POS 01: Pharmacy
Used primarily for vaccines administered at a pharmacy and pharmacist-rendered services under pharmacy benefit collaborative practice agreements.
CMS description
“A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.”
When to use POS 01
Used primarily for vaccines administered at a pharmacy and pharmacist-rendered services under pharmacy benefit collaborative practice agreements.
Reimbursement
Facility rate. Some payers have specific pharmacy-administered service policies (Medicare Part D vs Part B for vaccines).
Common billing issues
- Confused with POS 11 for clinic-affiliated pharmacy services
- Vaccine billing under wrong POS triggers denial
Frequently asked questions
What is POS 01?
Pharmacy. A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.
When do I use POS 01?
Used primarily for vaccines administered at a pharmacy and pharmacist-rendered services under pharmacy benefit collaborative practice agreements.
How does POS 01 affect reimbursement?
Facility rate. Some payers have specific pharmacy-administered service policies (Medicare Part D vs Part B for vaccines).
What are common POS 01 billing issues?
Confused with POS 11 for clinic-affiliated pharmacy services; Vaccine billing under wrong POS triggers denial.
Other POS codes
- POS 02 — Telehealth Provided Other than in Patient's HomeSince 2022, POS 02 must be used for telehealth when the patient is anywhere OTHE
- POS 03 — SchoolUsed for services provided in a school setting — typically school-based health c
- POS 04 — Homeless ShelterHealth services provided at a homeless shelter, typically by mobile clinics, str
- POS 05 — Indian Health Service Free-standing FacilityIHS billing only. Special encounter rates apply.
- POS 06 — Indian Health Service Provider-based FacilityIHS billing only, provider-based hospital outpatient setting.
- POS 07 — Tribal 638 Free-standing FacilityTribal 638 contract facility billing.
Sources
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