physician office or clinic space your practice operates.	Non-facility (higher)
20	Urgent Care Facility	A licensed urgent care centre treating walk-in unscheduled illness and injury.	Non-facility
49	Independent Clinic	A clinic not part of a hospital, providing outpatient care.	Non-facility
50	Federally Qualified Health Center	An FQHC providing services under FQHC payment methodology.	Special FQHC rules
72	Rural Health Clinic	A certified rural health clinic.	All-inclusive rate
12	Home (in person)	You physically travelled to the patient's residence.	Non-facility
10	Telehealth - Patient's Home	Telehealth where the patient was located at home.	Non-facility (higher)
02	Telehealth - Other Than Home	Telehealth where the patient was somewhere other than their home.	Facility (lower)
21	Inpatient Hospital	The patient was formally admitted as an inpatient.	Facility
22	On-Campus Outpatient Hospital	Hospital outpatient department on the main campus.	Facility (lower)
19	Off-Campus Outpatient Hospital	A provider-based hospital department away from the main campus.	Facility (lower)
23	Emergency Room - Hospital	Services in a hospital emergency department.	Facility
24	Ambulatory Surgical Center	A licensed freestanding ASC.	Facility
31	Skilled Nursing Facility	SNF during a covered Part A stay.	Facility
32	Nursing Facility	Custodial or non-Part A nursing facility residents.	Facility
61	Comprehensive Inpatient Rehab Facility	A CIRF providing intensive inpatient rehabilitation.	Facility
34	Hospice	Services furnished in a hospice setting.	Facility
65	End-Stage Renal Disease Treatment Facility	A dialysis or ESRD treatment facility.	Facility
81	Independent Laboratory	A laboratory independent of a physician office or hospital.	Facility

The Three Pairs People Mix Up

11 vs 19 vs 22. The question is not what the building looks like — it is who owns and operates it. A hospital-owned clinic in an ordinary office block is POS 19, not 11. Billing 11 there overpays you, and it is one of the most commonly recouped errors in outpatient billing.

02 vs 10. Both are telehealth; the only difference is whether the patient was at home. POS 10 (home) pays the non-facility rate, POS 02 pays the lower facility rate. Getting these backwards is a straight revenue loss on every telehealth claim.

31 vs 32. POS 31 is a skilled nursing facility during a Part A stay, where consolidated billing means many services must be billed by the facility rather than you. POS 32 is custodial or non-Part A, where normal billing resumes.

If a Wrong POS Already Went Out

A place-of-service error on a paid claim is usually fixed with a corrected claim rather than an appeal — nothing was denied, the wrong rate was simply applied. Check you are still inside the payer's correction window using our timely filing limits by payer table, and if the error ran across many claims, our A/R aging analyzer helps size what is still recoverable. If a modifier was also involved, the modifier decision tree covers that side.

Frequently Asked Questions

What is the difference between POS 11 and POS 22?

POS 11 is a physician office; POS 22 is an on-campus hospital outpatient department. The distinction is who owns and operates the space, not what the room looks like. It matters because POS 11 pays the non-facility rate, which is higher, while POS 22 pays the lower facility rate on the assumption the hospital bills separately for overhead.

What is the difference between POS 19 and POS 22?

Both are hospital outpatient. POS 22 is on the main hospital campus; POS 19 is an off-campus provider-based department. Many hospital-owned clinics in ordinary buildings are POS 19, and using POS 11 for them is one of the most common place-of-service errors.

What is the difference between POS 02 and POS 10?

Both are telehealth and the distinction is purely where the patient was. POS 10 means the patient was at home. POS 02 means the patient was anywhere other than home. POS 10 generally pays the non-facility rate while POS 02 pays the facility rate, so the choice has a direct payment consequence.

What is the difference between POS 31 and POS 32?

POS 31 is a skilled nursing facility during a covered Part A stay. POS 32 is a nursing facility for custodial or non-Part A residents. The distinction drives consolidated billing rules - during a Part A SNF stay many services must be billed by the facility rather than separately.

Does the place of service code change how much I get paid?

Yes, directly. Medicare's fee schedule carries two rates for most services. The non-facility rate applies to settings such as POS 11 where the practice absorbs overhead. The lower facility rate applies to settings such as POS 19, 21, 22 and 23 where a facility bills separately for that overhead. Choosing the wrong code either underpays you or creates an overpayment to be recouped.

Related tools: Modifier Decision Tree · E/M Code Calculator · All POS codes · All free tools

Which Place of Service Code Do I Use?

The Thing That Actually Costs You Money

Every POS Code, With the Pay Impact

The Three Pairs People Mix Up

If a Wrong POS Already Went Out

Frequently Asked Questions

Wrong Place of Service Costing You Quietly?