Place of Service 19

Place of Service 19 in Medical Billing:

Place of Service 19 also known as POS 19 in medical billing and this place of service 19 is reported on the claim form block# 24B to denote “Off-campus Outpatient Hospital”.

Place of Service 19 Description:

Place of Service 19 is stated on a claim “when a portion of an off-campus hospital doctor based unit which delivers diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation facilities to sick or injured persons who do not necessitate hospitalization or institutionalization”.

Many of them are confused to understand and usage of the place of service 19 and place of service 22, so for this if you know the differences between Place of service 19 and Place of service 22 you will be able to understand and you will be very much clear on the usage of this place of service codes.

Let us see the difference between Place of Service 19 and Place of Service 22.

POS 19 vs 22

Center for Medicare and Medicaid services revised POS 22 from “Outpatient hospital” to “On-campus outpatient hospital” effective from January 01 2016, so now when reporting the claim providers need to differentiate whether hospital provider based department is “Off campus (POS 19)” or “On campus (POS 22)”.

A hospital outpatient department is considered “on-campus”, if hospital provider based department are located within 250 yards of the main hospital campus.

A hospital outpatient department is considered “off-campus”, if hospital provider based department is away (more than 250 yards) from the main hospital campus.

Place of service 19 and Place of service 22 (both) are paid at the facility rate under the Medicare PFS-physician fee schedule and it’s defined as same except one variation. The only variation is that place of service 19 has been implemented to state medical services rendered in a provider based department “off” a hospital’s main campus and place of service 22 states medical services rendered in the outpatient department “on” a hospital’s main campus.

Center for Medicare and Medicaid services implemented place of service 19 and place of service 22 to gather statistics of “On-campus outpatient hospital (POS 22)” and Off-campus outpatient hospital (POS 19)”.

Center for Medicare and Medicaid ideas to revise the place of service 22 is to better understand the trend of hospitals, which are acquiring provider offices and handling those locations as “On-campus outpatient hospital” and “Off-campus outpatient hospital”.

Conclusion on the usage of Place of service 19 and Place of service 22 in Medical billing:

Place of Service 19 is used when outpatient healthcare services performed away from the hospital campus (more than 250 yards) and Place of Service 22 is used when outpatient healthcare services performed on hospital campus.

Important Note:

Observation codes or billed with either Place of Service 19 (Outpatient Hospital Off-Campus) or Place of Service 22 (Outpatient Hospital In-Campus) as it is consider as Hospital Outpatient.

Frequently asked questions:

What place of service code is used when Independent Laboratory bills the claim for sample collected in an Outpatient hospital off-campus?

Answer: As we know we need to mention the place where the samples are collected, so here samples are withdrawn in an Outpatient Hospital off-Campus and the correct place of service 19 to be reported.