POS 23: Emergency Room - Hospital
Emergency department services. ER-specific E&M codes (99281-99285).
CMS description
“A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.”
When to use POS 23
Emergency department services. ER-specific E&M codes (99281-99285).
Reimbursement
Facility rate. NSA §2799A applies to OON ER bills.
Common billing issues
- No Surprises Act protections — patient cost-sharing capped at in-network rate for emergency services
- POS 23 with non-ER E&M codes triggers audit
Frequently asked questions
What is POS 23?
Emergency Room - Hospital. A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.
When do I use POS 23?
Emergency department services. ER-specific E&M codes (99281-99285).
How does POS 23 affect reimbursement?
Facility rate. NSA §2799A applies to OON ER bills.
What are common POS 23 billing issues?
No Surprises Act protections — patient cost-sharing capped at in-network rate for emergency services; POS 23 with non-ER E&M codes triggers audit.
Other POS codes
- POS 01 — PharmacyUsed primarily for vaccines administered at a pharmacy and pharmacist-rendered s
- 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.
Sources
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