POS 11: Office
Most common POS for physician office visits, including private practice clinics and group practices.
CMS description
“Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.”
When to use POS 11
Most common POS for physician office visits, including private practice clinics and group practices.
Reimbursement
Non-facility rate (higher) — clinician's overhead absorbed in fee schedule. Most E&M billing.
Common billing issues
- Confused with POS 22 (Hospital Outpatient) when the office is hospital-owned (Provider-Based Billing rules)
- POS 11 used for hospital-owned offices may trigger reduced 'site-of-service differential' payment
Frequently asked questions
What is POS 11?
Office. Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.
When do I use POS 11?
Most common POS for physician office visits, including private practice clinics and group practices.
How does POS 11 affect reimbursement?
Non-facility rate (higher) — clinician's overhead absorbed in fee schedule. Most E&M billing.
What are common POS 11 billing issues?
Confused with POS 22 (Hospital Outpatient) when the office is hospital-owned (Provider-Based Billing rules); POS 11 used for hospital-owned offices may trigger reduced 'site-of-service differential' payment.
Related codes
Sources
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