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Place of Service (POS) (GEN)
Posted May 5, 2008
This is a reminder article in relation to the importance of correctly designating the place of service (POS). It is important for the provider to be well-informed on the matter of POS and to check with the billing agents to be certain that POS is correctly billed as identified by the provider. The POS codes and definitions are found in Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, §§10.5 and 10.6, which can be accessed at www.cms.hhs.gov/Manuals/IOM/list.asp on the Centers for Medicare & Medicaid Services (CMS) Web site. These sections classify POS codes as facilities and non-facilities. The privately-owned office, whether by an individual or by group, is usually clearly identified. At times, there can be questions in relation to a physician's office or physician group office within an institution. That is governed by a National Coverage Determination (NCD), and information on this can be found in the Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, §70.3.
The difference in payment in relation to facilities and non-facilities is to account for the differences in the responsibility for the payment of expenses in relation to a particular site. If incorrect billing is identified, it may be necessary to recoup a significant amount of money from the provider. Use of the CMS manuals as guidance is important, since there are changes which occur as POS codes are changed and it is necessary to identify the facility versus non-facility classifications. |
