On August 6, CMS published an updated “Place of Service Codes for Professional Claims” that includes a new Place of Service (“POS”) 19 for “Off-Campus Outpatient Hospital” and a revised POS 22 for “On-Campus Outpatient Hospital.” The descriptions are as follows:
| 19 | Off Campus-Outpatient Hospital | A portion of an off-campus hospital provider-based department that provides diagnostic, therapeutic (both surgical and nonsurgical) and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Effective January 1, 2016) |
| 22 | On Campus-Outpatient Hospital | A portion of a hospital’s main campus that provides diagnostic, therapeutic (both surgical and nonsurgical) and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016) |
The changes are effective January 1, 2016 and will require professionals providing services in hospital outpatient departments, including provider-based outpatient departments, to include the correct POS code in the applicable field on the CMS 1500 claim form (or electronic equivalent). Currently, POS 22 is used to identify hospital outpatient departments regardless of location. The change to specifically identify on- and off-campus outpatient departments as the place of service for professional claims follows the OIG Work Plan and its continued scrutiny of provider-based facilities. The updated POS code set can be found here.
If you have any questions regarding the revised POS code set or the Medicare provider-based rule please contact Regan E. Tankersley at rtankersley@hallrender.com or your regular Hall Render attorney.
