Q&A: Place of service codes 19 and 22

Q. How are place of service (POS) codes 19 and 22 used on claims for provider-based entities?

A. CMS developed different POS codes to better distinguish between professional services furnished in on-campus and off-campus hospital settings. Beginning January 1, 2016, POS code 22 was redefined as “On-Campus Outpatient Hospital” and a new POS code 19 was developed and defined as “Off-Campus Outpatient Hospital.” Effective January 1, 2016, POS 19 must be used on professional claims submitted for services furnished to patients registered as hospital outpatients in off-campus departments, and POS 22 must be used solely for services furnished to patients registered as hospital outpatients in on-campus hospital outpatient departments.

In combination with the -PO and -PN modifiers, which are used on the claim for the facility component of these services, the new POS codes on the professional claim will allow CMS to gather more accurate and complete information about the volume and types of professional services furnished in provider-based settings. Of course, that also means that CMS will be better armed to flag off-campus services for auditing and collection of overpayments and likely will eventually lead to further decreases in reimbursement for these services.

For more information, see Provider-Based Entities: A Guide to Regulatory and Billing Compliance, Second Edition.

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